London -- Friday January 19 2007
The battle to save Iraq's children
Doctors issue plea to Tony Blair to end the scandal of medical shortages in the war zone
Scroll down to read the letter to Blair signed by approximately 100 eminent members of the medical community By Colin Brown, Deputy Political Editor
The desperate plight of children who are dying in Iraqi hospitals for the lack of simple equipment that in some cases can cost as little as 95p is revealed today in a letter signed by nearly 100 eminent doctors.
They are backed by a group of international lawyers, who say the conditions in hospitals revealed in their letter amount to a breach of the Geneva conventions that require Britain and the US as occupying forces to protect human life.
In a direct appeal to Tony Blair, the doctors describe desperate shortages causing "hundreds" of children to die in hospitals. The signatories include Iraqi doctors, British doctors who have worked in Iraqi hospitals, and leading UK consultants and GPs.
"Sick or injured children who could otherwise be treated by simple means are left to die in hundreds because they do not have access to basic medicines or other resources," the doctors say. "Children who have lost hands, feet and limbs are left without prostheses. Children with grave psychological distress are left untreated," they add.
They say babies are being ventilated with a plastic tube in their noses and dying for want of an oxygen mask, while other babies are dying because of the lack of a phial of vitamin K or sterile needles, all costing about 95p. Hospitals have little hope of stopping fatal infections spreading from baby to baby because of the lack of surgical gloves, which cost about 3.5p a pair.
Among those who have signed the letter are Chris Burns-Cox, a consultant physician at Gloucester Royal Hospital; Dr Maggie Wright, the director of intensive care at James Page University Hospital; Professor Debbie Lawlor, professor of epidemiology and public health at University College London; Professor George Davey Smith, professor of clinical epidemiology at Bristol university; Dr Philip Wilson, senior clinical research fellow at Glasgow University; and Dr Heba al-Naseri, who has experienced the conditions in Iraqi hospitals. Dr al-Naseri, who has worked at Diwaniyah Maternity Hospital and the Diwaniyah University Hospital, describes in harrowing detail what the conditions were like for a newborn baby - one of the lucky ones who survived - called Amin.
"Amin had to be fed powdered milk, diluted with tap water. There wasn't enough money to buy expensive formula milk or bottled water - their price had risen above the increase in wages since 2003. The problems with the intermittent electricity and gas supply meant regular boiled water could not be guaranteed. With the dormant waste and sewage disposal systems, drinking-water is more likely to be contaminated," he said.
Cases the doctors highlight include a child who died because the doctor only had a sterile needle for an adult and could not find a needle small enough to fit the vein, and another child who died because the doctors had no oxygen mask that fitted.
The doctors say the UK, as one of the occupying powers under UN resolution 1483, has to comply with the Geneva and Hague conventions that require the UK and the US to "maintain order and to look after the medical needs of the population". But, the doctors say: "This they failed to do and the knock-on effect of this failure is affecting Iraqi children's hospitals with increasing ferocity."
They call on the UK to account properly for the $33bn (£16.7bn) in the development fund for Iraq which should have supplied the means for hospitals to treat children properly. They say more than half of the money - $14bn - is believed to have vanished through corruption, theft and payments to mercenaries.
They say that all revenues from Iraq's oil exports should now pass directly to the Iraqi people and that illegal contracts entered into by the Coalition Provisional Authority be revoked.
Their letter was supported by experts in international law, including Harvey Goldstein, professor of social statistics at the University of Bristol, and Bill Bowring, a barrister and professor of law at Birkbeck College.
Nicholas Wood, an architect who helped to organise the protest, said they had evidence on film of dead babies being dumped in cardboard boxes. "In one hospital, there were three babies to an incubator. The incubators are 36 years old and are held together by tape and a bit of wire. They are wrecks. They cost about £5,000 each, but that is nothing to compared to the cost of a missile," he said.
The letter was sent to Downing Street via Hilary Benn, the International Development Secretary, by his predecessor, Clare Short.
A system in meltdown
* Save the Children estimate that 59 in 1,000 newborn babies are dying in Iraq, one of the highest mortality rates in the world. Thousands of infants are dying because of the lack of basic cheap equipment. In Diwaniyah hospital, south of Baghdad, one doctor had to try to ventilate a baby with a plastic tube in its nose because he lacked an oxygen mask costing just 95p. The baby died.
* In the same hospital, a baby with a rare illness causing internal bleeding died due to lack of a phial of vitamin K, which would have cost less than £1.
* One doctor in a Baghdad hospital recently tried to save the life of a child with a drip, but he lacked a sterile needle for a child and the child died. The lack of rubber surgical gloves, which cost 3.5p a pair, has hugely increased the risk of infections.
* Premature babies are crammed three to an incubator, when an incubator can be found. An incubator costs about £5,000.
* Only 50 per cent of the pre-war total of doctors remain in Iraq. The US clearout of Ba'ath party members sympathetic to Saddam Hussein after the invasion has led to a breakdown of health administration.
* The British doctors are calling for guarantees of safety to be given to all medical staff in Iraq by the US and British forces. Above all there is a need to stop the militias killing doctors and nurses.
* Hospitals have been bombed and ambulances shot at. Helicopters could be laid on by the US and UK to ferry cases to Jordan, Syria, Iran and Saudi Arabia for treatment of acute trauma and disease.
* Doctors are calling on Britain and America to restore at least $2bn (£1bn) of $14bn that has gone missing since the invasion. Part of this sum, lost in corruption or to militias, was earmarked for hospitals.
* Up to 260,000 children may have died since the 2003 invasion of Iraq.
London -- Friday January 19 2007
'Sick or injured children, who could be easily treated, are left to die in hundreds' "We are concerned that children are dying in Iraq for want of medical treatment. Iraq, instead of being a country at the top of the league for medicine, as it once was, now has conditions and mortality of a Third World country.
Sick or injured children, who could otherwise be treated by simple means, are left to die in their hundreds because they do not have access to basic medicines or other resources. Children who have lost hands, feet, and limbs are left without prostheses. Children with grave psychological distress are left untreated.
We understand that the UK may withdraw its forces from Iraq in 2007. Before this happens, we call on the UK Government not to walk away from this problem, but to fulfil its obligations that it entered into under Security Council Resolution 1483 during the period 22 May 2003 to 28 June 2004.
This Resolution recognised the UK and US as being occupying powers in Iraq but also stated that they had to comply with the Geneva and Hague Conventions. These Conventions specifically require the occupying powers to maintain order and to look after the medical needs of the population. This they failed to do, and the knock-on effect of this failure is affecting Iraqi children's hospitals with increasing ferocity. We also ask the UK, as one of the Occupying Powers designated by Resolution 1483 as Trustees of "The Development Fund For Iraq," to properly account for these assets estimated at $23bn in May 2003. It is asserted that by June 2004 some $14bn vanished in corruption, theft and payment to mercenaries.
We ask that all the revenues from Iraq's oil now pass directly to the Iraqi people, and that illegal contracts entered into by the Coalition Provisional Authority are revoked.
Only in this way can the Iraqi people rebuild their country with its infrastructure, administration, and hospitals."
Submitted by: Dr Chris Burns-Cox MD FRCP Consultant Physician, Gloucester Dr Heba Al-Naseri MB BS BSc Dr K Alston FFARCSI Associate Specialist in Anaesthetics at Torbay Hospital Ghada Karmi MB ChB MRCP PhD MFPHM RCP former Consultant in Public Health Medicine, North Thanes Regional Health Authority Dr Brian Robinson MA MB BCh BAO (TCD) DPM (Engl) Dipl Clin Hypnosis (UCL) Martin Birnstingl MS FRCS Retired Senior Surgeon, St Bartholomew's Hospital Dr Fiona Godlee Editor-in-chief BMJ Dr Ihab M Emran MSc MD Consultant (Locum) Spinal Surgeon, Royal Devon and Exeter Hospital Dr Derek Summerfield BSc (Hons) MBBS MRCPsych. Hon Sen Lect, Inst of Psychiatry, Univ of London; Teaching Associate, Refugee Studies Centre, Univ of Oxford Dr. Maggie Wright BSc (hons) Pharmacology MB ChB FRCA Director of Intensive Care Unit, James Paget University Hospital Foundation Trust Lt Col G Vautier RAMC (ret) BM FRCP Consultant Gastroenterologist James Paget University Hospitals NHS Foundation Trust Richard LM Newell BSc FRCS Retired Consultant Trauma & Orthopaedic Surgeon Dr S.Sadullah FRCP FRCPath Consultant Haematologist James Paget University Hospital, Great Yarmouth Dr Stephen J Wilson MB ChB FRCA Consultant Anaesthetist Honorary Senior Lecturer Dr Tim Paine FRCGP MRCP General Practitioner (retd) Bristol Dr Christopher Richards MB ChB MRCGP DCH Retired General Practitioner and Psychotherapist Bristol Dr Nicholas Mayne MD FRCP Consultant Physician Cheltenham Prof Allyson Pollock Director, Institute for International Health Policy, University of Edinburgh Prof Debbie Lawlor Professor of Epidemiology University of Bristol Dr Eric Brunner PhD FFPH Reader in Epidemiology and Public Health University College London Prof George Davey Smith Professor of Clinical Epidemiology University of Bristol Dr Philip Wilson DPhil MRCP MRCPCH FRCGP General Practitioner and Senior Clinical Research Fellow University of Glasgow Dr John Macleod Senior Lecturer in Primary Care University of Birmingham Prof Trish Greenhalgh OBE MD FRCP FRCGP Professor of Primary Health Care Dr Ian Roberts Professor of Public Health London School of Hygiene & Tropical Medicine Dr Nick Maurice OBE GP (retd) Director UKOWLA Dr Jane Ferrie Senior Research Fellow Dept. Epidemiology and Public Health University College London Prof Martin McKee CBE MD DSc FRCP Professor of European Public Health London School of Hygiene and Tropical Medicine David Gunnell Professor of Epidemiology University of Bristol Dr Ros Kennedy GP Principal MB BS MRCP MRCGP Dr Sam Richmond MB BS FRCP FRCPCH Consultant Paediatrician and Neonatologist Sunderland Royal Hospital Mr Daniel B Byles FRCOpth Consultant Opthalmologist Royal Devon & Exeter Hospital Dr Megan Byles MB ChB MRCGP General Practioner Ottery St Mary Devon Dr S.Dixon MB ChB MRCGP Appley Somerset Dr L.Ibbs MRCGP MRCP General Practitioner Islip Medical Practice Mr S F Brewster FRCS (urology) Consultant Urologist Churchill Hospital Oxford Mr N Burns-Cox FRCS (urology) Musgrove Park Hospital Taunton Dr Iona Heath CBE FRCGP MRCP Caversham Group Practice Dr David Nicholl FRCP PhD Consultant Neurologist City Hospital Birmingham C.M.Davidson MB MCh FRCS FRCSEd FRFPSG Retired Senior Consultant Surgeon Prof Alun Evans Department of Epidemiology and Public Health Belfast David Halpin MB BS FRCS Consultant Orthopaedic and Trauma Surgeon (retd) Dr Ros Kennedy GP Principal MB BS MRCP MRCGP Robert Shearer MB BS FRCS Consultant Urological Surgeon (retd) Dr David Batty Research Fellow University of Glasgow Dr S Shakti MB BS MRCPH Paediatric SPR Mr Dawlatly MB BS MRCOG Consultant in Obstetrics and Gynaecology Dr Jack Piachaud FRCPsych Felicity de Zulueta BSc MA (Cantab) MBChB FRCPsych Consultant Psychiatrist at the Maudsley Hospital Dr Anita Sharma MB BS BSc Dr Salma Al-Ramadhani MBBS Dr John Ho MB BS MRCPH Paediatric consultant Bob Fryatt MD MRCP FFPHM Strategy Adviser World Health Organisation Geneva Dr Dhanusha Maheshwaren MB BS MSc Dr Deeksha Kashyap MB BS BSc Lord Nicholas Rea MD FRCP General Practitioner (retd) Sir A W Macara FRCP FRCGP DSc Timothy Southwood BDS MB BS MRCGP Nailsea Family Practice Dr Equi Ajogbe MB BS BSc Dr Shalini Kawar MB BS BSc Dr David Tovey FRCGP Editorial Director BMJ Knowledge BMJ Publishing Group Ltd Dr Vidya Thakur MB BS MRCOG Mr Kalshaker MB BS MRCOG Consultant in Obstetrics and Gynaecology Dr John Adey MB ChB MA Dr Salim Ali MB BS BSc Mrs Hussain MB BS MRCOG Consultant in Obstetrics and Gynaecology Dr S Felenstein MB BS Dr Peter Kandela MRCGP PhD General Practitioner Mr Kamal Salman Alubaid MB ChB FRCS Edin Mr John Fixsen MA MChir FRCS Orthopaedic Surgeon to the Great Ormond St Hospital for Children (retd) Dr Rashmi Madhu MB BS Dr Michael Cripwell General Practitioner Dr Gemma Petts MB BS BSc Dr Radika Acharya MB BS Dr Karen Sennett General Practitioner Dr Margaret Tatham General Practitioner Dr G Battle General Practitioner Dr Susan Hunt General Practitioner Dr David Davidson General Practitioner (ret) Dr Michael Sills General Practitioner Namir Kafil-Hussain FRCS Consultant Ophthalmic Surgeon (with special interest in paediatrics) Ashford & St. Peter's Hospital, Surrey Dr Beatrice Boctor MB BCh MRCPsych Dr Gohar Khan, Dr Mehnaz Khan MB BS BSc Dr Tariq AlTawil MB BS BSc Dr. Nagin Antoun MB BCh FRCP FRCR Consultant Neuroradiologist Addenbrookes Hospital Dr Peter Hall MB BS MRCPI DGM Dr Syed Raza MB BS Dr K Jain MB BS Dr M Somajundram MB BS BSc Dr Antony Davies MD PhD Professor of Physiology (retd) Margaret L Stewart MB ChB BSc BD retired doctor and Church of Scotland minister D.C. Jameson Evans MB BS FRCS Dr Judith Cook MB BChir DTM&H General Practitioner Dr Runa Mackay MD FRCPE Dr Dominic Scarr MB ChB Dr Shirley Brierley MB ChB MRCGP MPH Specialist Registrar in Public Health Yorkshire & Humber Public Health Training Scheme