 ~ London ~ Saturday November 14 2009, page 1
Huge rise in birth defects in Falluja
Iraqi former battle zone sees abnormal clusters of infant tumours and deformities Scroll down to also read "Depleted Uranium Weapons: The Dead Babies in Iraq and Afghanistan Are No Joke"
Martin Chulov in Falluja
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Video: HERE
The children of FallujaDoctors are dealing with an increase in chronic deformities in infants in Falluja, where heavy munitions were used in 2004
Martin Chulov and Shehani Fernando
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Doctors in Iraq's war-ravaged enclave of Falluja are dealing with up to 15 times as many chronic deformities in infants and a spike in early life cancers that may be linked to toxic materials left over from the fighting.
The extraordinary rise in birth defects has crystallised over recent months as specialists working in Falluja's over-stretched health system have started compiling detailed clinical records of all babies born.
Neurologists and obstetricians in the city interviewed by the Guardian say the rise in birth defects – which include a baby born with two heads, babies with multiple tumours, and others with nervous system problems - are unprecedented and at present unexplainable.
A group of Iraqi and British officials, including the former Iraqi minister for women's affairs, Dr Nawal Majeed a-Sammarai, and the British doctors David Halpin and Chris Burns-Cox, have petitioned the UN general assembly to ask that an independent committee fully investigate the defects and help clean up toxic materials left over decades of war – including the six years since Saddam Hussein was ousted.
"We are seeing a very significant increase in central nervous system anomalies," said Falluja general hospital's director and senior specialist, Dr Ayman Qais. "Before 2003 [the start of the war] I was seeing sporadic numbers of deformities in babies. Now the frequency of deformities has increased dramatically."
The rise in frequency is stark – from two admissions a fortnight a year ago to two a day now. "Most are in the head and spinal cord, but there are also many deficiencies in lower limbs," he said. "There is also a very marked increase in the number of cases of less than two years [old] with brain tumours. This is now a focus area of multiple tumours."
After several years of speculation and anecdotal evidence, a picture of a highly disturbing phenomenon in one of Iraq's most battered areas has now taken shape. Previously all miscarried babies, including those with birth defects or infants who were not given ongoing care, were not listed as abnormal cases.
The Guardian asked a paediatrician, Samira Abdul Ghani, to keep precise records over a three-week period. Her records reveal that 37 babies with anomalies, many of them neural tube defects, were born during that period at Falluja general hospital alone.
Dr Bassam Allah, the head of the hospital's children's ward, this week urged international experts to take soil samples across Falluja and for scientists to mount an investigation into the causes of so many ailments, most of which he said had been "acquired" by mothers before or during pregnancy.
Other health officials are also starting to focus on possible reasons, chief among them potential chemical or radiation poisonings. Abnormal clusters of infant tumours have also been repeatedly cited in Basra and Najaf – areas that have in the past also been intense battle zones where modern munitions have been heavily used.
Falluja's frontline doctors are reluctant to draw a direct link with the fighting. They instead cite multiple factors that could be contributors.
"These include air pollution, radiation, chemicals, drug use during pregnancy, malnutrition, or the psychological status of the mother," said Dr Qais. "We simply don't have the answers yet."
The anomalies are evident all through Falluja's newly opened general hospital and in centres for disabled people across the city. On 2 November alone, there were four cases of neuro-tube defects in the neo-natal ward and several more were in the intensive care ward and an outpatient clinic.
Falluja was the scene of the only two setpiece battles that followed the US-led invasion. Twice in 2004, US marines and infantry units were engaged in heavy fighting with Sunni militia groups who had aligned with former Ba'athists and Iraqi army elements.
The first battle was fought to find those responsible for the deaths of four Blackwater private security contractors working for the US. The city was bombarded heavily by American artillery and fighter jets. Controversial weaponry was used, including white phosphorus, which the US government admitted deploying.
Statistics on infant tumours are not considered as reliable as new data about nervous system anomalies, which are usually evident immediately after birth. Dr Abdul Wahid Salah, a neurosurgeon, said: "With neuro-tube defects, their heads are often larger than normal, they can have deficiencies in hearts and eyes and their lower limbs are often listless. There has been no orderly registration here in the period after the war and we have suffered from that. But [in relation to the rise in tumours] I can say with certainty that we have noticed a sharp rise in malignancy of the blood and this is not a congenital anomaly – it is an acquired disease."
Despite fully funding the construction of the new hospital, a well-equipped facility that opened in August, Iraq's health ministry remains largely disfunctional and unable to co-ordinate a response to the city's pressing needs.
The government's lack of capacity has led Falluja officials, who have historically been wary of foreign intervention, to ask for help from the international community. "Even in the scientific field, there has been a reluctance to reach out to the exterior countries," said Dr Salah. "But we have passed that point now. I am doing multiple surgeries every day. I have one assistant and I am obliged to do everything myself."
Additional reporting: Enas Ibrahim.
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London ~ Saturdau November 14 2009
My baby was blind. She couldn't eat or speak. I mourn for her' – families' heartache over Falluja birth defectsDoctors and parents tell of huge growth in abnormalities in children of city that saw some of the fiercest fighting – and largest quantities of munitions – of the Iraq war Martin Chulov in Falluja
 Zainab Abdul Latif with her six-year-old daughter Mariam. Neither Mariam nor her younger brothers can walk and all three have learning difficulties. Photograph: Muhannad Fala'ah/Getty Images
Zainab Abdul Latif moves wearily between her three children, wiping their foreheads and propping them up in their wheelchairs. "Every day, they need intensive care," the 29-year-old Falluja mother says. Neither her two sons, Amar, 5, and Moustafa, 3, or daughter, Mariam, 6, can walk or use their limbs. They speak two words – "mama, baba" – between them. All are in nappies.
Zainab is one of many faces of Falluja's postwar years, overwhelmed by a workload that she has no means to change. "They cannot eat, or drink by themselves and every day I have to take Mariam to the hospital. She is very sensitive to flu and regularly gets diarrhoea and other ailments. The doctors have told me they are mentally retarded and have nerve paralysis. They say it is congenital. I really can't take care of them like this and I need help."
One of few people she can turn to is Dr Bassem Allah, the senior obstetrician who is chief custodian of Falluja's newborns. During medical school he had to search Iraq for case studies of an infant with a birth defect. "It was almost impossible during the 80s," he says. "Now, every day in my clinic or elsewhere in the hospital, there are large numbers of congenital abnormalities or cases of chronic tumours."
He pauses, his thoughts seemingly interrupted by the gravity of his words, then slowly continues. "Now, believe me, it's like we are treating patients immediately after Hiroshima."
Across Falluja, neonatal wards and centres for disabled people are facing such an influx of infants or children aged under five with chronic deformities that they are fast running out of space and staff to help. After two years of anecdotal reports suggesting a spike in birth defects, more precise data is painting a picture of a deeply disturbing phenomenon.
The Guardian asked Dr Samira Abdul Ghani, a specialist at Falluja general hospital, to compile data from all the newborns she supervised over the three weeks from 11 October. She reported 37 cases of serious deformities, many of them neural tube defects [birth defects of the brain and spinal column including spina bifida and anencephaly], with accompanying heart problems. A sharp rise in the number of infant tumours is also being chronicled by hospital staff but, because tumours usually materialise months or years after birth, doctors are reluctant to quantify their research.
"There is ... a very marked increase in the number of paediatric cases of less than two years with brain tumours," said the hospital director, Dr Ayman Qais. "This is now a focus area of multiple tumours. We are seeing a very significant increase in central nervous system anomalies, especially neural tube defects."
Before 2003, he had been seeing sporadic deformities in babies. Now the frequency had increased dramatically. Most were in the head and spinal cord, but many were in lower limbs.
At Falluja General, doctors who care for newborns are dealing with phenomena none can explain.
The city was the site of the two most savage and prolonged battles in Iraq during the past six years. The potentially toxic residue of precision munitions that rained down on the city for up to two months in 2004 has left many medical professionals questioning the long-term impact of modern weaponry, although few are willing, so far, to directly blame the war.
Doctors point to many factors that could contribute to the birth defects: malnutrition, the psychological status of the parents, drug use, chemicals or radiation. Even preliminary treatment for the most common defect requires life-threatening surgery a price too high for many parents.
Evidence is on display throughout Falluja's new general hospital and at centres for disabled people across the city. On 2 November, there were four cases of neural tube defects in the neonatal ward. Several more were in intensive care and an out-patient clinic.
"Many more fathers and mothers are refusing ongoing hospital admissions and, until recently, we did not record their children as having been born with defects," said Qais. "I tell parents after each diagnosis that they will need a shunt procedure, which will most likely lead to chronic swelling in the head and the need for surgery in the skull or brain, so the majority of parents are not taking this option."
Falluja's obstetricians said the significant rise in diagnoses of congenital defects was not explained by improving healthcare in the city. "We used to diagnose all such patients before the war," said Qais. "They were registered here and then sent to Baghdad for treatment, but we knew the health base of the newborn."
The story in Falluja is playing out away from the clinical calm of hospital wards. In homes across the city, the care needs of children with debilitating injuries are faced by families with no access to social welfare and little support outside their inner-sanctum.
Not far from Zainab's house, Um Omar is mourning the death three months ago of her three-year old daughter, Fatima, who was born with a second mass that protruded from her neck. She was known as the girl with two heads.
Allah, who treated Fatima, said that there was no chance of saving her life in Iraq. "The second 'head' was actually a tumour that contained part of the hydrocephalus and part of the brain. To save her needed highly specialised equipment that we do not have here."
Her mother still grieves for Fatima. "I'm sad about the death of my baby despite all the hardship she faced," she said. "She was blind, she couldn't eat, she had no oesophagus and never walked or spoke. She was my last child. All the rest were born before the war.
All four children were registered by the Falluja Handicapped Organisation, a rudimentary facility with little funding or means to provide other than moral support to the increasing numbers of families flowing through its doors.
The director, Hussain Matroud, said there were 300 children on his books. Many thousands more remained in the community, with their parents and carers refusing help. Some patients being treated for congenital defects at the centre for people with disabilities were clearly born before the start of the war, but the vast majority of children on the register were aged six, or younger.
"Most of the children have brain injuries and nearly all are under eight years," he said. "There were very few before the war. We are in constant contact with NGOs in America, India and Britain, who try to help with treatment. But all we can really do for now is compile their names and the extent of their conditions."
Mohammed and Rana Majid have a daughter, Zahra, who was born four years ago. She has been diagnosed with developmental disabilities stemming back to the pregnancy. The parents complained to the American military and received a compensation form to fill out. They have done so, but received no reply.
Several other families have lodged claims with the US military, but without a scientific case are unlikely to get far. Allah believes science has to start playing a role in explaining what has happened to the city and its young.
"The numbers of abnormalities we are seeing is horrific and no one has yet concluded why," said Allah. "There is not yet any science to tell us why. No one has come here to take soil samples, or make examinations. I think the Iraqi government does not want it proven that the Americans used forbidden weapons here. If there is scientific proof that the war was responsible for so many deformities, there will likely be problems for officials here."
Back story A video grab of an American air attack on Falluja on November 6, 2004, possibly an AC-130 gunship hailing down fire on targets
US troops entered Falluja shortly after invading Iraq in March 2003, but it was the bloody assault some 19 months later that would become synonymous with the city. Operation Vigilant Resolve, in April 2004, was a response to the killing of four US private military contractors employed by Blackwater (now XE). On 8 November 2004 10,000 US troops and 2,000 Iraqi soldiers embarked on Operation Phantom Fury.
The US military called the fighting "some of the heaviest urban combat marines have been involved in since Hue City in Vietnam in 1968".
The US claimed to have killed 2,000 people, mainly insurgents, but produced no figures for civilians. Western media were kept out but accounts emerged of indiscriminate killing.
Iraqi medical officials and NGOs put the civilian toll at up to 6,000. Falluja's compensation commissioner said 36,000 out of 50,000 homes were destroyed, with 60 schools and 65 mosques and shrines. At least 200,000 civilians became refugees.
Additional reporting: Enas Ibrahim
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London ~ Saturday November 14 2009, page 21
Falluja's babies: The difficulties of pinning the blameDenis Campbell, health correspondent
War's effects on health can be much harder to identify than death and horrendous physical injuries. The US department of veterans affairs recently accepted that Vietnam war veterans may have developed B cell leukaemias, Parkinson's disease and ischemic heart disease as a result of exposure to a blend of herbicides known as Agent Orange, a defoliating agent sprayed by US warplanes to deprive their enemies of cover.
Similarly, ionising radiation from the atomic bombs dropped on Hiroshima and Nagasaki in 1945 led to medical complications such as cancers, nausea, hair loss, bleeding into the skin, inflammation of the mouth and throat and birth defects.
Professor Nigel Brown, an expert in the causes of birth defects and dean of the faculty of medicine and biomedical science at St George's, University of London, points out that war zones such as Falluja involve many of the risk factors that cause deformities in children.
"The whole of the war situation produces a very unusual set of circumstances to which the civilian population is exposed, mainly involving the destruction of the built environment and its knock-on effects," he said.
"Those include the degrading of sanitation, the stress [on people of being in a place of conflict], the disruption of the water supply, poor nutrition and air pollution caused by both chemicals and particulates."
It was impossible to identify any one of those particular factors that may lie behind the apparent dramatic increase of birth defects in Falluja.
In addition, despite suspicion to the contrary, there is no reliable evidence to show that the components of munitions causes birth defects, except for ionising radiation, Brown said.
Some American service personnel who had seen action in Vietnam and the first Gulf war believed those conflicts caused them to have children with serious malformations. However, when their concerns were investigated, no proof was found. But studies in this area have concentrated on the health of combatants and their offspring and not on civilians caught up in conflicts, so evidence is very limited.
But what of white phosphorus, which was used in Falluja in 2004? No studies have been done, among either combatants or civilians, so it is impossible to link it to the abnormalities.
"These birth defects in Falluja could be the result of multiple factors including the sheer psychological stress on the local population of being in a war zone, malnutrition, air and water pollution and a cocktail of chemicals, which may include contamination from munitions," said Brown.
Birth defects range from minor ailments, such as a discolouration of the skin, to life-threatening conditions such as hydrocephalus and spina bifida. In most countries between 2% and 3% of all babies born have some form of birth defect. However, only between 1% and 10% of those involve a neural tube defect, which are the most debilitating and likely to lead to death.
"If neural tube defects are occurring apparently quite frequently in Falluja now that would be a dramatic increase over the expected rate for what are, in normal circumstances, rare events and that would be a matter of considerable concern," said Brown.
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 20 October 2009
COMMENTARY:
Depleted Uranium Weapons: The Dead Babies in Iraq and Afghanistan Are No Joke by Dave Lindorff
Originally published in This Can't Be Happening:19 October 2009
Warning: a photo accompanying this story is not for the faint hearted
The deformed and dead babies in Iraq should make us demand a cleanup of Iraq and Afghanistan, medical aid for the victims, and a ban on all depleted uranium weapons.
The horrors of the US Agent Orange defoliation campaign in Vietnam, about which I wrote on Oct. 15, could ultimately be dwarfed by the horrors caused by the depleted uranium weapons which the US began using in the 1991 Gulf War (300 tons), and which it has used much more extensively--and in more urban, populated areas--in the Iraq War and the now intensifying Afghanistan War.
Depleted uranium, despite its rather benign-sounding name, is not depleted of radioactivity or toxicity. The term “depleted” refers only to its being depleted of the U-235 isotope needed for fission reactions in nuclear reactors. The nuclear waste material from nuclear power plants, DU as it is known, is what is removed from the power plants’ spent fuel rods and is essentially composed of the uranium isotope U-238 as well as U-236 (a product of nuclear reactor fission, not found in nature), as well as other trace radioactive elements. Once simply a nuisance for the industry, that still has no permanent way to dispose of the dangerous stuff, it turns out to be an ideal metal for a number of weapons uses, and has been capitalized on by the Pentagon. 1.7 times heavier than lead, and much harder than steel, and with the added property of burning at a super-hot temperature, DU has proven to be an ideal penetrator for warheads that need to pierce thick armor or dense concrete bunkers made of reinforced concrete and steel. Once through the defenses, it burns at a temperature that incinerates anyone inside (which is why we see the carbonized bodies of bodies in the wreckage of Iraqi tanks hit by US fire). Accordingly it has found its way into 30 mm machine gun ammunition, especially that used by the A-10 Warthog ground-attack fighter planes used extensively in Iraq and Afghanistan (as well as Kosovo). It is also the warhead of choice for Abrams tanks and is also reportedly used in GBU-28 and the later GBU-37 bunker buster bombs, each of which can have 1-2 tons of the stuff in its warhead. DU is also used as ballast in cruise missiles, and this burns up when a missile detonates its conventional explosive. Some cruise missiles are also designed to hit hardened targets and reportedly feature DU warheads, as does the AGM-130 air-to-ground missile, which carries a one-ton penetrating warhead. In addition, depleted uranium is used in large quantities in the armor of tanks and other equipment. This material becomes a toxic source of CU pollution when these vehicles are attacked and burned.
While the Pentagon has continued to claim, against all scientific evidence, that there is no hazard posed by depleted uranium, US troops in Iraq have reportedly been instructed to avoid any sites where these weapons have been useddestroyed Iraqi tanks, exploded bunkers, etc.and to wear masks if they do have to approach. Many torched vehicles have been brought back to the US, where they have been buried in special sites reserved for dangerously contaminated nuclear materials. (Thousands of tons of DU-contaminated sand from Kuwait, polluted with DU during the US destruction of Iraq’s tank forces in the 1991 war, were removed and shipped to a waste site in Idaho last year with little fanfare.) Suspiciously, international health officials have been prevented or obstructed from doing medical studies of DU sites in Iraq and Afghanistan. But an excellent series of articles several years ago by the Christian Science Monitor described how reporters from that newspaper had visited such sites in Iraq with Geiger-counters and had found them to be extremely “hot” with radioactivity.
The big danger with DU is not as a pure metal, but after it has exploded and burned, when the particles of uranium oxide, which are just as radioactive as the pure isotopes, can be inhaled or ingested. Even the smallest particle of uranium in the body is both deadly poisonous as a chemical, and over time can cause cancerparticularly in the lungs, but also the kidneys, testes and ovaries.
There are reports of a dramatic increase in the incidence of deformed babies being born in the city of Fallujah, where DU weapons were in wide use during the November 2004 assault on that city by US Marines. The British TV station SKY UK, in a report last month that has received no mention in any mainstream American news organization, found a marked increase in birth defects at local hospitals. Birth defects have also been high for years in the Basra area in the south of Iraq, where DU was used not just during America’s 2003 “shock and awe” attack on Iraq, but also in the 1991 Gulf War.
 Deformed baby born in post-US Invasion Iraq: DU's legacy?
Further, a report sent to the UN General Assembly by Dr Nawal Majeed Al-Sammarai, Iraq’s Minister of Women’s Affairs since 2006, stated that in September 2009, Fallujah General Hospital had 170 babies born, 24% of which died within their first week of life. Worse yet, fully 75% of the babies born that month were deformed. This compares to August 2002, six months before the US invasion, when 530 live births were reported with only six dying in the first week, and only one deformity. Clearly something terrible is happening in Fallujah, and many doctors suspect it’s the depleted uranium dust that is permeating the city.
But the real impact of the first heavy use of depleted uranium weaponry in populous urban environments (DU was used widely especially in 2003 in Baghdad, Samara, Mosul and other big Iraqi cities), will come over the years, as the toxic legacy of this latest American war crime begins to show up in rising numbers of cancers, birth defects and other genetic disorders in Iraq and Afghanistan.
Of course, as in the case of Agent Orange in Vietnam, the toxic effects of this latest battlefield use of toxic materials by the US military will also be felt for years to come by the men and women who were sent over to fight America’s latest wars. As with Agent Orange, the Pentagon and the Veterans Affairs Department have been assiduously denying the problem, and have been just as assiduously denying claims by veterans of the Gulf War and the two current wars in Iraq and Afghanistan who claim their cancers and other diseases have anything to do with their exposure to DU.
The record on Agent Orange should lead us to be suspicious of the government’s claims.
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 UK ~Tuesday June 10, 2008
Doctors To Study Iraq Birth DefectsSky News recently reported on families in the Iraqi city of Fallujah who are calling for an independent investigation into their concerns about a rise in the number of newborn babies suffering from deformities.
 US Marines in Fallujah in 2004
They raised concerns about the weapons used by American forces in 2004 during the war in Iraq - and are now questioning whether there could be any links with the deformities.
As a result of seeing our exclusive report,one of the world's leading authorities on foetal medicine, Professor Kypros Nicolaides, has decided to offer three scholarships to obstetricians in Fallujah.
This would involve the doctors coming to study at the Fetal Medicine Foundation in London, and on their return being supported to work in hospitals in Fallujah.
The hope is to improve the care of pregnant women in the city, and with better training and scanning equipment, ultimately doctors would be able to set up a birth registry which may throw some light on the concerns of those who believe Fallujah is suffering an abnormal rate of birth deformities.
In April and November, 2004, Fallujah saw some of the heaviest bombardments of the war in Iraq.
Hikmat Tawfeeq, deputy chairman of the Fallujah-based human rights group Alakhiyar said: "We have around 200 cases of deformities recorded by our society. Most of these birth deformities started appearing after the war in Iraq."
The evidence is anecdotal - there are no records from Saddam Hussein era to compare their stories with - but they believe their findings are disturbing.
Campaigners say officials are reluctant to speak out publicly but at Fallujah's Children's Hospital one doctor told us in the past month she's seen one or two cases of birth deformities every day.
An ophthalmologist said he deals with four or five case of newborn babies every week suffering from some form of eye deformity - and that's risen in the last two years.
At one of the cemeteries in Fallujah, undertaker Mahmoud Hummadi said he usually buries four to five newborns every day and most of them are deformed.
Speaking on Sky News, Professor Nicolaides said: "I was very disturbed by the report.
"It's impossible in the absence of specific records to define the extent of the problem and it's for this reason I feel it's important to try and help the families that are having babies with problems to identify them before they are born and to document the exact size of the problem.
"I feel it's important to have properly trained doctors that can carry out pre-natal diagnosis, ultra-sound scans in pregnancy so that all of the women are examined to identify if their babies are carrying any major deformities.
"Secondly, the same people could be trained in documenting all of the cases with deformities that already exist."
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20 October 2009