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Public Radio's Environmental News Magazine (follow us on Google News)

Iraq Cancer Epidemic

Air Date: Week of

In Iraq, economic sanctions have prevented the southern city of Basra from recovering from the effects of the Gulf War. Doctors in the region are seeing an alarming increase of health problems, including cancer. Quil Lawrence reports.


CURWOOD: At the southern tip of Iraq, just over the border with Kuwait lies the city of Basra. It's been a battlefield for almost twenty years. For most of the 1980s it was center stage in the war between Iraq and Iran. That conflict was barely over when Iraqi President Saddam Hussein invaded Kuwait in 1990, and again, Basra was pounded, this time by the US and its allies. In the ten years since the Gulf war, economic sanctions have prevented Basra from recovering. As Quil Lawrence reports, widespread malnutrition and disease are prevalent in the war-torn south. Doctors are also seeing a new epidemic of cancer.

LAWRENCE: On the delta of the Tigris and Euphrates Rivers, the city of Basra still shows signs of two decades of war. Bombed-out bridges remain twisted heaps of concrete and steel. Most of the city only gets a few hours of electricity each day. Hassan al-Rawhi [phonetic spelling], a sanitation engineer, is overseeing the construction of a new water treatment plant north of Basra. He says the sewage systems in the south are in terrible condition.

(Several voices talk about sewage)

AL-RAWHI: [phonetic spelling] Directing empty area just behind the hospital, and it was a lake of sewage with bad smell and a lot of insects, mosquitos and so on.

LAWRENCE: Mr. al-Rawhi's [phonetic spelling] new water treatment plant will only serve a fraction of the need. And even that water, he says, will flow through old and contaminated pipes that can still make people sick. A United Nations program has been in place since 1996, allowing Iraq to trade its oil for food and medicine. But the directors of the program say it's not enough. Some essential items like chlorinators for purifying water are held up because the U.N. fears they may be headed for Saddam Hussein's weapons stockpiles.

(Several voices; a child complains)

LAWRENCE: Doctors in Basra are swamped with cases of malnutrition and related diseases. And the hospitals themselves are in trouble. In the 1980s this country's medical care was among the best in the region. Now the hospitals lack beds, basic drugs, and equipment. This is the case here in Basra's crowded cancer wards. Patients rest on dirty woollen blankets, wearing whatever tattered clothes they came in with. Much of the problems here can be blamed on the economic embargo, but that doesn't explain why doctors are seeing so much cancer. Thumir Hamdan [phonetic spelling] is an orthopedic surgeon.

Hamdan: [phonetic spelling] It is a well-known fact internationally that orthopedic surgeons see one case of bone tumor every three years. That's in England. But we are seeing one case of bone tumor every one month.

LAWRENCE: Dr. Hamdan [phonetic spelling] is a lean, middle-aged man who walks through what he calls the miserable ward with an even determination. He's originally from Basra, but was educated in the U.S. and the U.K. and has been published internationally. Working without MRI scanning equipment or a decent supply of cancer drugs, Dr. Hamdan [phonetic spelling] spends most of his days now cutting out tumors. Sometimes he can reset the bone and save a patient's limb. But oftentimes he amputates.

HAMDAN: [phonetic spelling] This is a lady lost her limb because of [inaudible]. Now she's without limb. She had a malignant tumor. And she's too young, she developed abdominal tumor, recurrence. This is secondaries. An abdomen is not a common sight for secondaries in tumor of the leg. She lost her limb.

LAWRENCE: Dr. Hamdan [phonetic spelling], who has worked in Basra over 20 years, says the tumors he's seeing now are different than before. They're quicker and more deadly, but less painful. Unfortunately, this means that their victims often don't come to see a doctor until the tumor is advanced and swelling. As he checks one man's chart, Dr. Hamdan [phonetic spelling] notes that the patient comes from around the periphery of Basra. This is the poorest area, and the area closest to the battlefields. The man has a jagged hole where a tumor has been removed from his foot.

MAN: His name is Sadaman [phonetic spelling], he's 32 years old.

HAMDAN: [phonetic spelling] Did you think he is 32? If you look at his face you see he is 60 years old. That's poverty, malignancy, and pollution. Can you guess he is 32? He is too young.

LAWRENCE: Dr. Hamdan [phonetic spelling] does not research the cause of the cancers, but like many Iraqi doctors he suspects DU, depleted uranium. The U.S. Army first used DU rounds in the Gulf, and then more recently in Kosovo. The military developed the weapon after the Vietnam War, in search of a cheaper and more effective metal to make armor-piercing shells. DU, essentially nuclear waste, is twice as dense as lead and makes a great penetrator. The troops in the Gulf called it their silver bullet. In its solid form DU is not dangerous, emitting only weak alpha radiation. Not enough to get through human skin. But what most of the troops did not know is that the round vaporizes on contact, spreading radioactive dust all over its target and the surrounding area. The Pentagon estimates that the U.S. and the allies fired 320 tons of DU rounds in the Gulf War. Thousands of soldiers re-entered the battlefield wearing no protection.

KILPATRICK: That clearly was a major mistake on the part of the United States government. Most of the military people did not know depleted uranium was being used.

LAWRENCE: Dr. Michael Kilpatrick is a Pentagon spokesman. He says the Army now trains troops to take precautions, such as wearing protective clothing and masks, when dealing with DU exposure. But it didn't during the war. Veterans were outraged to discover that they had put themselves at risk after the cease-fire, climbing into and around dead Iraqi tanks looking for souvenirs, all the while breathing DU dust. Some soldiers who were hit by friendly fire and had DU shrapnel in their bodies didn't even find out they had been hit with DU until they began to suffer from a set of maladies now known as Gulf War Illness. The Pentagon was at first slow to acknowledge the problem, and they still refute a causal link between DU and symptoms. Kilpatrick says a control group of veterans hit by DU have shown no problems related specifically to the uranium.

KILPATRICK: Thirty-three of those individuals have been followed since 1993. And as of today, the physician following them has not been able to find any negative medical outcome as a result of that DU exposure. This group of soldiers has fathered over 20 children, all of whom are normal.

LAWRENCE: Likewise, Kilpatrick says that cancer rates have not jumped within this group of vets. But veterans groups say the Pentagon is motivated by a desire to continue using the cheap, effective weapon. One of the vets in the control group did develop a bone tumor. Others suffer from abdominal pains, skin rashes, about 60 different symptoms. And the Army knew DU was a risk even before the war, says Dan Fahey, a Navy veteran who studies DU.

FAHEY: This is an appendix of an Army report. But July 1990, it's written, and it says DU is a low-level alpha radiation emitter which is linked to cancer when exposures are internal. What this report identified was that when you use DU in combat, the dust gets created that soldiers, you know, might inhale the dust and then might have health problems as a result.

LAWRENCE: Fahey says he believes that the DU dust can be re-suspended in the air, causing new exposures almost indefinitely to local populations. And there are still contaminated Iraqi tanks in the vicinity of Basra. But even as he faults the Pentagon for a cover-up, Fahey says the Iraqi regime is overstating the effects of DU. In its campaign to bring an end to economic sanctions, Fahey says Iraqi government doctors in Geneva have been blaming DU for all of southern Iraq's many health problems.

FAHEY: Where the Iraqi government's using this for propaganda, the U.S. government is steadfastly denying that there are any problems that result. What's being lost is that there is a hazard that exists around these contaminated tanks. No one's telling them that there's a hazard. There's no effort to go in and clean these areas up.

LAWRENCE: Fahey points out that DU is not the only suspected hazard around Basra. Iraqi troops set fire to oil wells as they left Kuwait, turning the sky black with toxic fog. Chemical weapons alarms were ringing nonstop throughout the Gulf War, but the only confirmed exposure came when U.S. troops destroyed a munitions dump which contained Sarin gas. During the 1980s Saddam Hussein used chemical weapons here in the war with Iran, and then again when he mustard gassed uprisings in the nearby marshes after the Gulf War. Chemical weapons may also be a culprit for a cancer cluster. World Health Organization officials say that bone cancers usually don't appear until ten to 20 years after exposure. So any possible cancerous effects of DU may come later, for gulf vets and Iraqi civilians.

(Children call in a crowd)

LAWRENCE: In the crowded slums around Basra, it seems that isolation is the worst enemy, as people wonder if they've been forgotten by the world. A May issue of The Lancet medical journal verified that the child mortality rate in Iraq has doubled since the embargo began. No one has been able to get in and make a good independent study of cancer. The WHO did one cancer report in 1998, but they concluded only that more research was needed. So far the requests for a new study have gone nowhere. Gregory Hartl [phonetic spelling] is a WHO spokesman.

HARTL: [phonetic spelling] Iraq is a country which still has U.N. sanctions applying. We follow definitely what the U.N. Security Council says in New York, and that of course limits in certain instances what we can do there. It might also limit the international attractiveness of giving funds for studies in Iraq.

LAWRENCE: Mr. Hartl [phonetic spelling] says that the pre-war cancer records in Iraq are lacking, and the new study will have to start from scratch to determine if cancer rates have increased. Though the Iraqi regime has requested a study, the government makes it very difficult to work in the country and strictly controls information, monitoring all interviews with outsiders. A study of the problem may have to wait for a major political change inside or outside Iraq. But it could be a long wait. The embargo will remain in place until Saddam Hussein complies with U.N. weapons inspections. But the U.N. weapons inspection team hasn't been allowed in the country since 1998. For Living on Earth, I'm Quil Lawrence in Basra, Iraq.



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