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Joint FAO/WFP mission to Iraq finds that malnutrition is still widespread

A joint FAO/WFP assessment mission to Iraq in June/July has found that malnutrition is still a major problem throughout the country, despite the oil-for-food deal set up under UN Security Council Resolution (SCR) 986. Under the deal, which came into effect on 10 December 1996, Iraq is allowed to export limited quantities of oil to finance imports of food and other essential humanitarian needs. In the first six-month period, Iraq was permitted to sell up to US$2 billion of oil, out of which $805 million could be used for food imports and $44 million for urgently needed agricultural inputs. The Security Council approved a six-month extension on 8 June 1997 to cover the period until 8 December 1997. The Distribution Plan for phase II was approved by UN Secretary-General Kofi Annan on 4 August.

Weeds invade wheat fields in Iraq

In a Special Report issued on 3 October, the mission states that "although food rations under SCR 986 will provide a significant proportion of overall energy and protein needs, the provisions are low or deficient in a number of other nutrients, particularly Vitamins A and C, which are almost zero, and calcium, zinc, riboflavin and Vitamin B6, which are all less than 40 percent of needs." Cases of the nutritional diseases kwashiorkor and marasmus were widely observed by the assessment team.

Fruits, vegetables and animal products are all necessary to boost the nutritional quality of the SCR 986 rations, which are based heavily on cereals, according to the report. It also recommends fortification of the food commodities being imported, particularly wheat flour.

Before the Persian Gulf War in 1990, Iraq imported two-thirds of its food requirements. UN sanctions, imposed in August 1990, however, significantly constrained Iraq's ability to earn foreign currency needed to import sufficient quantities of food to meet needs. As a result, food shortages and malnutrition became progressively severe and chronic in the 1990s. Widespread starvation has only been avoided by a public rationing system that provided minimum quantities of food to the population.

Investment in agriculture is essential

Iraq's agricultural sector has deteriorated significantly in the1990s, because of lack of investment and shortage of essential inputs, according to the report. Perhaps the most far-reaching recommendation for both agriculture and nutrition concerns the need for economic rehabilitation and development throughout the whole country. Unless increased purchasing power is generated and greater investment is made in agriculture, additional and necessary high-quality proteins and bio-available micronutrients will be beyond the means of many, and nutritional problems will persist, despite the improved ration under SCR 986.

The estimated 2.76 million hectares planted to cereals in 1997 is the lowest since 1991. Large unplanted areas were observed in central and southern areas, where some 300 000 hectares of previously reclaimed land have been abandoned because of rising soil salinity and lack of irrigation water, farm machinery and inputs. The livestock industry has been severely hit by shortages of feed and vaccines.

The country's water and sanitation system has also deteriorated to a point where water-borne diseases, including nutritional marasmus, remain a major problem in spite of increased food availability. In addition to this, food safety has become a major problem: "many unsafe additives are in the food supply and the whole food industry has seriously deteriorated over the last seven years".

16 October 1997

GIEWS Special Report

• FAO/WFP food supply and nutrition assessment mission to Iraq

Health - increase of approximately 90,000 deaths yearly due to the sanctions (more than 250 people die every day) (pg. 42)

• "The increase in mortality reported in public hospitals for children under five years of age (an excess of some 40,000 deaths yearly compared with 1989) is mainly due to diarrhea, pneumonia and malnutrition. In those over five years of age, the increase (an excess of some 50,000 deaths yearly compared with 1989) is associated with heart disease, hypertension, diabetes, cancer, liver or kidney diseases. … With the substantial increase in mortality, under-registration of deaths is a growing problem." (pg. 42)
• "Malnutrition was not a public health problem in Iraq prior to the embargo. Its extent became apparent during 1991 and the prevalence has increased greatly since then: 18% in 1991 to 31% in 1996 of [children] under five with chronic malnutrition (stunting); 9% to 26% with underweight malnutrition; 3% to 11% with wasting (acute malnutrition), an increase in over 200%. By 1997, it was estimated about one million children under five were [chronically] malnourished." (pg. 23 and 63).

• "To address malnutrition efficiently, attention must be directed to all causal levels - direct (diet and health); underlying (household food security, care, water/sanitation, health services) and basic (education, resources - material, financial, human and organizational)." (pg. 74)
• "The situation throughout Iraq remains to be one in which Child's Right to Survival and for the health care decreed by the Convention on Rights for the Child remains subject to overwhelming risks to life and health generated by the economic hardship." (pg. 40)
• "[Before the 1990 sanctions] primary medical care reached about 97% of the urban population, and 78% of rural residents. … [Now] the health system is affected by lack of even basic hospital and health centre equipment and supplies for medical, surgical and diagnostic services. … In 1989, the [Iraqi] Ministry of Health spent more than US$500 million for drugs and supplies; the budget is [now] reduced by 90-95%. … Although SCR 986 [the Oil-for-Food programme] is meant to provide US$210 million for each six month period of the Phase I and II, only US$80 million (i.e., 20%) had been received as of November 15, 1997." (pg. 7 and 40)

Oil for Food plan - not reduced widespread suffering, nor provided supplies in full, in a timely manner (pg. 2)

• "The Oil-for-Food plan has not yet resulted in adequate protection of Iraq's children from malnutrition/disease. Those children spared from death continue to remain deprived of essential rights addressed in the Convention of Rights of the Child." (pg. 3)
• "As of March 15, 1988, of the allocations [from the Oil-for-Food plan] for medicines/health, about 75% has arrived in-country for the South/Centre and 50% of the North; for water/sanitation, 59% and 27%; education 37% and 45%; and for electricity/power 48% and 10% each respectively for South Centre and North." (pg. 18)

(Lack of ) Water Sanitation - resulting in increases in diarrhoea, typhoid, choldera, andViral Hepatitis (pg. 52)

• "It is likely that lack of safe water and sanitation has contributed greatly to the steep rise in malnutrition rates and mortality. In accordance with [the Convention on the Rights of the Child], the goal for the year 2000 for universal access to safe drinking water and sanitary means of excreta disposal, is unlikely to be achieved with the continuation of the embargo." (pg. 31)
• "Water treatment plants lack spare parts, equipment, treatment chemicals, proper maintenance and adequate qualified staff. … Plants often act solely as pumping stations without any treatment… The distribution network, on which most of the population relies, has destroyed, blocked or leaky pipes. There have been no new projects to serve the expected population increase over the past seven years." (pg. 32)

Economy - breakdown of socio-cultural fabric of the society, due to economic collapse (pg. i)

• "By September 1995, the UN's Department of Humanitarian Affairs estimated about 4 million Iraqis (about 20%) lived in extreme poverty. … The purchasing power of the local currency has been greatly reduced, … from US$3 = 1 Iraqi Dinar (ID) in 1990 … to about US $1 = ID1,500 in 1997." (pg. 9)
• "Basic causes of malnutrition are dominated by the economic situation where the GDP per capita has [been] reduced from $3500 to $600 and the current salary of public workers now averages about $3 to $5 per month, compared with $50-100 prior to 1990. … Accessibility to food beyond the amounts provided through public rations is limited by soaring food prices. … At least 80% of a family's income is spent on food." (pg. 27 and 29)

Education - [military] Gulf War and sanctions resulting in limited access to and poor quality of education (pg. i)

• "Historically, Iraq has given education a high priority. However, the protracted economic hardship on Iraqi population has seriously affected every level of formal and informal education…. The extent of destruction of the education sector as a result of the [military] Gulf War was extensive." (pg. 80)
• "As the unprecedented trend of declining school enrollment continues unabated, so does the related violation of the national Compulsory Education Law. Iraq, once honoured by UNESCO for its active promotion of Education, is now experiencing the unavoidable compromise of the Convention on the Rights of the Child for education. … Information on access to education does not indicate the quality of education, nor the decline in school facilities. These include lack of the most basic school supplies such as blackboards, chalks, pencils, notebooks and paper (designated as "non-essential" by the Sanctions Committee), inaccessibility to any water, and absent or defunct sanitation." (pg. 87-88)
• "84% of all schools need rehabilitation. … The Oil for Food programme is providing a rather limited contribution to the improvement of [these] conditions." (pg. 88 and 96)

* For copies of this UNICEF report, contact UNICEF reference librarian: tel. 212.326.7065; e-mail: jando@unicef.org

* Summarized by Rania Masri (IAC@leb.net )