Focus on malnutrition

The incidence of child malnutrition and water-borne diseases is increasing in some areas of Iraq, according to health experts. In Baghdad, one of the main causes of malnutrition is infections caused by poor sanitation, particularly in the suburbs. "Cases of children with chronic diseases are coming to us regularly. Sometimes it is too late to provide treatment and the child dies. Most families only take their children to a hospital when the case is practically out of our hands and resources. It is becoming chaotic," Dr Muhammad Yussef, a paediatrician from Kindy Hospital, told IRIN in Baghdad. The United Nations Children's Fund (UNICEF) reported, quoting recent Ministry of Health data, that about three out of 10 children in Iraq are chronically malnourished or stunted and have a low height for their age. This is a consequence of underlying poverty and the inadequate intake of micronutrients, it said. Chronic malnutrition is more common among children living in the central and southern governorates, particularly those of Thi-Qar, Wassit, Anbar, Babil and Basra, according to the agency. Almost half of Iraq’s total population of 26 million is aged under 18, according to UNICEF and a study by the agency in May last year showed that acute malnutrition among children had almost doubled since the war in March 2003, moving from 4 per cent to 7.7 percent. "Children who are acutely malnourished are literally wasting away and for severe cases their condition can be fatal," the agency warned in a statement last year. One Iraqi child in eight dies before their fifth birthday, it added. Most families recently interviewed by IRIN at hospitals in the capital agreed that the situation before the recent conflict was better, adding that medical assistance was quicker then. "I've been trying for three days to get medical help for my son and only today did they examine him and found that he has malnutrition and that the case is dangerous," Antissar Muhammad, 29, told IRIN at Sadr city hospital in a suburb of Baghdad. Staff at most of the big medical centres in Iraq say that for every five children treated, at least two are suffering from malnutrition, particularly those in three of the biggest suburbs of Baghdad: Sadr city, Shoola and Shawaka. Wathiq Ibrahim, one of the doctors at the Central Teaching Hospital for Paediatrics in the capital, told IRIN that cases of child malnutrition, before the US-led war to topple Saddam Hussein, were attributable to food deficiency, as 60 percent of the population was dependent on food rations following UN sanctions on the country as a result of Iraq's invasion of Kuwait in the early 1990s. However, 80 percent of current cases are due to infections caused by dirty water resulting in diseases such as cholera. "The street in front of my home is absolutely destroyed by US tanks and you can see the dirty water coming out everywhere. I cannot control my son in going out from home all the time and today I'm here for five nights waiting for him to recover from malnutrition and cholera," Madiha Abbas, who was waiting for his sick five-year-old son at the local hospital in the Shoola suburb, told IRIN. "We are a pour suburb; I think that the government should look first after us," he added. Dr Ibrahim argued that the suffering of children was also used in a political game by the former regime. "The old regime was giving higher numbers to the UN in relation to malnutrition in the country just to prove that the sanctions imposed by them were causing a big destruction of children's lives in Iraq. It is true that the numbers were high, but they were giving approximately double the real number," he said. The Iraqi Ministry of Health said that in order to overcome this situation, all agencies need to work together and target the most vulnerable areas. The country's health system is still suffering from the effects of conflicts, including the 1991 Gulf war, in which the infrastructure of Iraq was greatly damaged. The recent US-led conflict has also affected services available, following the large scale looting of medical facilities. Foreign aid has helped alleviate some of the problems. Despite insecurity, since the end of the war, UNICEF has delivered thousands of tons of supplies. These include emergency medical and water supplies and high-protein biscuits for malnourished infants. In addition, the World Food Programme (WFP) launched a new project in July 2004 to provide food aid to primary school children to encourage school enrollment and help reduce malnourishment. Pregnant and lactating mothers, as well as the chronically sick in vulnerable districts were also targetted by the scheme. However, the situation in the capital is improving. Paediatric specialists from the Medical Union in Iraq add that cases of malnutrition have been falling in Baghdad. Ibrahim said that immediately after the recent conflict, 12 out of 20 beds at the Central Teaching Hospital for Paediatrics in Baghdad, were occupied by youngsters suffering from malnutrition, but that this figure had now dropped to five or six. "Our statistics inside the hospital in Baghdad show that 40 percent of clinically treated children are suffering from malnutrition. But our medical sources in the south say 60 percent of them are suffering from malnutrition and of this number 80 percent are caused by untreated water," Ibrahim explained. Malnutrition is increasing in the south and cases are more critical in the under resourced suburbs of Baghdad due to poor sanitation, dirty water and an increase in cholera, doctors told IRIN. In order to help alleviate the problem, a group of medical students is volunteering their services in Baghdad and Basra. They are reaching out to communities, educating people about hygiene and how to prevent malnutrition. They teach mothers the importance of boiling water for drinking and alert them to the symptoms of cholera and malnutrition. "It's a nice preventive way to protect the child from reaching hospital in a chronic medical phase," Salah Abd-al-Hassan, one of the medical volunteers in Baghdad, told IRIN. "If all the Iraqi people, and especially the government, help us like these volunteers are, then we can be sure that our children are going to be safe in this country of war and blood," Youssef Al-Katabi, a father of six in Sadr city, told IRIN.