More than 20,000 Iraqis dead since war started

A new report by in the international health charity Medact estimates that more than 20,000 Iraqi's have died between the start of the war and late last month. "The statistics were collated from different reports from aid agencies and we spoke to people on the ground," director of Medact, Mike Rowson told IRIN from London on Thursday. "The number of people affected by the aftermath of the war is still rising as the Iraqi people continue to pay the price in death, injury and mental and physical ill health," the report said. A report published at the end of October by the US-based research group, Project on Defence Alternatives maintained that some 13,000 Iraqis, including 4,300 non-combatants, were killed during the war. "Some of the signs in the report are alarming particularly those relating to the deterioration in health," Rowson said. The report says that public health services in Iraq are at an all time low. "Limited access to clean water and sanitation, as well as poverty, malnutrition, and disruption of public services including health services continue to have a negative impact on the health of the Iraqi people," said Dr Sabya Farooq, author of the report. Rowson said some of the reasons for deteriorating health were related to security. "People are too sacred to leave their houses in search of medical help," he explained. In addition to this services were in dire need of help with some 10 percent of hospitals looted since the war. Medact is calling on the occupying forces and the UN to continue investigations into the long-term impacts of the war and to ensure that there is proper funding for public services. "What is certain is that the health of civilians and combatants has suffered greatly and continues to suffer," the report said, highlighting the fact that the Geneva Convention enjoins occupying powers to protect people's health, but that the death toll continues to rise. According to the World Health Organisation (WHO) Iraq's people face a dual burden of disease - both communicable diseases like diarrhoea and respiratory infections, and non-communicable diseases like cancers and cardiovascular diseases. "The communicable diseases are most frequently affecting poorer people: they are contributing to high levels of child mortality. Because many people lack access to basic health services, maternal ill health and death rates are particularly high," Fadela Chaib, Media and Communications officer for WHO in Geneva told IRIN. Chaib said there were no recent holistic studies of the health situation after the war but that efforts were underway to establish diseases surveillance and health information system. "Many years of under-funding in the health sector, a major drop in recurrent budget during the last few years, the international economic and political sanctions, destruction to public services following the recent war and constant threats to security have all affected the functioning of the health system in different ways," she explained. However, WHO says there is no humanitarian health crisis in Iraq so far but that the health care delivery system is so vulnerable that any further deterioration in the socio-economic environment may lead to a health crisis. The health of the country's people is among the poorest in the region, and compatible to those of developing countries with a low performance of health services. Maternal and infant mortality and malnutrition are high, as are the levels of communicable diseases; non-communicable conditions - such as cancer and cardiovascular diseases. Over 20,000 mt of pharmaceuticals and medical supplies have been brought into Iraq in the last six months under the Oil for Food Programme, however, there are concerns over the deteriorating security situation which could affect efforts made to improve the health system. "WHO like the other UN agencies- operations in Iraq has been severely affected by the assessments of the levels of risk to their staff associated with continuing major operations in Iraq at this time," Chaib said, adding that they now draw on the immense expertise and skills of the Iraqi national staff. International staff provides back-up from Amman and Kuwait.