Cancer, not WMD, may be Saddam's legacy

A woman with a headscarf, her long-sleeved shirt pushed up high on her arm to make room for an intravenous injection of chemotherapy drugs, lies quietly on a bed at the Baghdad Cancer Hospital. Declining to give her name because she feels she will be stigmatised by her neighbours if they know of the breast cancer she is being treated for, the 48-year-old woman laughs sadly as she pulls at her headscarf. In her case, it covers the fact that her hair is falling out, the woman told IRIN. "I don't know how I got the cancer, but when I went to the hospital, they told me I had to have my breast removed," the woman said. "I feel better now, but I'm still very scared." Cancer, rather than weapons of mass destruction, appears to be the legacy of Saddam Hussein's decades of war. The number of cases has exploded in recent years, especially for breast cancer, which shot up by 21 percent in terms of reported cases between 1999 and 2000. Childhood leukaemia is also on the rise. It is eight to 10 times more prevalent in Iraqi children than in those of the same age in Europe, Ahmed Delli, director of the cancer registry section of the Iraqi Cancer Board, told IRIN. "Cancer is a new disease to the population, so it is a stigma," Delli said. "People don't want to go to the doctor because they are worried other people in the community will find out." In the mid-1990s breast cancer became Iraq's most common form of cancer, possibly because of pollution or some specific environmental factors that doctors haven't been able to figure out yet, Delli said. The number of cases more than doubled from 1989, when 763 breast cancers were reported, to 2000, when 1,765 were reported. "We need to educate women about breast cancer especially, so they can get checked," Delli said. "We need training, we need money, we need to create a national network across the country to teach people about this." But lung and throat cancers also rose rapidly, most probably fuelled by polluted air in much of the country and the large number of cigarette smokers, Delli said. Skin cancers also rose, as did colon-related diseases. Delli admits Iraq is still behind in gathering statistics, but points out that at least one of his colleagues is now in the United States to learn how to create a cancer registry so that new health programmes can teach residents what to do in various parts of the country where cancer has been prevalent in the past. He is also pushing three northern provinces that are currently administratively independent to turn over statistics to Baghdad. Private hospitals must also hand over their statistics to Iraq's socialised medical system, Delli said. "In 2001, preliminary reports showed we had nearly 13,000 new reported cases," Delli said. "Just think how much clearer a picture we could get if we had all the statistics, since we're only able to cover about 75 percent of the cases right now." Back at the cancer hospital, a little girl wearing a big, pink floppy hat sits on her father's lap, the hat covering her bald head. Other patients wait their turn for chemotherapy to be applied. Virtually all of the patients say they are afraid to tell relatives and neighbours they have various forms of cancer, which makes accurate reporting even harder, Delli said. "Even my mother doesn't know she has the disease," said Mehmet, 30, father of five-year-old Lela. Children with leukaemia are the saddest part of the rise in cancer, Delli said. Although no one has been able to do a study to confirm it, he believes the increase, especially in southern Iraq, is the result of bombing during the 1991 Gulf war. In addition, an increase in congenital deformities in newborns was tentatively linked to soldiers who fought in that war, Delli said, research that needs further study. He also wants to check further on rumours that contaminated food could have caused increases in colon-rectal cancers. "Cancer is usually related to ageing," Delli said. "We need to investigate, because we need to be careful with the information we have been given." Aid agencies and governments have offered to bring in more modern drugs for chemotherapy patients, to build new hospitals specifically for cancer patients, among other things. But with the rapid increase in car bombings and kidnappings in Iraq, foreign groups who made promises now follow up by e-mail from outside of the country, Delli said. "Our hope, as soon as the security status improves, is to do a mass screening and nationwide registry and surveillance," Delli said. "Then, we can start taking advantage of the offers made to us."