Humanitarian Situation in Iraq

November 6, 2000

On November 6, 2000, the Carnegie Endowment for International Peace International Migration Policy Program hosted a breakfast to discuss the humanitarian effects of the sanctions against Iraq. Mr. Beat Schweizer spoke; he is the head of the International Committee of the Red Cross's Delegation in Iraq. Kathleen Newland, co-director of the International Migration Policy Program, was the moderator.

Mr. Schweizer began by describing some of the current humanitarian problems in Iraq and the International Committee of the Red Cross's (ICRC) role in the country. The ICRC opened its office in Iraq in 1981. At the time, Iraq was a prosperous country, so the ICRC focused mainly on protecting and repatriating prisoners of war (POWs) from the war with Iran.

In 1991, the Gulf War began, and again the ICRC was heavily involved with the exchange of POWs. Some 67,000 prisoners were released and repatriated under the auspices of the ICRC; 60,000 of them were Iraqis. A tripartite commission was formed to deal with remaining missing persons and made some progress. However, Iraq withdrew from the commission after the 1998 United States bombings in Iraq.

In 1990, the United Nations imposed international trade sanctions against Iraq with UN resolution 661. In 1995, the UN Security Council passed resolution 986, approving the food-for-oil program. Thanks to that program, today Iraq can meet most of its basic food and medicine needs. The food-for-oil program allows Iraq to sell some oil, and the revenues from the sales go into an account managed by the United Nations. The Iraqi government may order numerous items such as food and equipment from abroad but may not spend the money in Iraq. Since 1995, the welfare of the Iraqi people has definitely improved. Food and medicines are widely available, and despite some problems, the distribution system generally works.

However, there are many problems the food-for-oil program cannot address. The first is a decline in infrastructure. Iraq built most of its modern infrastructure in the 1970s. In the last few years maintenance has been seriously neglected, due to lack of money, skills, and equipment. For example, ICRC visited a hospital in Basra where the water and sewage systems had completely broken down. Sewage leaked from the ceilings and into the walls. Mr. Schweizer commented that while the food-for-oil program allows hospitals to buy medical equipment, it is irrelevant if there is sewage in the operating areas.

A second problem is the shortage of skilled labor. Before the Gulf War, much of Iraq's work force was imported. Almost all foreign workers have left, and the sanctions do not allow the government to use oil money to pay salaries on the ground. There are a number of skilled workers in the most highly-skilled fields; however, one skill level below there are severe shortages. For example, there are enough doctors but very few nurses -- about one nurse per five doctors. There are good engineers but no one to implement their designs. The Iraqi government can order pumps from abroad for water treatment centers, but there is no one to install them. The ICRC is assisting with infrastructure repair, especially water systems and sanitation, but it is not a long-term solution. If they fix something, it will break again.

Primary health care facilities have broken down completely, for lack of workers. The well-educated doctors stay in the hospitals, and the newly educated doctors graduating from Iraqi schools have a very low level of education. In a grassroots attempt to improve health care, ICRC is training people on the job and working to get local communities involved.

Psychiatry and orthopedics are particularly neglected fields. There is only one major psychiatric facility, which mainly uses electroshock therapy on almost all its patients. ICRC is providing training in both areas and producing prostheses.

The northern autonomous zone of Iraq, which is controlled by two Kurdish parties -- the Kurdistan Democratic Party (KDP) and the Patriotic Union of Kurdistan (PUK) -- also benefits from the food-for-oil program. 13% of the revenues from Iraqi oil sales go to the north, a considerable amount since Iraq is expected to earn $14 billion this year in oil sales. The sanctions allow the Kurdish parties in the north to spend money on the ground, so their infrastructure is better than in government-controlled Iraq. However, the amount of money does not mean the people in the autonomous zones are better off than the rest of Iraq. "They are swimming in money," Schweizer said, but neither the UN agencies working there nor the Kurdish parties have the capacity to absorb it. The food-for-oil program has also destroyed the agricultural sector; under the sanction's rules, food must be imported, and everyone gets a food ration, so there is no incentive to farm.

Despite all the material problems, Schweizer said the most disturbing consequence of the embargo was the loss of a generation who grew up under the sanctions and now have no jobs, have never worked, and have no perspective. They have nothing to lose, which can have dangerous implications for the future.

After Schweizer concluded, members of the audience asked questions and discussed the issues he raised:

• Kathleen Newland asked if the Iraqi people were making the most of what they have. Schweizer said people on the ground, which includes government ministry workers, are working to make the best of the situation. However, the ministries have no decision making power. The government wants the UN to simply send the money from the oil revenues straight to it and account for it later, which is unacceptable to the UN and the US. He said it is essential to understand the importance of pride to the Iraqi people; it is sometimes more important than lives. Being forced to rely on humanitarian handouts, asking for permission to spend their money, and seeing UN workers with nice cars and salaries paid for with Iraqi money causes serious injury to their pride.
• Newland asked why the public education system has deteriorated since it does not rely on equipment installation and infrastructure. Schweizer said that many of the teachers were imported and have left. Demoralization is also a factor in the decline of public services, in general. There is collective depression; people feel that no matter what they do, they cannot improve anything. Many of the well-educated have left and are leaving. Those who once thought they could help have given up.
• Daniel Valle of the American Red Cross asked if the ICRC has faced any lack of respect or animosity? Schweizer responded that the ICRC is very well known in Iraq. The POWs who have returned all know the ICRC, and everyone knows someone who was a POW. Therefore, they have never felt animosity. The United Nations, on the other hand, is very unpopular. The Iraqi Red Crescent Society was strongly affecteby the sanctions; they were once financed mostly by oil. The ICRC is working to involve them more in community-based programs, with varying results.
• Another audience member asked what type of employment Iraqis without high levels of education had when Iraq imported many foreign workers. Schweizer pointed out that the Iraqis are known as traders, so many of them were involved in trade or owned small shops. In rural areas, they farmed. When the foreign workers left, some Iraqis learned their skills where there was a market for them, such as light manufacturing and mechanics. Before 1996, ICRC had to import most of the parts it needed, but in the last three or four years it has been able to get them inside Iraq, although there is still a lack of skilled workers. People do it because it pays, but the public sector pays almost nothing, so there is little incentive. Therefore, there is a great dirth of teachers, nurses, and cleaners.
• When asked what types of Iraqis are leaving, Schweizer said that it is the well-educated. The only obstacle for most people to leave is money. It costs between $400 and $500 to obtain an exit visa, something most Iraqis cannot afford.
• Jim Matlack from the American Friends Service Committee said that many people believe that the Iraqi government misallocates funds. His personal feeling was that there was a lot of confusion in the system but not systematic diversion. Schweizer said that the nearly sufficient quantities of food and medicine make the question of allocation less relevant now. The main problem is distribution. Iraq is a very centralized state, which depends on effective communication. If you need to order medicine in Najat, then you need to call Baghdad to get it. However, often phones and electricity do not work.
• Newland asked about child mortality rates. They are still dramatically high, but the cause is no longer lack of food and medicine. The problems now are contaminated water, poor nutrition, and lack of primary health care. If the primary health care centers are not operating or are too expensive, then the family will go to the hospital, but the hospital may be far away, so they wait a few days to see if the situation improves. By the time the child reaches health care, it may be too late to help.
• Newland asked how the situation would change if the embargo was completely lifted. Schweizer said people would not feel any difference at first; it would take several decades to return to normal. Training, rebuilding infrastructure, the affect on peoples' minds and the "lost generation" will all take time to fix and heal.
• Newland commented that it may be helpful to Saddam Hussein to have a scapegoat like the embargo to blame the country's problems on. Schweizer agreed, adding that pride has rallied people around the government.
• Valle asked about Iraq's relations with other Arab and Middle Eastern states. The strategy of the Iraqi government has been to improve relations with other Arab states. It hopes to weaken the embargo by convincing the Arab states to break or circumvent it. It has been successful with some countries, such as Jordan and some Gulf states. Relations with Iran are still tense. Relations with Saudi Arabic and Kuwait are still blocked, although improving with Saudi Arabia. The Arab states are increasingly uneasy with the embargo; they may not like Saddam Hussein but sympathize with the Iraqi people. The increased violence in the Palestinian territories has also increased feelings of Arab solidarity.

Summary by Kerry Boyd
Junior Fellow for the International Migration