The Secret Behind the Sanctions
How the U.S. Intentionally Destroyed Iraq's Water Supply

by Thomas J. Nagy

Over the last two years, I've discovered documents of the Defense Intelligence Agency proving beyond a doubt that, contrary to the Geneva Convention, the U.S. government intentionally used sanctions against Iraq to degrade the country's water supply after the Gulf War. The United States knew the cost that civilian Iraqis, mostly children, would pay, and it went ahead anyway.

The primary document, "Iraq Water Treatment Vulnerabilities," is dated January 22, 1991. It spells out how sanctions will prevent Iraq from supplying clean water to its citizens.

"Iraq depends on importing specialized equipment and some chemicals to purify its water supply, most of which is heavily mineralized and frequently brackish to saline," the document states. "With no domestic sources of both water treatment replacement parts and some essential chemicals, Iraq will continue attempts to circumvent United Nations Sanctions to import these vital commodities. Failing to secure supplies will result in a shortage of pure drinking water for much of the population. This could lead to increased incidences, if not epidemics, of disease."

The document goes into great technical detail about the sources and quality of Iraq's water supply. The quality of untreated water "generally is poor," and drinking such water "could result in diarrhea," the document says. It notes that Iraq's rivers "contain biological materials, pollutants, and are laden with bacteria. Unless the water is purified with chlorine, epidemics of such diseases as cholera, hepatitis, and typhoid could occur."

The document notes that the importation of chlorine "has been embargoed" by sanctions. "Recent reports indicate the chlorine supply is critically low."

Food and medicine will also be affected, the document states. "Food processing, electronic, and, particularly, pharmaceutical plants require extremely pure water that is free from biological contaminants," it says.

The document addresses possible Iraqi countermeasures to obtain drinkable water despite sanctions.

"Iraq conceivably could truck water from the mountain reservoirs to urban areas. But the capability to gain significant quantities is extremely limited," the document states. "The amount of pipe on hand and the lack of pumping stations would limit laying pipelines to these reservoirs. Moreover, without chlorine purification, the water still would contain biological pollutants. Some affluent Iraqis could obtain their own minimally adequate supply of good quality water from Northern Iraqi sources. If boiled, the water could be safely consumed. Poorer Iraqis and industries requiring large quantities of pure water would not be able to meet their needs."

The document also discounted the possibility of Iraqis using rainwater. "Precipitation occurs in Iraq during the winter and spring, but it falls primarily in the northern mountains," it says. "Sporadic rains, sometimes heavy, fall over the lower plains. But Iraq could not rely on rain to provide adequate pure water."

As an alternative, "Iraq could try convincing the United Nations or individual countries to exempt water treatment supplies from sanctions for humanitarian reasons," the document says. "It probably also is attempting to purchase supplies by using some sympathetic countries as fronts. If such attempts fail, Iraqi alternatives are not adequate for their national requirements."

In cold language, the document spells out what is in store: "Iraq will suffer increasing shortages of purified water because of the lack of required chemicals and desalination membranes. Incidences of disease, including possible epidemics, will become probable unless the population were careful to boil water."

The document gives a timetable for the destruction of Iraq's water supplies. "Iraq's overall water treatment capability will suffer a slow decline, rather than a precipitous halt," it says. "Although Iraq is already experiencing a loss of water treatment capability, it probably will take at least six months (to June 1991) before the system is fully degraded."

This document, which was partially declassified but unpublicized in 1995, can be found on the Pentagon's web site at www.gulflink.osd.mil. (I disclosed this document last fall. But the news media showed little interest in it. The only reporters I know of who wrote lengthy stories on it were Felicity Arbuthnot in the Sunday Herald of Scotland, who broke the story, and Charlie Reese of the Orlando Sentinel, who did a follow-up.)

Recently, I have come across other DIA documents that confirm the Pentagon's monitoring of the degradation of Iraq's water supply. These documents have not been publicized until now.

The first one in this batch is called "Disease Information", and is also dated January 22, 1991. At the top, it says, "Subject: Effects of Bombing on Disease Occurrence in Baghdad." The analysis is blunt: "Increased incidence of diseases will be attributable to degradation of normal preventive medicine, waste disposal, water purification/distribution, electricity, and decreased ability to control disease outbreaks. Any urban area in Iraq that has received infrastructure damage will have similar problems."

The document proceeds to itemize the likely outbreaks. It mentions "acute diarrhea" brought on by bacteria such as E. coli, shigella, and salmonella, or by protozoa such as giardia, which will affect "particularly children," or by rotavirus, which will also affect "particularly children," a phrase it puts in parentheses. And it cites the possibilities of typhoid and cholera outbreaks.

The document warns that the Iraqi government may "blame the United States for public health problems created by the military conflict."

The second DIA document, "Disease Outbreaks in Iraq," is dated February 21, 1990, but the year is clearly a typo and should be 1991. It states: "Conditions are favorable for communicable disease outbreaks, particularly in major urban areas affected by coalition bombing." It adds: "Infectious disease prevalence in major Iraqi urban areas targeted by coalition bombing (Baghdad, Basrah) undoubtedly has increased since the beginning of Desert Storm. . . . Current public health problems are attributable to the reduction of normal preventive medicine, waste disposal, water purification and distribution, electricity, and the decreased ability to control disease outbreaks."

This document lists the "most likely diseases during next sixty-ninety days (descending order): diarrheal diseases (particularly children); acute respiratory illnesses (colds and influenza); typhoid; hepatitis A (particularly children); measles, diphtheria, and pertussis (particularly children); meningitis, including meningococcal (particularly children); cholera (possible, but less likely)."

Like the previous document, this one warns that the Iraqi government might "propagandize increases of endemic diseases."

The third document in this series, "Medical Problems in Iraq", is dated March 15, 1991. It says: "Communicable diseases in Baghdad are more widespread than usually observed during this time of the year and are linked to the poor sanitary conditions (contaminated water supplies and improper sewage disposal) resulting from the war. According to a United Nations Children's Fund (UNICEF)/World Health Organization report, the quantity of potable water is less than 5 percent of the original supply, there are no operational water and sewage treatment plants, and the reported incidence of diarrhea is four times above normal levels. Additionally, respiratory infections are on the rise. Children particularly have been affected by these diseases."

Perhaps to put a gloss on things, the document states, "There are indications that the situation is improving and that the population is coping with the degraded conditions." But it adds: "Conditions in Baghdad remain favorable for communicable disease outbreaks."

The fourth document, "Status of Disease at Refugee Camps," is dated May 1991. The summary says, "Cholera and measles have emerged at refugee camps. Further infectious diseases will spread due to inadequate water treatment and poor sanitation."

The reason for this outbreak is clearly stated again. "The main causes of infectious diseases, particularly diarrhea, dysentery, and upper respiratory problems, are poor sanitation and unclean water. These diseases primarily afflict the old and young children."

The fifth document, "Health Conditions in Iraq, June 1991," is still heavily censored. All I can make out is that the DIA sent a source "to assess health conditions and determine the most critical medical needs of Iraq. Source observed that Iraqi medical system was in considerable disarray, medical facilities had been extensively looted, and almost all medicines were in critically short supply."

In one refugee camp, the document says, "at least 80 percent of the population" has diarrhea. At this same camp, named Cukurca, "cholera, hepatitis type B, and measles have broken out."

The protein deficiency disease kwashiorkor was observed in Iraq "for the first time," the document adds. "Gastroenteritis was killing children. . . . In the south, 80 percent of the deaths were children (with the exception of Al Amarah, where 60 percent of deaths were children)."

The final document is "Iraq: Assessment of Current Health Threats and Capabilities," and it is dated November 15, 1991. This one has a distinct damage-control feel to it. Here is how it begins: "Restoration of Iraq's public health services and shortages of major medical materiel remain dominant international concerns. Both issues apparently are being exploited by Saddam Hussein in an effort to keep public opinion firmly against the U.S. and its Coalition allies and to direct blame away from the Iraqi government."

It minimizes the extent of the damage. "Although current countrywide infectious disease incidence in Iraq is higher than it was before the Gulf War, it is not at the catastrophic levels that some groups predicted. The Iraqi regime will continue to exploit disease incidence data for its own political purposes."

And it places the blame squarely on Saddam Hussein. "Iraq's medical supply shortages are the result of the central government's stockpiling, selective distribution, and exploitation of domestic and international relief medical resources." It adds: "Resumption of public health programs . . . depends completely on the Iraqi government."

As these documents illustrate, the United States knew sanctions had the capacity to devastate the water treatment system of Iraq. It knew what the consequences would be: increased outbreaks of disease and high rates of child mortality. And it was more concerned about the public relations nightmare for Washington than the actual nightmare that the sanctions created for innocent Iraqis.

The Geneva Convention is absolutely clear. In a 1979 protocol relating to the "protection of victims of international armed conflicts," Article 54, it states: "It is prohibited to attack, destroy, remove, or render useless objects indispensable to the survival of the civilian population, such as foodstuffs, crops, livestock, drinking water installations and supplies, and irrigation works, for the specific purpose of denying them for their sustenance value to the civilian population or to the adverse Party, whatever the motive, whether in order to starve out civilians, to cause them to move away, or for any other motive."

But that is precisely what the U.S. government did, with malice aforethought. It "destroyed, removed, or rendered useless" Iraq's "drinking water installations and supplies." The sanctions, imposed for a decade largely at the insistence of the United States, constitute a violation of the Geneva Convention. They amount to a systematic effort to, in the DIA's own words, "fully degrade" Iraq's water sources.

At a House hearing on June 7, Representative Cynthia McKinney, Democrat of Georgia, referred to the document "Iraq Water Treatment Vulnerabilities" and said: "Attacking the Iraqi public drinking water supply flagrantly targets civilians and is a violation of the Geneva Convention and of the fundamental laws of civilized nations."

Over the last decade, Washington extended the toll by continuing to withhold approval for Iraq to import the few chemicals and items of equipment it needed in order to clean up its water supply.

Last summer, Representative Tony Hall, Democrat of Ohio, wrote to then-Secretary of State Madeleine Albright "about the profound effects of the increasing deterioration of Iraq's water supply and sanitation systems on its children's health." Hall wrote, "The prime killer of children under five years of age--diarrheal diseases--has reached epidemic proportions, and they now strike four times more often than they did in 1990. . . . Holds on contracts for the water and sanitation sector are a prime reason for the increases in sickness and death. Of the eighteen contracts, all but one hold was placed by the U.S. government. The contracts are for purification chemicals, chlorinators, chemical dosing pumps, water tankers, and other equipment. . . . I urge you to weigh your decision against the disease and death that are the unavoidable result of not having safe drinking water and minimum levels of sanitation."

For more than ten years, the United States has deliberately pursued a policy of destroying the water treatment system of Iraq, knowing full well the cost in Iraqi lives. The United Nations has estimated that more than 500,000 Iraqi children have died as a result of sanctions, and that 5,000 Iraqi children continue to die every month for this reason.

No one can say that the United States didn't know what it was doing.




source:
http://www.progressive.org/0801issue/nagy0901.html

see also Depleted Uranium

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IRAQ WATER TREATMMENT VULNERABILITIES (U)     

Filename:511rept.91


DTG: 221900Z JAN 91

FM: DIA WASHINGTON DC
VIA: NMIST NET
TO: CENTCOM
INFO: CENTAF					  
      UK STRIKE COMMAND
      MARCENT
      18 ABC
      NAVCENT
      SOCCENT
      7TH CORPS
      ANKARA

       

SUBJECT: IRAQ WATER TREATMMENT VULNERABILITIES (U)     
         AS OF 18 JAN 91 KEY JUDGMENTS.

1.     IRAO DEPENDS ON IMPORTING-SPECIALIZED EQUIPMENT-AND 
SOME CHEMICALS TO PURIFY ITS WATER SUPPLY, MOST OF WHICH IS 
HEAVILY MINERALIZED AND FREQUENTLY BRACKISH TO SALINE.
2.     WITH NO DOMESTIC SOURCES OF BOTH WATER TREATMENT	
 REPLACEMENT PARTS AND SOME ESSENTIAL CHEMICALS, IRAO WILL
CONTINUE ATTEMPTS TO CIRCUMVENT UNITED NATIONS SANCTIONS TO
IMPORT THESE VITAL COMMODITIES.
3.     FAILING TO SECURE SUPPLIES WILL RESULT IN A SHORTAGE OF
PURE DRINKING WATER FOR MUCH OF THE POPULATION. THIS COULD LEAD
TO INCREASED INCIDENCES, IF NOT EPIDEMICS, OF DISEASE AND TO
CERTAIN PURE-WATER-DEPENDENT INDUSTRIES BECOMING INCAPACITATED,
INCLUDING PETRO CHEMICALS, FERTILIZERS, PETROLEUM REFINING,
ELECTRONICS,PHARMACEUTICALS, FOOD PROCESSING, TEXTILES, CONCRETE
CONSTRUCTION,AND THERMAL POWERPLANTS.
4.     IRAQ'S OVERALL WATER TREATMENT CAPABILITY WILL SUFFER A
SLOW DECLINE, RATHER THAN A PRECIPITOUS HALT, AS DWINDLING
SUPPLIES AND CANNIBALIZED PARTS ARE CONCENTRATED AT HIGHER
PRIORITY LOCATIONS. ALTHOUGH IRAQ IS ALREADY EXPERIENCING A LOSS
OF WATERTREATMENT CAPABILITY, IT PROBABLY WILL TAKE AT LEAST SIX
MONTHS (TO JUNE 1991) BEFORE THE SYSTEM IS FULLY DEGRADED.
5.     UNLESS WATER TREATMENT SUPPLIES ARE EXEMPTED FROM THE
UNSANCTIONS FOR HUMANITARIAN REASONS, NO ADEQUATE SOLUTION
EXISTS FOR IRAQ'S WATER PURIFICATION DILEMMA, SINCE NO SUITABLE
ALTERNATIVES,INCLUDING LOOTING SUPPLIES FROM KUWAIT,
SUFFICIENTLY MEET IRAQI NEEDS.)
6.     IRAQI WATER QUALITY. SURFACE WATER FROM THE TIGRIS AND
EUPHRATES RIVER SYSTEM SUPPLIES ABOUT HALF OF IRAQ'S LAND
AREA,INCLUDING URBAN AREAS AND THEIR ASSOCIATED INDUSTRIES.
IRAQ'S REMAINING AREA, PRIMARILY RURAL, RELIES ON GROUND WATER
FROM WELLS.THE QUALITY OF UNTREATED WATER THROUGHOUT THE COUNTRY
VARIES WIDELY BUT GENERALLY IS POOR. HEAVY MINERALIZATION,
SUSPENDED SOLIDS AND,FREQUENTLY, HIGH SALINITY CHARACTERIZE
IRAQ'S WATER SUPPLY.ALTHoUGH IRAQ HAS MADE A CONSIDERABLE EFFORT
TO SUPPLY PURE WATER TO ITS POPULATION, THE WATER TREATMENT
SYSTEM WAS UNRELIABLE EVEN BEFORE THE UNITED NATIONS SANCTIONS
SALINITY CHARACTERIZE IRAO'S WATER SUPPLY.ALTHOUGH IRAQ HAS
MADE A CONSIDERABLE EFFORT TO SUPPLY PURE WATER TO ITS
POPULATION, THE WATER TREATMENT SYSTEM WAS UNRELIABLE EVEN
BEFORE THE UNITED NATIONS SANCTIONS WERE IMPOSED. MOST IRAQIS
PREFER TO DRINK IMPORTED BOTTLED WATER.
7. THE MINERALS IN THE WATER INCLUDE CONCENTRATIONS OF
CARBONATES, SULPHATES, CHLORIDES, AND, IN SOME LOCATIONS,
NITRATES.DRINKING HEAVILY MINERALIZED WATER COULD RESULT IN
DIARRHEA AND,OVER THE LONG TERM, STONES FORMING WITHIN THE
BODY. FOR INDUSTRIAL APPLICATIONS, PIPES AND OTHER EOUIPMENT
WOULD SCALE (BECOME ENCRUSTED), EVENTUALLY CAUSING PLANTS TO
SHUT DOWN. SCALING IN BOILERS WOULD CAUSE EXPLOSIONS IF NOT
PREVENTED OR REMOVED.
8.     MUCH OF IRAO'S GROUND WATER SUPPLIES ARE BRACKISH TO
SALINE. THE,LARGE RESERVOIRS NEAR BAGHDAD--THE THARTHAR, -	
HABBANIYAH, AND AL MILH LAKES--ARE SALINE. SINCE THESE LAKES
SERVE AS CATCH BASINS FOR FLOODS ON  THE TIGRIS AND EUPHRATES
RIVERS, THE IRAOIS MUST REDUCE THE WATER VOLUME IN-THE LAKES
DURING THE LOW-WATER SEASON. EVAPARATlON DURING THE SUMMER	-
ACCOMPLISHES THIS IMPART.  SINCE REDUCING THE WATER VOLUME IN
THE LAKES ONLY INCREASES SALINITY, THE IRAQIS FLUSH THE LAKES
BY DIVERTING FRESH WATER FROM UP STREAM ON THE TIGRIS AND
EUPHRATES. THE FLOW IS DISCHARGED FURTHER DOWNSTREAM TO AVOID
FILLING THE BASINS. SINCE THE DISCHARGE OCCURS WHERE THE
RIVERS ENTER THE MESOPOTAMIAN PLAIN, THE DISCHARGE INCREASES
THE NATURAL SALINITY OF THE WATERS DOWNSTREAM, AFFECTING
IRRIGATED AGRICULTURAL LANDS IRAQ SPECIALIZES IN		-
SALINE-RESISTANT CROPS SUCH AS BARLEr AND DATES) AND URBAN
AREAS, INCLUDING BAGHDAD.THE KARKH WATER TREATMENT PROJECT FOR
WESTERN BAGHDAD HAS AN IN TAKE POINT ABOUT 40 KILOMETERS NORTH
OF BAGHDAD, UPSTREAM FROM WHERE LAKE THARTHAR DISCHARGES INTO
THE TIGRIS. WATER BELOW THE DISCHARGE POINT REQUIRES
DESALINIZATION.
9.     AT BASRAH, THE SHATT AL ARAB TENDS TO BE SALINE UNDER
CONDITIONS OF LOW-RIVER WATER VOLUMES AND DEPENDING ON TIDE
AND WIND DIRECTIONS. NORMALLY, THE SHATT AL ARAB AT BASRAH HAS
A SALINITY OF 1,500 TO 2,000 PARTS PER MILLION (PPM). SALINITY
HAS BEEN INCREASING OVER THE LAST 5 YEARS, AND IN THE FALL
1989, THE SALINITY HAD REACHED 6,000 TO 7,000 PPM, HIGHER THAN
EXISTING DESALINIZATION SYSTEMS COULD HANDLE. (OCEAN SEAWATER
IS ABOUT 36,000 PPM OF DISSOLVED SALTS; THE PERSIAN GULF IS
APPROXIMATELY 42,000 PPM.BRACKISH WATER IS A MINIMUM OF 1,000
PPM. THE WORLD HEALTH ORGANIZATION STANDARD FOR HUMAN
CONSUMPTION IS 500 PPM OR LESS.GROUND WATER IN IRAO'S LOWER
MESOPOTAMIAN BASIN RANGES FROM 5,000 TO 60,000 PPM, WITH SOME
LOCATIONS REACHING 80,000). SALINE WATER IS UNFIT FOR DRINKING
AND CORRODES INDUSTRIAL PIPES OR OTHER EXPOSED EQUIPMENT.
10. (U) SUSPENDED SOLIDS, PRIMARILY SILT, IN THE TIGRIS AND
EUPHRATES RIVER SYSTEM INCREASE WITH WATER VOLUME. UNLESS
REMOVED FROM THE WATER, THESE PARTICLES WOULD CLOG PIPES AND
FILTERS AND WOULD REQUIRE STRAINING BEFORE CONSUMPTION BY END
USERS.
11.     IRAQ'S RIVERS ALSO CONTAIN BIOLOGICAL
MATERIALS,POLLUTANTS, AND ARE LADEN WITH BACTERIA. UNLESS THE



WATER IS PURIFIED WITH CHLORINE  EPIDEMICS OF SUCH DISEASES AS
CHOLERA,HEPATITIS, AND TYPHOID COULD OCCUR.)
12.     WATER TREATMENT REGIMES. WATER TREATMENT IS SPECIFIC
TO THE IMPURITIES OF THE WATER TREATED AND TO THE APPLICATION
FOR WHICH THE WATER WILL BE USED. THE BASIC PROCESS REQUIRES
CLARIFICATION (REMOVING SUSPENDED SOLIDS), FILTRATION, AND, 
FOR
DRINKING AND SOME INDUSTRIAL USES, PURIFICATION. IN IRAQ, THE
PROCESS ALSO INCLUDES DESALINATING AND WATER SOFTENING.
13.     CLARIFICATION REQUIRES ADDING FLOCCULANTS AND
COAGULANTS TO THE WATER. THE IRAOIS USE ALUMINUM SULPHATE
ALTHOUGH IRON SULPHATES ARE ACCEPTABLE TO BIND THE SUSPENDED
SOLIDS INTO CLUMPS FOR SETTLING. IF NOT REMOVED, THE
SEDIMENTS, OR SLUDGE, WOULD CLOG THE FILTRATION SYSTEM
(PROBABLY SAND) AND SHUT DOWN THE WATER PURIFICATION PLANT
UNTIL THE CLOGS WERE REMOVED. ALUMINUM SULPHATE SUPPLY LEVELS 
ARE KNOWN TO BE CRITICALLY LOW, SINCE IRAQ TRIED AND FAILED TO
OBTAIN PRECURSOR CHEMICALS FROM JORDAN FOR ITS MANUFACTURE.
14.  CHLORINATION NORMALY IS ACCOMPLISHED DURING SEVERAL
STAGES OF PURIFICATION, INCLUDING THE INITAL TREATMENT STAGE
TO PREVENT THE EQUIPMENT FROM LIMING AND TO KILL PATHOGENS 
JUST PRIOR TO STORING  THE FULLY TREATED WATER. THE CHLORINE
USED IN MOST PLANTS IS EITHER SODIUM HYPOCHLORITE, A LIOUID,
OR CALCIUM HYPOCHLORITE, A POWDER. IF THEY ARE EQUIPPED WITH
INJECTORS, LOW-CAPACITY PLANTS CAN USE CHLORINE GAS DIRECTLY.
IRAO'S PLANT IN FALLUJA AND THE PC-I PETROCHEMICAL PLANT AT
BASRAH PRODUCE SODIUM HYPOCHLORITE AND, AS A BY-PRODUCT,
CAUSTIC SODA, WHICH IS USED TO ADJUST THE PH OF WATER
SUPPLIES. NORMALLY, BOTH LOCATIONS PRODUCE RELATIVELY SMALL
QUANTITIES OF CHLORINE FOR INDUSTRIAL AND SOME MUNICIPAL USE;
CHLORINE FOR MUNICIPAL SUPPLIES ALSO IS IMPORTED.RECENT
REPORTS INDICATE THE CHLORINE SUPPLY IS CRITICALLY LOW. ITS
IMPORTATION HAS BEEN EMBARGOED, AND BOTH MAIN PRODUCTION
PLANTS EITHER HAD BEEN SHUT DOWN FOR A TIME OR HAVE BEEN
PRODUCING MINIMAL OUTPUTS BECAUSE OF THE LACK OF IMPORTED
CHEMICALS AND THE INABILITY TO REPLACE PARTS. PREVIOUSLY WHEN
SUPPLIES WERE LOW, THE IRAQI SHAVE STOPPED CHLORINATING THE
DRINKING WATER, BUT ONLY FOR SHORT PERIODS. TO RETARD ALGAE
GROWTH, WHICH COULD CLOG PIPES, COPPER SULPHATE NORMALLY IS
ADDED TO THE WATER. BUT THIS PRACTICE HAS NOT BEEN VERIFIED IN
IRAO, AND SUPPLIES OF COPPER SULPHATE ARE UNKNOWN.SULFURIC
ACID TYPICALLY IS ADDED AS WELL, BUT IRAQ PROBABLY CAN PRODUCE
SUFFICIENT SUPPLIES.
15.    IRAQ APPARENTLY USES LIME, AT LEAST AT THE NEW KARKH
TREATMENT PLANT, TO SOFTEN WATER. THE LIME PRECIPITATES
COLLOIDAL CARBONATE IMPURITIES FROM THE WATER. SODA ASH AND
ZEOLITES ALSO NORMALLY ARE USED TO REMOVE NONCARBONATE MINERAL
IMPURITIES, BUT THEIR USE IN IRAO HAS NOT BEEN DETERMINED.
LOCAL COMPANIES SELL BOTTLED SOFT WATER IN IRAO, SUGGESTING
THAT MUNICIPAL WATER SYSTEMS DO NOT NORMALLY SOFTEN WATER.
IRAQ SHOULD HAVE NO SHORTAGES OF LIME. HOWEVER, THE LACK OF
SOFTENING CHEMICALS REPORTEDLY HAS INCAPACITATED THE BOTTLED
SOFT-WATER INDUSTRY.
16.     BETWEEN 1982 AND 1990, SOME IRAOI INDUSTRIES INSTALLED
REVERSIBLE ION EXCHANGE ELECTRODIALYSIS MEMBRANE SYSTEMS,

OBTAINED FROM AN AMERICAN SOURCE, TO SOFTEN AND DESALINATE
WATER. THE MEMBRANES LAST 5 TO 7 YEARS AND DO NOT REQUIRE
CHEMICAL PRETREATMENT OF THE WATER. THEY NORMALLY SERVE
SMALLER VOLUME REQUIREMENTS.HOWEVER, A MAJOR OIL REFINERY, AL
DAURA IN BAGHDAD, INSTALLED THIS SYSTEM IN 1985, AND IT
PRODUCES 24,000 CUBIC METERS OF PURIFIED WATER PER DAY.
17.     ABOUT ONE QUARTER OF ALL IRAOI WATER SUPPLIED FOR
INDUSTRIAL AND HUMAN CONSUMPTION REQUIRES DESALINIZATION. IRAO
RELIES ALMOST EXCLUSIVELY ON ION EXCHANGE OR REVERSE OSMOSIS
SYSTEMS RATHER THAN MULTISTAGE FLASH UNITS. ION EXCHANGE AND
REVERSE OSMOSIS MEMBRANES ARE SPECIFIC TO THE TYPE OF
EQUIPMENT OF WHICH THEY ARE A COMPONENT, AS ARE THE CHEMICALS
REOUIRED. PREVIOUS IRAQI USE OF SUBSTITUTES HAS NOT BEEN
SATISFACTORY. IRAO REPORTEDLY DEPENDS ON IMPORTED MEMBRANES
AND IMPORTS CHEMICALS FROM SEVERAL SOURCES. IRAQ HAD NOT 
COMPLETED THE MAJOR PURCHASE AND DELIVERY OF SPARE MEMBRANES
BEFORE INVADING KUWAIT. ATTEMPTS TO PROCURE MEMBRANES SINCE 
THE UN SANCTIONS WERE IMPOSED HAVE FAILED. SINCE THE ATTEMPT 
TO IMPORT MEMBRANES CORRESPONED TO THEIR NORMAL REPLACEMENT PERIOD, IRAQ 
APPARENTLY DID NOT STOCKPILE  ABUNDANT SPACE MEMBRANES OR CHEMICALS AND 
PROBABLY HAD NO MORE THAN A 2-MONTH SUPPLY PRIOR TO THE INVASION. 
18.     POLYAMIDE MEMBRANES WHICH IRAO USES IN SOME 
DESALINIZATION EOUIPMENT, DETERIORATE WHEN EXPOSED TO CHLORINE
IONS.PRIOR TO PASSING THROUGH THE MEMBRANE, WAT-ER IS TREATED
WITH SODIUM METABISULPHITE TO REMOVE THE CHLORINE USED IN
PRETREATMENT. THE CHLORINE THEN IS RE-STORED FOR LATER
PURIFICATION. THE STATUS OF SODIUM METABISULPHITE SUPPLIES IS
NOT KNOWN, BUT SUPPLIES PROBABLY ARE DWINDLING, WHICH WILL
ESCALATE FAILURES OF THIS MEMBRANE TYPE.IRAO ALSO USES
CELLULOSE ACETATE MEMBRANES (AN OLD TECHNOLOGY),WHICH HAVE AN
EXCEPTIONALLY SHORT LIFE AND ARE SUSCEPTIBLE TO BIOLOGICAL
CONTAMINATION. IRAO REPORTEDLY CAN MANUFACTURE CELLULOSE
MEMBRANES, BUT THE AVAILABILITY OF PRECURSOR STOCKS IS
PROBABLY LOW.IRAQ HAD BEEN ACOUIRING REVERSE ELECTRODIALYSIS
ION EXCHANGE MEMBRANES PRIOR TO THE UN SANCTIONS. HOWEVER,
MOST SYSTEMS USE REVERSE OSMOSIS OR UNIDIRECTIONAL
ELECTRODIALYSIS, WHICH, UNLIKE REVERSE ELECTRODIALYSIS
MEMBRANES, REOUIRE CHEMICALS TO MAKE THEM WORK.)
19.    INDUSTRIAL WATER TREATMENT. INDUSTRIES REQUIRE TREATED
WATER, AND THE TYPE OF TREATMENT DEPENDS ON THE
APPLICATION. NORMALLY, SOFTENING AND DESALINIZATION ARE
REOUIRED TO PREVENT PIPE SAND EOUIPMENT FROM CORRODING OR
SCALING. IN THE PETRO CHEMICAL INDUSTRY, WATER USED FOR
COOLING IS PARTIALLY TREATED TO PREVENT SCALING. WATER USED IN
THERMAL POWERPLANTS OR REFINERIES TO PRODUCE STEAM MUST BE
PURE TO PREVENT BOTH CORROSION AND SCALING.OTHERWISE, LOSS OF
CAPABILITY COULD OCCUR WITHIN 2 MONTHS. IN ADDITION, FOOD
PROCESSING, ELECTRONIC, AND, PARTICULARLY,PHARMACEUTICAL
PLANTS REOUIRE EXTREMELY PURE WATER THAT IS FREE FROM
BIOLOGICAL CONTAMINANTS. LARGE INDUSTRIAL PLANTS, INCLUDING
PETROCHEMICAL, REFINING, AND FERTILIZER PLANTS, COLLOCATE
THEIR WATER TREATMENT FACILITIES. TURNKEY CONTRACTORS BUILT
THESE FACILITIES, AND THE PARTS ARE SPECIFIC TO EACH SYSTEM,
WHICH COMPLICATES THEIR REPLACEMENT. THE IRAOIS COULD NOT
MANUFACTURE DUPLICATES AND THEIR IMPORTATION IS EMBARGOED.)
20.     IRAQI ALTERNATIVES. IRAQ COULD TRY CONVINCING THE
UNITED NATIONS OR INDIVIDUAL COUNTRIES TO EXEMPT WATER
TREATMENT SUPPLIES FROM SANCTIONS FOR HUMANITARIAN REASONS. IT
PROBABLY ALSO IS ATTEMPTING TO PURCHASE SUPPLIES BY USING SOME
SYMPATHETIC COUNTRIES AS FRONTS. IF SUCH ATTEMPTS FAIL, IRAQI
ALTERNATIVES ARE NOT ADEOUATE FOR THEIR NATIONAL REOUIREMENTS.
21.     VARIOUS IRAOI INDUSTRIES HAVE WATER TREATMENT CHEMICAL
SAND EQUIPMENT ON HAND, IF THEY HAVE NOT ALREADY BEEN CONSUMED
OR BROKEN. IRAO POSSIBLY COULD CANNIBALIZE PARTS OR ENTIRE
SYSTEMS FROM LOWER TO HIGHER PRIORITY PLANTS, AS WELL AS
DIVERT CHEMICALS,SUCH AS CHLORINE. HOWEVER, THIS CAPABILITY
WOULD BE LIMITED AND TEMPORARY. IRAQ PREVIOUSLY HAD ACQUIRED
SEVERAL HUNDRED CONTAINERIZED REVERSE OSMOSIS MODULES FOR		'
LOCALIZED USE THAT COULD BE RELOCATED. WITHOUT CHEMICALS AND
REPLACEMENT MEMBRANES, THESE UNITS WHERE EVENTUALLY WOULD BECOME
USELESS. HOWEVER, CONSOLIDATING CHEMICALS OR CANNIBALIZING
PARTS AND MOVING UNITS WHERE NECESSARY COULD SUSTAIN SOME
PURIFICATION OPERATIONS INDUSTRIAL PLANTS THAT ARE INOPERABLE
FOR REASONS-OTHER THAN THE LACK OF WATER TREATMENT SUPPLIES
COULD PROCESS WATER FOR MUNICIPAL NEEDS OR POSSIBLY RELOCATE
THEIR PURIFICATION EOUIPMENT.
22.     THE DIFFERENCE IN WATER TREATMENT SYSTEMS LIMITS THE
BENEFITS TO IRAQ OF PLUNDERING KUWAIT'S WATER TREATMENT
CHEMICALS.  THE KUWAITIS RELY PRIMARILY ON DESALINATING
SEAWATER, AND THEIR WATER NEEDS ARE CONSIDERABLY SMALLER THAN
IRAQ'S. IRAQ COULD NOT USE CHEMICALS INTENDED FOR KUWAITI
WATER TREATMENT SYSTEMS, EXCEPT FOR LIMITED QUANTITIES OF
CHLORINE. ATTEMPTS TO CIRCUMVENT THE SANCTIONS TO OBTAIN WATER
TREATMENT CHEMICALS SUGGEST THAT ANY USEFUL SUPPLIES FROM
KUWAIT ALREADY HAVE BEEN LOOTED AND USED.
23.     IRAO HAS INSTALLED A PIPELINE FROM THE DOHA
DESALINIZATION PLANT IN KUWAIT THAT CONNECTS WITH DISTRIBUTION
PIPES AT A WATERTREATMENT PLANT NEAR BASRAH. THIS SOURCE OF
PURE WATER APPARENTLY HAS ENABLED THE PC-I PETROCHEMICAL PLANT
TO OPERATE AND TO PRODUCE CHLORINE BY ELECTROLYSIS OF KUWAITI
WATER MIXED WITH PURE SODIUM CHLORIDE. AT LEAST SOME OF THIS
CHLORINE PROBABLY IS USED FOR MUNICIPAL WATER PURIFICATION,
BUT THE OUANTITY PRODUCED WOULD BE INADEOUATE FOR NATIONAL
REOUIREMENTS. MOREOVER, SOME OF THE CHLORINE PROBABLY IS USED
AT THE PC-I PLANT TO MAKE POLYVINYL CHLORIDES TO CREATE THE
PLASTIC SHEETS USED IN AGRICULTURAL PRODUCTION. THE USE OF
KUWAITI WATER PROBABLY WILL NOT LAST LONG SINCE THE DOHA PLANT
USES THE MULTISTAGE FLASH DESALINIZATION PROCESS, WHICH
REOUIRES ACID DOSING OR THE ADDITION OF POLYMERS TO PREVENT
SCALING OF THE HEAT EXCHANGES. THE UN SANCTIONS MAY PREVENT
RESUPPLY OF THESE CHEMICALS. INTENSIVE MAINTENANCE ALSO IS
REOUIRED TO KEEP THE UNITS OPERATING, AND THAT PROBABLY WOULD
REOUIRE THE SERVICES OF TRAINED KUWAITI EMPLOYEES SINCE IRAQ
HAS LITTLE EXPERIENCE WITH MULTISTAGE FLASH UNITS.
24.     IRAQ'S BEST SOURCES OF QUALITY WATER ARE IN THE
MOUNTAINS OF THE NORTH AND NORTHEAST, WHERE MINERALIZATION AND
SALINITY ARE WITHIN ACCEPTABLE LIMITS. FOR THE SHORT TERM,
                                          
IRAO CONCEIVABLY COULD TRUCK WATER FROM THE MOUNTAIN
RESERVOIRS TO URBAN AREAS. BUT THE CAPABILITY TO GAIN
SIGNIFICANT QUANTITIES IS EXTREMELY LIMITED. THE AMOUNT OF PIPE
ON HAND AND THE LACK OF PUMPING STATIONS WOULD LIMIT LAYING
PIPELINES TO THESE RESERVOIRS. MOREOVER, WITHOUT CHLORINE
PURIFICATION, THE WATER STILL WOULD CONTAIN BIOLOGICAL
POLLUTANTS. SOME AFFLUENT IRAQIS COULD OBTAIN THEIR OWN
MINIMALLY ADEQUATE SUPPLY OF GOOD OUALITY WATER FROM NORTHERN
IRAOI SOURCES.IF BOILED, THE WATER COULD BE SAFELY CONSUMED.
POORER IRAQIS AND INDUSTRIES REQUIRING LARGE OUANTITIES OF PURE
WATER WOULD NOT BE ABLE TO MEET THEIR NEEDS.
25.     PRECIPITATION OCCURS IN IRAQ DURING THE WINTER AND
SPRING,BUT IT FALLS PRIMARILY IN THE NORTHERN MOUNTAINS.
SPORADIC RAINS,SOMETIMES HEAVY , FALL OVER THE LOWER PLAINS.
BUT IRAQ COULD NOT RELY ON RAIN TO PROVIDE ADEQUATE PURE
WATER.
26.     THE SALINE OR ALKALINE CONTENT-OF GROUND WATER IN MOST
LOCATIONS WOULD CONSTRAIN DRILLING WELLS IN THE MESOPOTAMIAN
PLAIN TO OBTAIN PURER WATER MOREOVER, MUCH OF THE POPULATION
USES SEPTIC TANKS, AND THE UNDERLYING GEOLOGY AND TOPOGRAPHY 
WOULD CONTAMINATE WELLS IN MANY LOCATIONS.))OUTLOOK)
27.     IRAQ WILL SUFFER INCREASING SHORTAGES OF PURIFIED
WATER BECAUSE OF THE LACK OF REOUIRED CHEMICALS AND
DESALINIZATION MEMBRANES. INCIDENCES OF DISEASE, INCLUDING
POSSIBLE EPIDEMICS,WILL BECOME PROBABLE UNLESS THE POPULATION
WERE CAREFUL TO BOIL WATER BEFORE CONSUMPTION, PARTICULARLY
SINCE THE SEWAGE TREATMENT SYSTEM, NEVER A HIGH PRIORITY, WILL
SUFFER THE SAME LOSS OF CAPABILITY WITH THE LACK OF CHLORINE.
LOCALLY PRODUCED FOOD AND MEDICINE COULD BE CONTAMINATED. LACK
OF COAGULATION CHEMICALS WILL CAUSE PERIODIC SHUTDOWNS OF
TREATMENT PLANTS FOR UNCLOGGING AND CLEANING FILTERS, CAUSING
INTERRUPTIONS OF WATER SUPPLIES. AS DESALINIZATION EQUIPMENT
BECOMES INOPERABLE, SALINE WATER SOURCES WILL BECOME
INCREASINGLY UNUSABLE. TEMPORARY OR PERMANENT SHUT DOWNS OF
INDUSTRIAL PLANTS THAT RELY ON TREATED WATER WILL
MULTIPLY.CANNIBALIZING LOWER PRIORITY OPERATIONS WILL
ACCELERATE THE TREND.
28.     THE ENTIRE IRAOI WATER TREATMENT SYSTEM WILL NOT
COLLAPSE PRECIPITOUSLY, BUT ITS CAPABILITIES WILL DECLINE
STEADILY AS DWINDLING SUPPLIES INCREASINGLY ARE DIVERTED TO
HIGHER PRIORITY SITES WITH COMPATIBLE EQUIPMENT. KARKH, IRAO'S
LARGEST WATERTREATMENT PLANT (AND ONE OF THE WORLD'S LARGEST),
WAS DESIGNED TO STORE 30 DAYS OF SUPPLIES ON SITE. THE
QUANTITY OF SUPPLIES, IF ANY, NORMALLY STOCKPILED IN
CENTRALIZED WAREHOUSES BEFORE SHIPMENT TO TREATMENT PLANTS IS
UNKNOWN, BUT A 6 MONTH TO I YEAR SUPPLY OF CHEMICALS IS THE
NORMAL INDUSTRIAL PRACTICE. HOWEVER, CURRENT IRAQI EFFORTS TO
OBTAIN CHEMICALS AND MEMBRANES AND THE INSTALLATION OF A
PIPELINE TO OBTAIN PURE KUWAITI WATER SUGGEST THAT THERE WAS
NOT ADEOUATE STOCKPILING PRIOR TO THE INVASION OF KUWAIT. SOME
CHEMICALS ARE DEPLETED OR ARE NEARING DEPLETION, AND OLDER
MEMBRANES ARE NOT BEING REPLACED ON SCHEDULE. CONSEOUENTLY,
IRAQ PROBABLY IS USING UNTREATED OR PARTIALLY TREATED WATER IN
SOME LOCATIONS. FULL DEGRADATION OF THE WATER TREATMENT SYSTEM



PROBABLY WILL TAKE AT LEAST ANOTHER 6 MONTHS.

[   (b)(2)   ]

http://www.gulflink.osd.mil/



Date: Jan 91 15:18:35 EST
From: 
To: 
Subject: DISEASE INFORMATION
Comments: Forwarding note of Jan 91 15:17:40-EST from 


From:	                                --
*** Forwarding note from AFMICOPS--FSTCVMl 01/22/91 15:17 ***
Date: Jan 91 15:17:40 EST
Subject: DISEASE INFORMATION

From:

1. Please Pass the attached information to:
ARCENT G2
ARCENT G5
ARCENT SURGEON
[   (b)(6)   ]

2. As this is our first attempt over this circuit, please 
respond upon receip

of this message.


SUBJECT: Effects of Bombing on Disease Occurrence in Baghdad 

ANALYST: [   (b)(6)   ]

DATE: JAN 91

SUMMARY:  Food- and waterborne diseases have the greatest 
potential for outbreaks in the civilian and military 
population over the next 30 to 60 days.

Increased incidence of diseases will be attributable to 
degradation of normal preventive medicine, waste disposal, 
water purification/distribution, electricity, and decreased 
ability to control disease outbreaks. Any urban are

in Iraq that has received infrastructure damage will have 
similar problems. 

The following diseases are prioritized in descending order of 
expected outbreak potential in Baghdad over the next 30 to 60 
days. Prioritization is based on level of endemicity, seasonal 
distribution, and mode of transmission.

1.  FOOD- AND WATER-BORNE DISEASES:

         Disease	  Primary Agents/Comments

    a. Acute Diarrheas	Bacterial: E. coli, Shigella spp., and
	Salmonella spp.

	Protozoal: Giardia lamblia (particularly
	children) and Entamoeba histolytica



Viral: Rotavirus (primarily children)

b. Typhoid/Paratyphoid Salmonella typhi, S. paratyphi

c. Cholera               Difficult to assess. Poorly reported. 
Outbreaks possible.

NOTE: Hepatitis A (HAV) is highly endemic, and therefore 
causes a limited

threat to the indigenous population.               -~

2.  OTHER ENDEMIC DISEASES:

a. Influenza	Strain A(H3N2) predominates over A(HlNl) and B.

b. Meningococcal	Group A predominates, but W135 reporting has
   Meningitis	increased. Associated with overcrowding.

c. Childhood Diseases Primarily measles, but also diphtheria 
and pertussis.

d. Trachoma	Associated with poor personal hygiene.

e. Intestinal Helminths Primarily ascariasis, ancylostomiasis, 
enterobiasis, trichuriasis.

|SUBJECT: Effects of Bombing on Disease Occurrence in Baghdad 

3.  VECTORBORNE DISEASES: Generally, vectorborne diseases are 
more of a lon

term problem, with increased transmission occurring after 60 
days. However, increased incidence can be expected, especially 
in a prolonged military campaign.

a. Louse-borne typhus Rickettsia prowazekii. Associated with 
poor hygiene and overcrowding, especially in winter months.

b. Leishmaniasis	 Primarily cutaneous form due to Leishmania
	 tropica. Focal increase associated with debris
	 accumulation.

c. Malaria	Currently no indigenous transmission and
	considered a low risk. Potential vectors are
	present.

4.  More detailed explanations on conditions affecting 
expected disease occurrence are available. Extrapolation of 
this analysis should only be done after further consultation 
with AFMIC analysts.

|SUBJECT: Iraq - Medical Civil Defense Preparations and BW 
Propoganda 

[   (b)(6)   ]
DATE: JAN 91
According to open source press releases in November and 
December, several Iraqi ministries delivered public health 
information announcements outlining precautions that civilians 
should be taking because of the Persian Gulf crisis

Early guidelines by the Ministry of Local Government called on 
citizens to avoid careless use of drinking water, such as 
using it for watering domestic gardens and washing cars and 
sidewalks". In late December, the Baghdad Domesti

Service stated that 'the enemy may resort to biological war 
means on human, animal, or plant targets; these germs include 
bacteria, viruses-, fungi, and parasites which cause malaria 
and dysentery". Also, the announcement provided guidelines in 
the following subject areas for protecting personnel, 
facilities food/water supplies, and crops from these 
biological agents:
A. Health precautions (NFI) to reduce possibility of 
contamination.
B. Isolation of infected persons and contaminated areas to 
prevent spread of disease.
C. "Sterilization" (decontamination) of infected persons and 
contaminated equipment and areas.
D. Proper storage of food and water to avoid contamination.
E. Plans to protect crops.

Comment: These types of statements would increase public 
awareness and encourage the civilian population to take 
additional preventive measures against health problems (such 
as medical shortages and disease outbreaks) that would result 
from an infrastructure weakened by sanctions or military 
conflict
Early statements may represent a legitimate attempt by the 
Iraqi government to prepare the civilian population. However, 
as the United Nations deadline approached, the Iraqi 
government's tactics became more exploitative as indicated by 
the "biological war" announcement propagandizing a possible 
U.S. biological threat. (See AFMIC Weekly Wire 50-90 for 
additional information on similar disinformation statements.)

The government disinformation citing potential increases of 
endemic diseases that are not biological warfare candidates 
would allow the government to blame the United States for 
public health problems created by military conflict. 
Additionally, an even more subversive motive could have formed 
the rationale for the disinformation campaign. The statements 
would create a scenario that would allow the U.S. to be blamed 
for potential civilian biological warfare (BW) casualties 
resulting from Iraqi BW use or contamination by agents 
released as a result of damage inflicted by coalition forces 
on BW facilities. Military planners, particularly civil 
affairs and humanitarian assistance groups, and political 
officials should be aware of the potential for the Iraqi 
population to blame coalition forces for these problems.


http://www.gulflink.osd.mil/



File: 950901_0404pgf_91.txt
Page: 91
Total Pages: 1

Iraq: Assessment of Current Health Threats and Capabilities


Filename:0404pgf.91
AFMIC Assessment 05-91
15 November 1991


	Armed Forces Medical Intelligence Center
	Assessment

	Iraq: Assessment of Current Health Threats and Capabilities

Key Judgments

                   Restoration of Iraq's public health services 
and shortages of major medical materiel remain dominant 
international concerns ([   (b)(2)   ]                        ).  
Both issues apparently are being exploited by Saddam Hussein in an 
effort to keep public opinion firmly against the U.S. and its 
Coalition allies and to direct blame away from the Iraqi 
government.

    Disease incidence above pre-war levels is more attributable to 
the regime's inequitable post-war restoration of public health 
services rather than the effects of the war and United Nations 
(UN)-imposed sanctions. Although current countrywide infectious 
disease incidence in Iraq is higher than it was before the Gulf 
War, it is not at the catastrophic levels that some groups 
predicted. The Iraqi regime will continue to exploit disease 
incidence data for its own political purposes ([   (b)(2)   ]
                      ).

          Iraq's medical supply shortages are the result of the 
central government's stockpiling, selective distribution, and 
exploitation of domestic and international relief medical 
resources. These same factors will play a role in the ongoing 
regional incidence of post-war infectious disease. 

             Compared with pre-war capabilities, hospital services 
have been significantly reduced, with comprehensive medical care 
available only to the political elite, the very wealthy, and the 
military.

          Post-war reporting indicates that Iraq may be storing 
nuclear, biological, and chemical (NBC) materials in or around 
hospitals in an attempt to conceal them [   (b)(1) sec 1.3(a)(4)  
 ],      [   (b)(2)   ]               . If true, the storage of 
these materials is contrary to basic safety tenets and poses a 
serious health threat to hospitalized patients and medical staff. 
  

Public Health

                 [   (b)(1) sec 1.3(a)(4)   ]                     
                                             that restoration of 
water, sewerage, and electricity services appears to be limited to 
select regions. While the water is dirty in appearance, water 
quality reportedly has improved in Baghdad. However, conditions 
have not improved correspondingly in Al Basrah or other 
Shiite-dominated southern cities and in northern Kurdish regions. 
Nationwide restoration of water potability has been slowed by 1) 
the destruction of Iraqi's chlorine production capability and 2) 
the financial cost of rebuilding damaged petrochemical plants and 
the interim requirement of importing chloring products from 
aborad.  Water purification systems and protable generators 
provided through humanitarian assistance have served, at best, as 
stop-gap measures.  Iraq's Ministry of Health (MOH) continues to 
provide public health communiques instructing inhabitants to boil 
water, fully cook food, and store food and water in clean 
containers.

    The MOH appears to be regaining administrative control of the 
nation's health care system, but restoration of nationwide public 
health programs apparently is not being addressed. Resumption of 
public health programs (such as disease surveillance, vector 
control, and immunization programs; food and food handler 
inspections; bacteriological testing of potable water sources; and 
local level primary health services and education) depends 
completely on the Iraqi government. Until these programs are fully 
reinstated, most Iraqi citizens will remain vulnerable to 
otherwise preventable diseases.

        Refugee medical care remains a specific concern of 
international humanitarian agencies as an estimated 300,000 Iraqi 
refugees remain in Iran and another 24,000 are in Turkey. A number 
of these refugees are attempting to return to northern Iraq before 
cold weather returns to the region. Current reports describe an 
influx of 10,000 refugees per week returning from Iran. However, 
destruction of villages and current violence in Kurdish areas may 
prevent a significant number from reaching their homes, leaving 
them without shelter and prone to cold and other exposure-related 
injuries and illnesses. Moreover, warehouses containing tents, 
clothing, and heating supplies that were provided by the UN and 
other international agencies for this contingency are located in 
the area of current fighting. Workers at these warehouses 
reportedly have fled, leaving those goods unprotected from looters 
on both sides of the conflict. Additional humanitarian assistance 
for the refugees is not likely to be forthcoming from the Iraqi 
Government, although the plight of the refugees continues to be 
exploited by Baghdad.

Infectious Disease Incidence
                    Although current countrywide infectious 
disease incidence in Iraq is higher than it was prior to the Gulf 
War, it is not at the catastrophic levels that some groups 
predicted.  Disease incidence above prewar levels is more 
attributable to the regime's inequitable post-war restoration of 
public health services rather than the effects of the war and 
UN-imposed sanctions. Recent intelligence reports from reliable 
sources have indicated that life in Baghdad essentially has 
returned to normal, with no signs of poverty or food shortages. In 
contrast, increased infant and child mortality rates, evidence of 
child malnourishment, and poor sanitary conditions continue to 
plague vulnerable groups outside of Baghdad, particularly in 
southern Iraq.

    Because the regime did not report adequate pre-war disease 
surveillance data and current disease reporting appears 
politically-biased, the current disease situation in Iraq is 
difficult to assess. Pre-war disease surveillance data are not 
available for comparison; therefore, it is unclear what amount of 
current disease incidence reported through the Iraqi Government 
reflects normal incidence levels. Recent Iraqi reports linking 
increased disease morbidity and mortality (particularly cholera, 
typhoid fever, hepatitis A, giardiasis, amebic dysentery, 
bruce]losis, and echinococcosis) to vaccine and medicine shortages 
created by the international embargo are particularly misleading. 
 These diseases are fundamentally prevented through basic 
sanitation and hygiene, not public vaccinations or curative 
medicine. Therefore, much of the current reporting is regarded as 
an attempt to gain international sympathy.

    In addition, morbidity and mortality forecasts publicly 
provided by international and private medical organizations 
frequently have been based on incomplete information. Baghdad has 
restricted the access of foreign observers, limiting the quantity 
and quality of collected data. Many of the early post-war 
estimates assumed that health and living conditions would not 
improve, which led to significant overestimates of projected 
morbidity and mortality rates. Because of the restoration of 
essential services and international relief efforts, the United 
Nations Children's Fund (UNICEF) recently reduced its estimates of 
Iraqi children at-risk from 170,000 children to between 50,000 and 
80,000 children.

    Infectious disease incidence in areas where services are 
restored is likely to stabilize in a range that is somewhat above 
pre-war levels, with discriminated groups (particularly Kurds and 
Shiites) sustaining substantially higher disease incidence. With 
the advent of winter, cases of acute respiratory infections, 
preventable childhood diseases (measles, diphtheria, and 
pertussis), and meningococcal meningitis are expected to increase 
 significantly in populations receiving inadequate public health 
services. The Iraqi regime will continue to exploit the hardships 
of discriminated groups for its own domestic and international 
political purposes.

Medical Materiel
          Iraq's loudly-proclaimed medical supply shortages are 
believed to have been artificially created.  Possible evidence of 
Iraqi government stockpiling, selective distribution, and 
exploitation of domestic and international relief medical 
resources has been provided by [   (b)(1) sec 1.3(a)(4)   ]       
         .                      warehouses at the Samarra 
Pharmaceutical Plant (34-12N 043-52E) that were between 50 and 75 
percent full (including items looted from Kuwait), despite Baghdad 
claims the warehouses were only filled to 10 percent of capacity. 
[   (b)(1) sec 1.3(a)(4)   ]  400,000 doses of 
diphtheriapertussis-tetanus (DPT) vaccine from UNICEF stored at 
the Serum and Vaccine Institute in Amiriyia (33-18N 044-17E). 
Iraqi leaders are alleged to have sold, for personal profit, 
medical materiel and equipment donated by international 
humanitarian assistance groups as well as some of the medical 
equipment stolen from Kuwait.

       The extent of Iraqi medical stores is not known but appears 
to be massive. A southern Iraqi medical depot, reportedly 
destroyed in the wake of Desert Storm, was reputed to house 10 
years of medical materiel. Other large medical supply warehouses 
are believed to be distributed around the country. U.S. forces 
deployed to Dahuk (36-52N 043-00E) during Operation Provide 
Comfort noted that medical personnel at the Dahuk Hospital were 
not permitted access to a nearby warehouse filled with medical 
supplies. The supplies reportedly had been moved from Baghdad to 
protect them from Coalition bombing attacks and were to have 
eventually been returned to Baghdad.

[      (b)(1) sec 1.3(a)(4)    ]




Health Care Delivery

        Health care services for the majority of Iraqis are 
basically limited to emergency and acute care services. More 
comprehensive health services are believed available at the more 
prestigious government medical centers, select private hospitals, 
and sob military medical centers (most of which are situated in 
remote areas away from public observation). This level of health 
care principally is reserved only for those with substantial 
financial means or political connections.

          The current outbreak of fighting in northern Iraq 
reportedly has resulted in large numbers of non-military 
casualties. lLocal hospitals, filled to overflowing, are incapable 
of handling these casualties and heavily depend on international 
medical assistance. The International Red Cross is attempting to 
augment local health care services with medical supplies and 
personnel. Two, relatively-modern hospitals recently have been 
identified [   (b)(1) sec 1.3(a)(4)   ] in As Sulaymaniyah, a 
focal point in the current fighting. One hospital appears to be a 
modification of the 16 identical Japanese constructed hospitals 
known to exist in Iraq [   (b)(2)   ]              .  The other 
hospital is a modification of four, nearly-similar, new military 
hospitals.

          Military casualties and medical health care capabilities 
have been kept secret from the public. The shroud of secrecy may 
be to forestall the negative public outcry that would result if 
Iraqis were to observe the inequitable distribution of medical 
services and materiel between the civilian and military sectors. 
There also is a possibility that a significant number of soldiers 
who sustained serious, long-term injuries (such as amputees and 
para/quadraplegics) during the Gulf War and subsequent civil war 
are being held out of the public eye in clandestine facilities 
(remote military hospitals and converted sport stadiums, hotels, 
and gymnasiums) around the country. This theory is supported by an 
unconfirmed report of an Iraqi order placed in spring 1991 with a 
North Korean firm for 17,000 hospital beds and 23,000 wheelchairs. 
The order, which is excessive given the relatively minimal 
destruction sustained by Iraqi health care facilities, would be 
appropriate for large numbers of casualties who are bedridden 
and/or possess limited mobility.

             Overall, medical materiel shortages and delayed 
restoration of public utility services have contributed 
significantly to the reduction of Iraqi health care services from 
pre-war levels. Surgical and diagnostic capabilities appear to 
have suffered the greatest decline as the result of erratic and 
insufficient water and electricity services, anesthetic shortages, 
equipment failures, and shortages of laboratory reagents and other 
diagnostic support material. [   (b)(1) sec 1.3(a)(4)   ] have 
reported that the Al Khadimiya Hospital in Baghdad (33-22-20N 044- 
19-30E), designated by Iraq as the referral facility for [   
(b)(1) sec 1.3(a)(4)   ] in the event of chemical agent exposure 
and believed to be the largest of the Japanese-designed hospitals 
constructed throughout Iraq during the mid-1980s, is incapable of 
performing electrolyte, arterial blood gas, and serum 
cholinesterase evaluations (serum cholinesterase is both a 
presurgical screening tool and a method of diagnosing and 
assessing nerve agent poisoning). Saddam Hussein Medical City in 
Baghdad (33-20-58N 044-22-46E), the government's premier medical 
center, is unable to operate its CT scan and other sophisticated 
medical equipment because of repair problems, but still is 
believed capable of performing routine diagnostic examinations 
(xray, ultrasound, and laboratory).

    Iraq's medical diagnostic capabilities are further degraded by 
lack of qualified medical maintenance technicians. Traditionally, 
most medical maintenance in Iraq was performed by Western 
contractors. Following the invasion of Kuwait, the majority of 
foreign workers departed Iraq and have not returned.  

    The reduction of diagnostic support specifically impaets the 
quality of surgical and other specialty services (such as 
orthopedics, gastroenterology, and pulmonary medicine) received by 
Iraqis. Although still great, the impact on the quality of 
emergency and other primary care services is believed to be less. 
Therefore, an appreciable decline in patient care in the primary 
care setting is more likely to result among poorly-trained 
physicians (believed prevalent throughout Iraq), especially those 
confronted with heavy workloads created by the decline in post-war 
public health and the civil war. Without diagnostic support, these 
physicians are more likely to resort to shotgun therapy, which 
commonly relies on multiple-drug regimens. Patient care, 
therefore, is further degraded by an increased probability of an 
erroneous diagnosis compounded by inappropriate therapy that may 
worsen the initial complaint. Additionally, Iraqi health care 
providers who practice shotgun medicine waste medical resources 
that already are in short supply. Iraqi health care providers 
serving in medical facilities that are historically poorly 
supported or those having experience with the health care 
deprivations associated with the Iran/Iraq War probably are more 
capable of providing astute diagnoses without the benefit of 
diagnostic tests than most Iraqi health care providers.

Storage of NBC Materials in Hospitals
          Post-war reporting alleges that the Iraqi military is 
storing nuclear, biological, and chemical (NBC) materials in or 
around hospitals in an effort to conceal them from UN special 
observer teams. The health threat to patients and medical staff is 
borne out by Iraq's historical lack of regard concerning safe 
handling and storage of NBC material. Reports of accidental 
chemical agent exposure among Iraqi military personnel date back 
to the Iran/Iraq War. More recently, [   (b)(1) sec 1.3(a)(4)   ]
        medical reports found at the Muthanna State Establishment 
(MSE; 33-49-56N 043-48-13E, also known as the Samarra Chemical 
Warfare Research, Production, and Storage Facility) estimate an 
annual chemical exposure accident rate at that facility 
approaching 30 percent. [   (b)(1) sec 1.3(a)(4)   ] lack of 
appropriate detection equipment at Iraqi chemical production 
facilities, indicating that Iraq would have a significantly 
limited capability to detect a chemical contamination occurring 
during the storage of chemical agents on or near hospital grounds. 
Moreover, most civilian Iraqi physicians lack the capability to 
diagnose signs and symptoms of chemical agent exposure.

             Suspect medical facilities believed to be housing NBC 
material include the Saddam Hussein Medical City and the Al Rashid 
Hospital, both located in Baghdad (33-21N 044-25E), the Saddam 
Hussein General Hospital in Kirkuk (35-28N 044-23E), the Mosul 
Hospital 0621-28N 043-07-00E), and the Dagalah Hospital (36-09N 
044-23E). There also have been unconfirmed reports of chemical 
warfare agents stored in the King Hussein Medical Center in Amman, 
Jordan (31-57N 035-56E).

Summary
          Iraq is exploiting the humanitarian issue to maintain 
world sympathy and possibly to extend as long as possible the 
influx of free goods. However, Iraq is capable of reversing its 
current medical materiel shortages through the equitable 
distribution of current stockpiles, the use of proceeds from oil 
sales approved by the UN for humanitarian purchases, and the use 
of an estimated U.S. $340 million frozen in the Bank for 
International Settlements. Iraq has demonstrated its capability to 
fund high priority health care sector projects during its costly 
war with Iran, as evidenced by the construction of more than 20 
major medical treatment facilities and the purchases of Western 
medicines and medical technology during that period.

http://www.gulflink.osd.mil/



Subject:	DEPLETED URANIUM 

b1 SEC 1.5C

IRAQI DIPLOMATS TO DISTRIBUTE SUMMARY OF A REPORT LINKING ALLIED USE OF 
DEPLETED URANIUM IN MUNITIONS TO INCREASES IN CANCER AND OTHER DISEASES:  
OCTOBER 1994.

IRAQI DIPLOMATS IN OCTOBER 1994, WERE TO DISTRIBUTE INFORMATION ON THE 
HEALTH IMPACT OF VARIOUS WEAPONS USED AGAINST THE IRAQIS DURING THE GULF 
WAR, SPECIFICALLY FOCUSING ON THE USE OF DEPLETED URANIUM IN MUNITIONS.

IRAQI DIPLOMATS HAD A SUMMARY OF  A REPORT ALLEGING A CONNECTION BETWEEN 
ALLIED USE OF WEAPONS CONTAINING DEPLETED URANIUM DURING THE GULF WAR 
AND A SUBSEQUENT INCREASE IN VARIOUS TYPES OF ILLNESS AND HAD BEEN 
INSTRUCTED TO ENSURE THAT THE INFORMATION RECEIVE THE WIDEST POSSIBLE 
DISTRIBUTION.

THE REPORT ALLEGED THAT SCIENTIFIC EVIDENCE COLLECTED FROM AREAS WHICH 
WERE BOMBARDED HAD PROVIDED SOLID 
EVIDENCE OF THE USE OF CHEMICAL AND BIOLOGICAL AGENTS, AND STRESSED THEIR 
POTENTIAL DANGER TO THE ENVIRONMENT. IT ADDRESSED THE USE OF DEPLETED 
URANIUM, CLAIMING THAT APPROXIMATELY 40 TONS OF THE MATERIAL HAD BEEN 
FOUND IN SOUTHERN IRAQ.  IT CLAIMED THAT THIS MATERIAL CAME FROM æRADIATIONÆ 
WEAPONS USED AGAINST 
THE IRAQI MILITARY AND ON THE MAIN ROAD TO KUWAIT.  THE REPORT ALSO ALLEGED 
THAT DEPLETED URANIUM FELL INTO THE CATEGORY OF BANNED WARFARE AGENTS, 
AND THAT ITS USE HAD LED TO BOTH SHORT-TERM AND LONG-TERM DAMAGE.

THE REPORT DETAILED WHAT IT CLAIMED WERE INCREASES IN CERTAIN DISEASES DUE 
TO ALLIED MILITARY ACTIONS, INCLUDING:

1. A TWO-FOLD INCREASE IN THE INCIDENCE OF EPIDEMIC VERTIGO, ALONG WITH 
MANY CASES OF AN UNDIAGNOSED DISEASE CHARACTERIZED BY BLINDNESS, 
FITS OF SEVERE HEADACHE, AND NUMBNESS.  INITIAL REPORTS OF SUCH CASES 
WERE MADE ABOUT SIX MONTHS AFTER THE WAR;
 
2. AN INCREASE IN VARIOUS TYPES OF CANCER, SUCH AS LEUKEMIA, 
PARTICULARLY AMONG THE YOUNG.  THE REPORT CLAIMED AN INCREASE IN 
DAILY REPORTS OF THESE CANCERS FROM TWO TO THREE IN 1991 TO 10 TO 15 A 
DAY AT THE PRESENT TIME; AND
 
3. AN INCREASE IN THE INCIDENCE OF JUVENILE DIABETES, ATTRIBUTING THIS TO 
THE PSYCHOLOGICAL EFFECTS OF EXPOSURE TO BOMBING, EXPLOSIONS, 
SHELLING, MISSILE ATTACKS, AND AIR STRIKES BY SUPERSONIC FIGHTERS.

http://www.gulflink.osd.mil/


Subject: MEDICAL PROBLEMS IN IRAQ


Filename:0me018.91


MEDICAL PROBLEMS IN IRAQ
March 15, 1991

KEY JUDGMENTS

    HEALTH PROBLEMS CURRENTLY FACING IRAQ ARE PRIMARILY PUBLIC 
HEALTH IN NATURE; ATTRIBUTABLE TO THE BREAKDOWN OF NORMAL 
PREVENTIVE MEDICINE, WASTE DISPOSAL, WATER PURIFICATION AND 
DISTRIBUTION, ELECTRICITY, AND TRANSPORTATION (IMPEDING HEALTHCARE 
ACCESS). THERE ARE INDICATIONS THAT THE BAGHDAD GOVERNMENT IS 
FOCUSING ITS EFFORTS RESTORING THESE SERVICES, AS EXAMPLED BY A 
RECENT REPORT OF AN ICRC DELIVERY TO BAGHDAD OF WATER PURIFICATION 
AND SEWAGE EQUIPMENT.

[      (b)(1) sec 1.3(a)(4)    ]


DISEASE OCCURRENCE IN BAGHDAD

(U) OPEN SOURCE NEWS RELEASES, CITING INTERNATIONAL AND IRAQI 
HEALTH OFFICIALS, INDICATE THAT COMMUNICABLE DISEASES IN BAGHDAD 
ARE MORE WIDESPREAD THAN Usually OBSERVED DURING THIS TIME OF THE 
YEAR AND ARE LINKED TO THE POOR SANITARY CONDITIONS (CONTAMINATED 
WATER SUPPLIES AND IMPROPER SEWAGE DISPOSAL) RESULTING FROM THE 
WAR. ACCORDING TO A UNITED NATIONS CHILDREN'S FUND (UNICEF)/WORLD 
HEALTH ORGANIZATION REPORT, THE QUANTITY OF POTABLE WATER IS LESS 
THAN 5 PERCENT OF THE ORIGINAL SUPPLY, THERE ARE NO OPERATIONAL 
WATER AND SEWAGE TREATMENT PLANTS, AND THE REPORTED INCIDENCE OF 
DIARRHEA IS FOUR TIMES ABOVE NORMAL LEVELS. ADDITIONALLY, 
RESPIRATORY INFECTIONS ARE ON THE RISE. CHILDREN PARTICULARLY HAVE 
BEEN AFFECTED BY THESE DISEASES. INCREASED INCIDENCE OF TYPHOID 
AND CHOLERA HAS BEEN REPORTED BY IRAQI RED CRESCENT OFFICIALS, BUT 
THE SPREAD OF THESE DISEASES HAS NOT BEEN CONFIRMED BY OTHER 
SOURCES.

(U) THE PREVALENCE OF SOME DISEASES HAS INCREASED IN BAGHDAD, BUT 
MAJOR DISEASE OUTBREAKS (INCLUDING TYPHOID, CHOLERA, AND 
MENINGITIS) HAVE NOT OCCURRED.  THERE ARE INDICATIONS THAT THE 
SITUATION IS IMPROVING AND THAT THE Population IS COPING WITH THE 
DEGRADED CONDITIONS. DAILY RADIO BROADCASTS HAVE PROVIDED 
PRECAUTIONARY MEASURES TO BE TAKEN BY CIVILIANS TO PREVENT 
DISEASES. HOWEVER, CONDITIONS IN BAGHDAD REMAIN FAVORABLE FOR 
COMMUNICABLE DISEASE OUTBREAKS; THE DELAYED RESTORATION OF PUBLIC 
HEALTH SERVICES AND APPROACHING WARMER TEMPERATURES WILL INCREASE 
THE LIKELIHOOD OF SIGNIFICANT DISEASE OUTBREAKS. ADDITIONALLY, 
CIVIL DISTURBANCES COULD FURTHER DELAY INFRASTRUCTURE REPAIRS.

    NEWS RELEASED TO WESTERN AUDIENCES FROM BAGHDAD ON SANITARY 
CONDITIONS AND DISEASE INCIDENCE IS CONSIDERED BIASED. THE IRAQI 
GOVERNMENT HAS MANDATED THE DEPARTURE OF NEWS PERSONNEL AND RELIEF 
AGENCY OBSERVERS, MAKING EVALUATION OF ACTUAL HEALTH CONDITIONS 
(DISEASES, INCIDENCE LEVELS, AND GROUPS AFFECTED) UNCLEAR.


http://www.gulflink.osd.mil/


DISEASE INFORMATION

Filename:0504rept.91


From: [   (b)(6)   ]              ~      Date and time ~ 
15:18:37
======================================--===================

Date: Jan 91 15:18:35 EST
From: 
To: 
Subject: DISEASE INFORMATION
Comments: Forwarding note of Jan 91 15:17:40-EST from 


From:	                                --
*** Forwarding note from AFMICOPS--FSTCVMl 01/22/91 15:17 ***
Date: Jan 91 15:17:40 EST
From: 
To: arcentg2@sandman.[    b.2.    ]
Subject: DISEASE INFORMATION

From:

1. Please Pass the attached information to:
ARCENT G2
ARCENT G5
ARCENT SURGEON
[   (b)(6)   ]

2. As this is our first attempt over this circuit, please 
respond upon receip

of this message.


SUBJECT: Effects of Bombing on Disease Occurrence in Baghdad 

ANALYST: [   (b)(6)   ]

DATE: JAN 91

SUMMARY:  Food- and waterborne diseases have the greatest 
potential for outbreaks in the civilian and military 
population over the next 30 to 60 days.

Increased incidence of diseases will be attributable to 
degradation of normal preventive medicine, waste disposal, 
water purification/distribution, electricity, and decreased 
ability to control disease outbreaks. Any urban are

in Iraq that has received infrastructure damage will have 
similar problems. 

The following diseases are prioritized in descending order of 
expected outbreak potential in Baghdad over the next 30 to 60 
days. Prioritization is based on level of endemicity, seasonal 
distribution, and mode of transmission.

1.  FOOD- AND WATER-BORNE DISEASES:

         Disease	  Primary Agents/Comments

    a. Acute Diarrheas	Bacterial: E. coli, Shigella spp., and
	Salmonella spp.

	Protozoal: Giardia lamblia (particularly
	children) and Entamoeba histolytica



Viral: Rotavirus (primarily children)

b. Typhoid/Paratyphoid Salmonella typhi, S. paratyphi

c. Cholera               Difficult to assess. Poorly reported. 
Outbreaks possible.

NOTE: Hepatitis A (HAV) is highly endemic, and therefore 
causes a limited

threat to the indigenous population.               -~

2.  OTHER ENDEMIC DISEASES:

a. Influenza	Strain A(H3N2) predominates over A(HlNl) and B.

b. Meningococcal	Group A predominates, but W135 reporting has
   Meningitis	increased. Associated with overcrowding.

c. Childhood Diseases Primarily measles, but also diphtheria 
and pertussis.

d. Trachoma	Associated with poor personal hygiene.

e. Intestinal Helminths Primarily ascariasis, ancylostomiasis, 
enterobiasis, trichuriasis.

|SUBJECT: Effects of Bombing on Disease Occurrence in Baghdad 

3.  VECTORBORNE DISEASES: Generally, vectorborne diseases are 
more of a lon

term problem, with increased transmission occurring after 60 
days. However, increased incidence can be expected, especially 
in a prolonged military campaign.

a. Louse-borne typhus Rickettsia prowazekii. Associated with 
poor hygiene and overcrowding, especially in winter months.

b. Leishmaniasis	 Primarily cutaneous form due to Leishmania
	 tropica. Focal increase associated with debris
	 accumulation.

c. Malaria	Currently no indigenous transmission and
	considered a low risk. Potential vectors are
	present.

4.  More detailed explanations on conditions affecting 
expected disease occurrence are available. Extrapolation of 
this analysis should only be done after further consultation 
with AFMIC analysts.

|SUBJECT: Iraq - Medical Civil Defense Preparations and BW 
Propoganda 

[   (b)(6)   ]
DATE: JAN 91
According to open source press releases in November and 
December, several Iraqi ministries delivered public health 
information announcements outlining precautions that civilians 
should be taking because of the Persian Gulf crisis

Early guidelines by the Ministry of Local Government called on 
citizens to avoid careless use of drinking water, such as 
using it for watering domestic gardens and washing cars and 
sidewalks". In late December, the Baghdad Domesti

Service stated that 'the enemy may resort to biological war 
means on human, animal, or plant targets; these germs include 
bacteria, viruses-, fungi, and parasites which cause malaria 
and dysentery". Also, the announcement provided guidelines in 
the following subject areas for protecting personnel, 
facilities food/water supplies, and crops from these 
biological agents:
A. Health precautions (NFI) to reduce possibility of 
contamination.
B. Isolation of infected persons and contaminated areas to 
prevent spread of disease.
C. "Sterilization" (decontamination) of infected persons and 
contaminated equipment and areas.
D. Proper storage of food and water to avoid contamination.
E. Plans to protect crops.

Comment: These types of statements would increase public 
awareness and encourage the civilian population to take 
additional preventive measures against health problems (such 
as medical shortages and disease outbreaks) that would result 
from an infrastructure weakened by sanctions or military 
conflict
Early statements may represent a legitimate attempt by the 
Iraqi government to prepare the civilian population. However, 
as the United Nations deadline approached, the Iraqi 
government's tactics became more exploitative as indicated by 
the "biological war" announcement propagandizing a possible 
U.S. biological threat. (See AFMIC Weekly Wire 50-90 for 
additional information on similar disinformation statements.)

The government disinformation citing potential increases of 
endemic diseases that are not biological warfare candidates 
would allow the government to blame the United States for 
public health problems created by military conflict. 
Additionally, an even more subversive motive could have formed 
the rationale for the disinformation campaign. The statements 
would create a scenario that would allow the U.S. to be blamed 
for potential civilian biological warfare (BW) casualties 
resulting from Iraqi BW use or contamination by agents 
released as a result of damage inflicted by coalition forces 
on BW facilities. Military planners, particularly civil 
affairs and humanitarian assistance groups, and political 
officials should be aware of the potential for the Iraqi 
population to blame coalition forces for these problems.

http://www.gulflink.osd.mil/



Disease Outbreaks in Iraq

Filename:0pgv072.90p




SUBJECT:   Disease Outbreaks in Iraq
TO:
DOI: 21 FEB 90
ANALYST:                   [ (b)(6) ]


KEY JUDGEMENTS

       [ (b)(2) ]  assessment is that major disease outbreaks
currently have not occurred in Baghdad or Basrah. For severe
outbreaks to develop, a protracted war or more extensive
collateral damage would have to occur.

        However, conditions are favorable for communicable disease
outbreaks, particularly in major urban areas affected by
coalition bombing. Data necessary for determining expected
numbers and rates of cases are not available, and any estimate
would be totally unreliable.



COMMENTS

       Infectious disease prevalence in major Iraqi urban areas
targeted by coalition bombing (Baghdad, Basrah) undoubtedly has
increased since the beginning of Desert Storm. However, reporting
has been limited, conflictive, and non-specific, making the
actual levels are unclear; specific diseases, numbers of cases,
and groups affected have not been reported. Current public health
problems are attributable to the reduction of normal preventive
medicine, waste disposal, water purification and distribution,
electricity, and the decreased ability to control disease
outbreaks.

    Prior to Desert Storm, the Iraqi government broadcast several
public civil defense preparation statements. The language used in
some of the public health statements would allow the government
to propagandize increases of endemic diseases on military
conflict (and potentially on contamination by agents released as
a result of damage inflicted by coalition forces on CBW
facilities). Increased incidence of diseases in these cities is
assessed to be due to increased occurrence of endemic diseases.

       Recent Iraqi controlled news releases to Multi-National
Force audiences about the poor sanitary conditions in Baghdad is
considered biased. Reportedly, the Iraqi government has denied
ICRC staff into Iraq to evaluate current health problems
(presumably the ICRC staff could refute the "deplorable"
conditions). In contrast, broadcasts to "friendly" Arab countries
have painted a "life as normal" situation in Baghdad.



SUBJECT:   Disease Outbreaks in Iraq          cont.
DOI: 21 FEB 9O

    Generalizations can be made on the most likely diseases to
occur in significantly elevated or outbreak proportions over the
near-term.



MOST LIKELY DISEASES DURING THE NEXT 60-90 DAYS (DESCENDING
ORDER)

      - Diarrheal diseases (particularly children)
      - Acute respiratory illnesses (colds and influenza)
      - Typhoid
      - Hepatitis A (particularly children)
      - Measles, diphtheria, and pertussis (particularly children)
      - Meningitis, including meningococcal (particularly
children)
      - Cholera (possible, but less likely)



MOST LIKELY DISEASES DURING THE FOLLOWING 90-180 DAYS

      - Diarrheal diseases (particularly children)
      - Acute respiratory illnesses (colds)
      - Typhoid
      - Hepatitis A (particularly children)
      - Conjunctivitis (Eye infections)
      - Measles, diphtheria, and pertussis (particularly children)
      - Cutaneous leishmaniasis
      - Meningococcal meningitis (particularly children)
      - Malaria
      - Cholera (possible, but less likely)


Note: Filth fly populations can be expected to increase to high
levels in warmer months, but their contribution to disease
transmission is limited. The more proper analogy to make is that
the circumstances that create favorable conditions for diarrheal
diseases are the same that are favorable for massive fly
populations. However, flies do not cause that much disease.

http://www.gulflink.osd.mil/



IIR 6 898 0446 91 / STATUS OF DISEASE AT REFUGEE

Filename:68980446.91z
PATHFINDER RECORD NUMBER: 15178
GENDATE:         950504
NNNN
TEXT:            
ENVELOPE CDSN = LGX086 MCN = 91122/22766 TOR = 911221352
PTTCZYUW RUEKJCS5947 1221352---RUEALGX.
ZNY 
RUHGRPG T COMUSNAVCENT
HEADER P 021352Z MAY 91
FM JOINT STAFF WASHINGTON DC
TO AIG 8781
INFO RUEALGX/SAFE
P 021357Z MAY 91
FM [   (b)(2)   ]
TO RUEKJCS/DIA WASHDC PRIORITY
INFO RUEKJCS/DIA WASHDC//DAT-7// PRIORITY
RUFTWSA/CTFPROVIDE COMFORT PRIORITY
RUFGAID/USEUCOM AIDES VAIHINGEN GM PRIORITY
RUSNNOA/USCINCEUR VAIHINGEN GE//ECJ2-ISC// PRIORITY
RUFRMHA/CTF SIX ONE PRIORITY
RUFRSGG/CTF SIX TWO PRIORITY
RHDLOJA/CTF SIX SEVEN PRIORITY
RUEORDF/DIRAFMIC FT DETRICK MD//AFMIC-CR//
BT
[   (b)(2)   ]



SERIAL: (U) IIR 6 898 0446 91.


/*********** THIS IS A COMBINED MESSAGE ************/
BODY PASS: (U) DIA PASS TO AIG 8781.

[   (b)(2)   

SUBJ: IIR 6 898 0446 91 / STATUS OF DISEASE AT REFUGEE
CAMPS - PROVIDE COMFORT (U)

[   (b)(2)   ]


---------------------------------------------------
DEPARTMENT OF DEFENSE
---------------------------------------------------

DOI: (U) 910501

REQS: (U) [    b.2.    ]

[   (b)(1) sec 1.3(a)(4)   ]

SUMMARY: CHOLERA AND MEASLES HAVE EMERGED AT REFUGEE CAMPS. 
FURTHER INFECTIOUS DISEASES WILL SPREAD DUE TO INADEQUATE WATER 
TREATMENT AND POOR SANITATION.

TEXT: 1.  THE MAIN CAUSES OF INFECTIOUS
DISEASES, PARTICULARLY DIARRHEA, DYSENTERY AND UPPER
RESPIRATORY PROBLEMS, ARE POOR SANITATION AND UNCLEAN
WATER. THESE DISEASES PRIMARILY AFFLICT THE OLD AND
YOUNG CHILDREN. ALTHOUGH THE EXACT PERCENTAGE OF
INFECTIOUS DISEASES IS UNKNOWN FOR EACH CAMP, 
 [      (b)(1) sec 1.3(a)(4)    ] THAT AT LEAST EIGHTY PERCENT OF
THE POPULATION OF CUKURCA HAS DIARRHEA.

2. THE MOST FREQUENT CASE OF NON-INFECTIOUS
DISEASE IN THE CAMPS INVOLVES TRAUMA - USUALLY SOMEONE
STEPPING ON A LAND MINE. THESE TRAUMA INJURIES ARE
ALSO THE MOST LIKELY CASES TO BE EVACUATED FROM THE
CAMP TO A MAJOR MEDICAL FACILITY.

3. CHOLERA, HEPATITIS TYPE B, AND MEASLES HAVE
BROKEN OUT AT THE CUKURCA CAMP. ([      (b)(1) sec 1.3(a)(4)    ] 






 REPORTED NINE POSITIVE CHOLERA
CASES OUT OF TWENTY-TWO SAMPLES SUBMITTED. AMERICAN
SAMPLES FROM CUKURCA ON 910501 INDICATE POSSIBLE
CHOLERA. THE NUMBER OF MEASLE CASES IS UNDETERMINED.

4. THERE HAVE BEEN NO REPORTED DIAGNOSIS OF
TYPHOID AND ONLY ONE SUSPECTED CASE OF MENINGOCOCEAL
MENINGITIS. MEDICAL ANALYSIS ON OTHER INFECTIOUS
DISEASES IS STILL AWAITING COMPLETION OF DATA COLLECTION.

5.  ZAHKO HAS SIMILAR MEDICAL PROBLEMS AS THE
BORDER CAMPS. DURING A DISCUSSION WITH A MEDICAL TEAM
ON 910430, [      (b)(1) sec 1.3(a)(4)    ] WAS TOLD THAT MOST OF 
THE CASES THEY WERE SEEING WERE DIARRHEA AND UPPER
RESPIRATORY INFECTIONS.

 ([   (b)(1) sec 1.3(a)(4)   ]  1. THE WEATHER
HAS BEEN A POSITIVE FACTOR IN KEEPING THE NUMBER OF
CERTAIN KINDS OF INFECTIOUS DISEASES DOWN TO A
RELATIVELY MANAGEABLE LEVEL. HOWEVER, THE CONTINUING
LACK OF CLEAN WATER FOR THE CAMPS AND THE LACK OF
APPROPRIATE SANITATION FACILITIES HAS MANY MEDICAL
PERSONNEL WORRIED. THE APPEARANCE OF CHOLERA AND
MEASLES WAS EXPECTED, UNFORTUNATELY THE SLOW
INTRODUCTION OF MEDICAL SUPPLIES AND ABSENCE OF A COLD
CHAIN FOR PROPER STORAGE OF MEDICAL SUPPLIES ONLY ADDED
TO A POTENTIALLY SERIOUS MEDICAL PROBLEM AT THE LARGER
CAMPS.

http://www.gulflink.osd.mil/



(U) IIR 6 050 0007 91/HEALTH CONDITIONS IN IRAQ (U)




File: 950719_60500007_91r.txt


Page: 91r


Total Pages: 1

(U) IIR 6 050 0007 91/HEALTH CONDITIONS IN IRAQ (U)

Filename:60500007.91r
PATHFINDER RECORD NUMBER: 12699
GENDATE:         950504
NNNN
TEXT:            
ENVELOPE CDSN = LGX501 MCN = 91154/21957 TOR = 911541708
PTTCZYUW RUEKJCS1415 1541710-    --RUEALGX.
ZNY 
HEADER P 031710Z JUN 91
FM JOINT STAFF WASHINGTON DC
INFO RUEADWD/OCSA WASHINGTON DC
RUCQVAB/USCINCSOC INTEL OPS CEN MACDILL AFB FL
RUCJACC/USCINCCENT MACDILL AFB FL//CARA//
RHEPAAB/TAC IDHS LANGLEY AFB VA//IDHS//
RUFTAKA/USAINTELCTRE HEIDELBERG GE
RUFTAKC/UDITDUSAREUR HEIDELBERG GE
RUDOGHA/USNMR SHAPE BE//SURVEY//
RUEALGX/SAFE
P 031700Z JUN 91
FM JICEUR VAIHINGEN GE//DO//
TO RUFTWSA/CTF PROVIDE COMFORT INCIRLIK AB TU//J2//
RUEKJCS/DIA WASHINGTON DC//DAT-6/DAT-7//
RHFQAAA/HQ USAFE RAMSTEIN AB GE//IN/INO//
RUFDAAA/HQ USAREUR HEIDELBERG GE//AEBG//
INFO RUFGAID/ USEUCOM AIDES VAIHINGEN GE
RUEKJCS/JOINT STAFF WASHINGTON DC
RUEKJCS/OCSA WASHINGTON DC
RUENAAA/CNO WASHINGTON DC
RUEAHQA/CSAF WASHINGTON DC
RUEACMC/CMC WASHINGTON DC
RUEBJFA/MPC FT GEORGE MEADE MD
RUEABOL/HQ AFOSI BOLLING AFB DC
[   (b)(2)   ]
RUEHC/SECSTATE WASHINGTON DC
RUWSMXI/MAC INTEL CEN SCOTT AFB IL//IN//
RUFDAAA/USA INTEL CENTER HEIDELBERG GE
RUFTAKC/UDITDUSAREUR HEIDELBERG GE
RUDOGHA/USNMR SHAPE BE//SURVEY//
RUEALGX/SAFE
RUEADDS/DITDS
RUFHMD/USDAO MADRID SP
RHFUMHE/BRFINK MHE BOERFINK GE
RHDLCNE/CINCUSNAVEUR LONDON UK//N-2//
RUCBSAA/FICEURLANT NORFOLK VA
RUCBSAA/USCINCLANT NORFOLK VA
RUCBSAA/CINCLANTFLT NORFOLK VA
RUSNNOA/USCINCEUR VAIHINGEN GE//ECJ2-OC//
RHFQAAA/USAFE COIC RAMSTEIN GE//INRMH//
RUFLFSA/16AF TORREJON SP//IN//
RUFLFSA/AFOSI DIST 68 TORREJON AB SP//CC//
RUFDAAA/CINCUSAREUR HEIDELBERG GE//AEAGB-C-RE//
RUFTAKA/USAINTELCTRE HEIDELBERG GE//AEAGB-PD-CUR//
RUFHNA/USMISSION USNATO
RUEOFAA/CMDRJSOC FT BRAGG NC//J-2//
ZEN/FSTC INTEL OPS CHARL//AIFICB//
RUDOECA/DET 3 FTD LINDSEY AS GE//CC//
RUDOECA/USCINCEUR LINDSEY AS GE//ECJ1-SADEM//
RUEHNC/USDAO NICOSIA CY
RUFHRA/USDAO RABAT MO
RUEHTU/USDAO TUNIS TS
RUDMNIC/COMNAVINTCOM WASHINGTON DC//NIC-03//
RUEORDA/CDR AFMIC FT DETRICK MD
BT
CONTROLS 
SECTION 001 OF 002
BODY MSGID/SYS.RRM/JICEUR//
RMKS/SERIAL: (U) 6 050 0007 91
COUNTRY: (U) IRAQ (IZ)
SUBJECT: (U) IIR 6 050 0007 91/HEALTH CONDITIONS IN IRAQ (U)
WARNING: (U) THIS IS AN INFORMATION REPORT, NOT FINALLY
EVALUATED INTELLIGENCE. 


------------------------------------------------------------------
DEPARTMENT OF DEFENSE
-----------------------------------------------------------------

DOI: (U) 910508
REQS: (U) [  (b)(2)  ] 
SOURCE: (U) [  (b)(1) sec 1.3(a)(4)  ]


SUMMARY:      SOURCE WAS  [  (b)(1) sec 1.3(a)(4)  ] 
TO ASSESS CONDITIONS THERE. SOURCE [      (b)(1) sec 1.3(a)(4)    
]TRAVELED TO
[  (b)(1) sec 1.3(a)(4)  ]
TO ASSESS HEALTH CONDITIONS AND DETERMINE THE MOST CRITICAL 
MEDICAL
NEEDS OF IRAQ. SOURCE OBSERVED THAT IRAQI MEDICAL SYSTEM WAS IN
CONSIDERABLE DISARRAY, MEDICAL FACILITIES HAD BEEN EXTENSIVELY
LOOTED AND ALMOST ALL MEDICINES WERE IN CRITICALLY SHORT SUPPLY.
IN THE OPINION OF THE SOURCE, ENTERIC DISEASES, SPECIFICALLY
GASTROENTERITIS, POSE THE MOST SIGNIFICANT THREAT COUNTRY-WIDE,
ESPECIALLY AS THE WEATHER GROWS WARMER.
TEXT: 1.     [  (b)(1) sec 1.3(a)(4)  ], SOURCE WAS  
[  (b)(1) sec 1.3(a)(4)  ] TO ASSESS HEALTH CONDITIONS IN IRAQ.



 [  (b)(1) sec 1.3(a)(4)  ]
 




2. [      (b)(1) sec 1.3(a)(4)    ]



3. 

[  (b)(1) sec 1.3(a)(4) ]. SOURCE ALSO STATED THAT ACCORDING TO 

[  (b)(1) sec 1.3(a)(4)  ]

MORTALITY DATA COLLECTED BETWEEN 1990 AND 1991 SHOWED THAT CHOLERA 
AND TYPHOID HAVE ALWAYS BEEN ENDEMIC TO IRAQ AND THERE HAD BEEN 
REPORTS OF CASES IN BAGHDAD AND BASRAH. FOR THE FIRST TIME, 
HOWEVER, KVASHIORKOR HAD BEEN OBSERVED IN IRAQ, ALONG WITH 
EVIDENCE OF PROTEIN DEFICIENCY. [  (b)(1) sec 1.3(a)(4)  ] FELT 
THAT TYPHOID WAS A PROBLEM, BUT GASTROENTERITIS WAS KILLING 
CHILDREN. THEY STATED THAT IN THE SOUTH, 80 PERCENT OF THE DEATHS 
WERE CHILDREN (WITH THE EXCEPTION OF AL AMARAH, WHERE 60 PERCENT 
OF DEATHS WERE
CHILDREN). THEY ALSO NOTED THAT IN THE REFUGEE CAMPS IN THE
SOUTH, 50 PERCENT OF THE POPULATION WERE CHILDREN AND 30% WERE
WOMEN. THEIR PRIMARY CONCERN, HOWEVER, WAS THAT THE COMING WARM
WEATHER AND POTENTIAL BACTERIAL GROWTH IN THE WATER WOULD
ACCELERATE THE SPREAD OF DISEASE.
4. [      (b)(1) sec 1.3(a)(4)    ]



5.[      (b)(1) sec 1.3(a)(4)    ]




6.        [  (b)(1) sec 1.3(a)(4)  ] 




7. [      (b)(1) sec 1.3(a)(4)    ]


8. [      (b)(1) sec 1.3(a)(4)    ]




9. [      (b)(1) sec 1.3(a)(4)    ]




10. [      (b)(1) sec 1.3(a)(4)    ]




/IPSP: (U) PG2520; PT 1810./
/COMSOBJ: (U) [    b.2.    ]
ADMIN PROJ: (U)
INSTR: (U) [    b.2.    ]
PREP: (U) [  (b)(6)  ]
ACQ: (U) [   (b)(2)   
DISSEM: (U) [    b.2.    ]
WARNING: (U) 
[  (b)(2)  ]
BT

#1428


INFODATE:        0

http://www.gulflink.osd.mil/