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“There Were Only Local Anaesthetics Available To Amputate Limbs”

By Inge Van de Merlen

20 December, 2005
BRussells Tribunal

What’s a young Iraqi physician doing in snowy Brussels on a chilly November night? Dr. Salam Ismael is in Europe to testify about the human rights violations committed against his people in Iraq. Iraq, the country in our history books defined as the "cradle of civilization;" a country that every Iraqi is proud of. Medical Aid for the Third World[1], the Belgian NGO that sent four physicians into the bombed-out hell of Baghdad in 2003, has brought him to Brussels for a few days to share his experiences. I had the opportunity to talk with him before he presented his uncensored photo and film material in a conference room of Intal[2]

Twenty-nine years ago, Salam (whose name means "peace") was born in the Al-Adhamya district of Baghdad to a Shia mother and a Sunni father, so the idea of a civil war — Sunni against Shia — is, understandably, alien to him. After finishing his secondary schooling he went to the Medical School of Baghdad, and, as a young doctor, had just started his first year of specialization in orthopaedic surgery, when the United States attacked his country in March 2003. Dr. Salam chose to cease his studies and leave his position as chief of junior doctors in Baghdad, to volunteer his services in the heaviest hit areas of the country. In October 2003, together with a few other junior doctors, he founded Doctors for Iraq, and since that time has undertaken missions to the most remote and besieged areas and refugee camps to bring aid to the victims.

You were in Fallujah during the first siege in April 2004. Can you tell me something about what you witnessed there?

The day prior to the siege of Fallujah I had a day off. I was home alone and Al-Jazeera transmitted images of the first bombings. Together with a few other doctors I decided to go to Fallujah. I left a note for my family explaining where I was and that I hoped to see them again when I returned. When we arrived at Fallujah the bombings had started and we entered the city through the desert, as all the roads were blocked. Fallujah lies along the Euphrates and to get to the hospital one has to traverse a bridge across the river. It was impossible to reach the hospital, since American troops had closed the bridge. We turned back to town and established a field clinic.

During our stay in Fallujah, American snipers controlled a part of the city, which we called the 'ghost area’. Everything that moved became a target and even ambulances weren’t spared. An ambulance was hit by a missile right before our eyes and completely burned out. This incident was reported by BBC news.[3] I was wounded in the chest by shrapnel during this attack.

The first siege of Fallujah was carried out under a frequently applied tactic called the 'general punishment rule’. When American troops get attacked near a city or village they besiege it. They impose a curfew, which makes it rather impossible for residents to get food supplies. Electricity and water are cut off. This situation persists for days or weeks; families are trapped in their homes. Then, during house raids, numerous people get arrested without any charge.

The 9th of April became known as 'cluster bomb night’. US troops tried to capture the Julan district and used cluster bombs, which cause extremely severe injuries. We treated numerous victims and we had to divide our limited amount of anaesthetics among them. There were only local anaesthetics available to amputate limbs and the doctors had to stitch the wounds with ordinary needles and sewing thread.

After a few days we ran out of food and had to survive on juice, cookies and sugar. There wasn’t a living soul in the streets and ambulances were constantly targeted. When the siege finally came to an end, the first convoy entered the city. Young men arrived in trucks with food supplies and a banner displaying the words "Gift from Sadr City". Sadr City is a poor Shia neighbourhood in Baghdad and Fallujah has a mainly Sunni population. In Iraq there is a great solidarity among the people and the so-called looming civil war is nothing but a fabrication to divide the country.

Half a year later Fallujah was besieged again. What happened then?

The second siege of Fallujah was much worse. When we tried to transport the dead bodies out of the city, we discovered that the American army had made use of illegal weapons.

Is there any evidence of that?

I’m convinced that the testimony of eyewitnesses, scientific facts and an international investigation will provide the evidence. Napalm is an inflammable, sticky gel that burns at 300-350°C (572-662°F), causing fourth degree burnings. The American troops used napalm combined with white phosphorous, which makes the temperature increase up to 3000°C (5432°F). The chemicals react with the water in human cells. Clothes stay intact, but the affected skin burns to the bone. Since these chemicals react with water, the effect worsens when you pour water on it. The only means to stop the burning is by smothering it with mud.

During the three or four days following the attacks, aid workers couldn’t get access to the city. When they were finally allowed to enter, they found that in some districts whole streets and compounds had been bulldozed. You need to understand that the remains of white phosphorous and napalm only stay on the ground for 48-72 hours. After that period you can’t find any useful samples for analysing purposes. On human bodies the effects of these weapons will remain visible for a longer time. We also found bodies of civilians that were obviously not killed in a fighting position. Some of them were lying in their beds when they died and didn’t show external injuries, which also indicates the use of chemical weapons.

Even absent the use of chemical weapons, crimes against humanity occurred. According to the Geneva Conventions it is forbidden to deny life necessities to the people. This is, as a matter of fact, a much more severe violation of human rights than is the use of phosphorous and napalm.

The second attack on Fallujah took place one year ago. How are living conditions in the city today?

Fallujah is still besieged; it’s a prison. Without an identity card no one can move within the city. People who want to enter are required to have retina scans and fingerprints taken. It’s very difficult to move around and there are fixed times to enter or leave the city. Around Fallujah there are five American checkpoints, which are still under daily attacks of the resistance. Fallujans will never forget the losses they suffered and they want the occupiers out.

On weblogs where civilian casualties of Fallujah are mentioned you often read reactions like: "It was the residents’ own fault. They had been warned beforehand to leave the city." What do you think of that?

Before the first siege of Fallujah nobody was warned, so nobody was prepared to leave. Immediately before the second siege women and children had indeed been warned to leave the city. They had to pass through American checkpoints to get out. The population learned, via loudspeakers, that men between 18 and 35 weren’t allowed to leave. Can you imagine that mothers, daughters, sisters and wives would leave their sons, fathers, brothers and husbands behind in a city that was to undergo one of the severest attacks of this war? It’s only natural that they chose to stand beside their loved ones.

Besides, there wasn’t any provision of shelter for the refugees. Those who had permission to leave didn’t have any place to go, so they preferred to barricade themselves in their houses, rather than flee into the desert without any necessities.

For more than six months, American and Iraqi troops have been attacking other cities along the Euphrates. Mass media mentions these attacks rather sporadically and reports are restricted to official press releases of the army and the government. What have you seen there?

I was involved in aid missions to Rawah, Hit, Haditha, Al-Qaim and Tal Afar. These are smaller cities than Fallujah. The army used the same strategy and the attacks were of a similar intensity, although there are some differences to observe. In Qaim, for example, they used so-called 'smart bombs’. These bombs get their name from the assertion that they target insurgents without killing civilians. Can you imagine that?!

Such a 500 kg bomb leaves a crater of 5-6 meters depth and everything within a radius of 500 meters is swept away. These smart bombs increased the number of casualties drastically. There were many children among the victims, since whole families were buried under the rubble of their houses.

In Al-Qaim, a city of about 80,000 inhabitants, one attack on a district resulted in 40 civilian casualties. In Haditha, I know about one bomb attack that killed 31 people.

But that’s not all there is to say about it. By destroying their cities thousands of people were forced to flee. In western Iraq alone, the number of refugee families is estimated at 6,400. Many of them live in the desert without shelter; others live in their cars. They lack all essential provisions and in these remote areas medical care is extremely restricted.

In the official media we don’t hear about any of this. Aren’t there any international fact-finding missions investigating these crimes?

We shouldn’t expect much support from international human rights organisations like Amnesty International or Human Rights Watch. In 2004, AI mentioned that it could be that human rights violations occurred. That’s it. There are very obvious examples of breaches of international law and Amnesty declares that it could be that human rights in Iraq are violated.

With regards to the (mass) media, they haven’t been in Fallujah since the first siege. Journalists report from their hotels in the Green Zone in Baghdad. This heavily fortified area covers only 5 km; the rest of Iraq is Red Zone.

Anyway, we were the only Iraqi organisation that received an invitation from the WHO in Geneva. About a month and a half ago I submitted reports to a session on the humanitarian crisis in western Iraq and the situation of the health care system. I’ve called on the WHO to encourage international aid organisations to resume operations in Iraq; to start an investigation into breaches of the Geneva Conventions regarding medical neutrality; and to pressure the occupying forces to cease their misconduct. We’re still waiting for a reaction from the WHO, but one aid organisation has already announced a mission to Iraq.

What does Doctors for Iraq do to help?

It’s a very difficult task for our small organisation. First, we organise convoys with supplies to the refugee camps. This direct aid to the victims is of great value to them.

Of much higher importance for the future of Iraq is finding a solution to the 'brain drain’ problem, the forced emigration of highly educated medical personnel, which considerably weakens the Iraqi society. A clear example is the case of Dr. Talib Khairiullah, former head of the Iraqi Centre of Cardiology. In 2003 he was forced to resign because of his membership in the Baathist Party. After repeated harassment he decided to leave the country. Before he resigned, he treated a thousand patients a month, and he was the only doctor in Iraq with an American Medical Board certification, an important title for highly qualified medical specialists. His fame reached across Iraq’s borders. After he was dismissed, the centre’s staff protested. During a conversation with the American Minister of Health in Iraq, they learned that an order from Washington required 25 of the 26 residents to resign also. They all left Iraq and are working in Jordan now.

In 2004, the Medical School of Baghdad started the first term with just 60% of its teaching staff; at the beginning of the second term, 50% were left. At the department of ophthalmology only 2 of 9 senior instructors remained.

Have you, personally, also been targeted?

Yes. Our family house was raided three times by the American army. The last time, they detained my 65-year-old father. They held him for eight hours and humiliated him. Then, they took my two sisters to the roof of the house and brought my father there as well, and one of the soldiers forced a gun into his hands and tried to make him kill himself in front of my sisters. Neighbours called the police to intervene, but when they arrived, they told the neighbours they couldn’t do anything to stop it and left. Finally, the soldiers released my father. They returned again to search the house once more.

Is there anything we could do from here to help?

Aid supplies and financial support are of course very important and more than welcome. We have to send out medical teams all the time and therefore we need medical supplies, surgery sets in particular. The problem is that we can hardly do our work. We’re constantly hindered.

Let me give the example of Haditha hospital. At the beginning of last May a car bomb exploded 500 meters from the hospital next to an American convoy. The hospital itself was also damaged. The soldiers came to the hospital and asserted the insurgents were hiding inside. They raided the hospital as if it was a military camp, with sound and light bombs and with snipers. The hospital was occupied from 9 pm until midnight. In one of the operating rooms they arrested all of the doctors, who were prevented from completing the ongoing operations. Soldiers forced the manager of the hospital to lead them through the building, although he had keys to all the rooms, he wasn’t allowed to use them. Instead, they blew open every door of the hospital with explosives and destroyed everything that came in their way. The doctors warned them about the many inflammable products in the hospital, but the soldiers ignored these warnings and set the store and the laundry on fire. They let them burn for 9 hours without making any attempt to extinguish the flames. A 35-year-old patient was killed in his bed.

After the raid we tried to repair the hospital. According to an official report the reparation costs for the building alone amounted to 200,000,000 Iraqi dinars. At the end of the same month, the soldiers returned to destroy the hospital a second time. On the first day of Ramadan in October, the military occupied the hospital for 7 days and used it as a military camp. The hospital manager and one doctor were arrested on charges of treating insurgents. The other doctors issued a press release, but no one responded.

In addition to financial support there is a huge need of volunteers to train doctors because so many of our own doctors are forced to leave the country. Establishing a network of such volunteers would be ideal.

Donations for Doctors for Iraq:

HSBC Bank plc.
56 Cornmarket, Oxford
Oxfordshire,
OX1 3HY
Account name: Doctors for Iraq
Account number: 92302349
Branch Sort Code: 40-35-34

The website of Doctors for Iraq is still under construction but is already operative on: www.doctorsforiraq.org

The author of this interview is a member of the BRussells Tribunal Executive committee[4].

With thanks to Fred Samia who contributed to the English translation of the text.


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