Life Under Occupation
By Rory McCarthy in Khalis
The Guardian
29 May , 2003When Tony Blair visits Iraq today, he will be told about the achievements of the British armed forces, the swift and widely welcomed defeat of Saddam Hussein's tyrannical regime and how reconstruction, though difficult, is beginning apace.
It will only be half the story. He will not, for example, hear about Dr Hussain Ridha and the plight of Khalis, a small, provincial capital about 50 miles north of Baghdad. But if Khalis is anything like the hundreds of other small towns and villages across the country, then postwar Iraq is already in a far deeper crisis than its military occupiers will ever admit.Khalis is an unremarkable town of around 40,000 people, set in fertile plains to the east of the Tigris river. Two days ago a newborn baby died in Dr Ridha's hands because the hospital where he works has run out of oxygen.
Doctors are now seeing 200 new patients daily, all suffering from severe diarrhoea. It is twice the average for this time of year. In addition, each day they see at least seven new typhoid patients. Yesterday Dr Ridha was on his last bottle of Flagyl, or metronidazole, one of the main antibiotics he uses for bacterial stomach illnesses.
One of his patients is Ayham Mortadha, a boy just three months old who is suffering from diarrhoea and marasmus, a sign of severe malnutrition that will leave him permanently affected.
Yesterday Ayham lay on a dirty hospital bed next to his mother, Nuha, 18. His face was grey, his small eyes were sunk back in his skull and he was too weak even to cry.
"This is simply the result of poor nutrition, bad hygiene and dirty water," Dr Ridha said. "There is nothing I can do for him other than give him fluids. We have to accept he will grow up stunted and there will be some damage to his brain."
His young mother explained that the family has had to rely on river water for drinking and cooking since the war. "There was no other water available. It was dirty but I had no choice," she said.
The taps in their home ran dry and mineral water in the market is too expensive at around 1,500 dinars (£1) a bottle.
Outside the ward, the hospital's corridors are overcrowded with the sick and the desperate. There are 55 beds and many times more patients. Dr Ridha's paediatrics ward alone has 26 beds and yesterday had 44 young patients, mostly severely dehydrated and undernourished infants.
Remaining stocks of medicine will run out within a week and diesel supplies to run the two overworked generators that keep the hospital operating are already perilously low. Unlike thousands of government employees in Basra and Baghdad, the doctors of Khalis have not been paid for the past three months.
"We prepared ourselves before the war with three months of supplies for us to work only under normal circumstances, not with the number of patients we have now. The supplies run out at the beginning of June," said Mohammad Ahmed, the hospital director.
There is no gas to cook in the kitchen and staff must burn scraps of wood instead. Where they used to serve patients four meals with meat each week, now they serve barely two.
It should be no surprise that more and more people are falling sick every day. With only one hour of power a day there is not enough electricity to keep the town's water treatment plant pumping. One of the main sewage plants in the town was inexplicably bombed during the war and then picked to the bone by looters. It has been repaired but has no generator to allow it to run. The network of cast-iron pipes that supplies people's homes is cracked and leaking. When the power cuts out, the negative pressure sucks in all the sewage pooled around the pipes and delivers it directly into the people's homes.
Chaos
The aid agency Care, one of the few organisations which worked in Iraq for several years before the war, is trying to stop Khalis descending into chaos.Care has delivered medicine and equipment to the hospital and rebuilt the bombed sewage plant. It has repaired the water treatment plant, which finally operates properly for the first time in years.
But the plant still shuts down several times each day because the back-up generators, which take over when the power is out, are already on the verge of breakdown. None of the plant's 30 staff has been paid and so few bother coming to work. The vital chlorine stocks that disinfect the water will last only another three weeks.
At the heart of the problem, aid workers say, is that the highly centralised system of the former regime has been replaced by a power vacuum, run ad hoc by the US-led authority in Baghdad.
"There was a system before. It didn't work very well, but it worked," said Majeed Waleed, Care's programme manager for Iraq. "We welcome the change. But what the authorities are doing now is dismantling it and starting from zero. This is the biggest risk. It has become so politicised that the basic structure to run the country is not yet there. This is now the emergency."
When the US military swept into Iraq they expected after a brief battle to find a government decapitated but otherwise largely intact. Instead the structure has fallen apart, its collapse sped by the US-led de-Ba'athification programme, which excludes up to 30,000 senior government officials from any role in the state.
Many of the problems are the chronic result of 13 years of UN sanctions and Saddam's corruption and mismanagement. Yet under the Geneva conventions, Britain and America, as the occupying powers of Iraq, are obliged to provide basic services such as health, clean water, power and security.
Too few troops on the ground means poor security. Poor security means electricians have only been able to repair half of Iraq's damaged electricity pylons, so power supplies across the country are intermittent at best.
As the crisis in Khalis demonstrates, limited power means little clean water and enormous and mounting pressure on the already fragile health system.
Senior aid officials have warned that as pre-war health and sanitation supplies run out and the summer heat rises, the crisis will deepen before it improves.
"Power is not a luxury. It is the key," said Ramiro Lopes da Silva, the UN humanitarian coordinator for Iraq. "If we are not able to get back these services before the summer sets in when you have no power there will be not enough hands to handle the situation."
In Khalis, Dr Ridha is sanguine given the pathetic state of his hospital. He remembers the years before the sanctions came in 1990, when malnutrition cases were so rare that students flocked to study them and when diarrhoea was as easily treated as in Britain today.
"There is so much we need: medicines, clean water, more space in the hospital, salaries," he said. "It shouldn't be as bad as this." It is not the message Mr Blair is expecting to hear.