Collateral damage: the health and environmental costs of war on Iraq (revisiting a 2002 report)

Collateral Damage: the health and environmental costs of war on Iraq was issued in London on 12 November 2002 by the global health organisation Medact, the UK affiliate of International Physicians for the Prevention of Nuclear War - winner of the Nobel Peace Prize in 1985. It was released on the same day in the US by IPPNW and its US affiliate Physicians for Social Responsibility, and by other IPPNW affiliates in over a dozen other countries, including: Australia; Denmark; France; Germany; Guatemala; Malaysia; Norway; Netherlands; Japan; India; Philippines; Canada; US; UK; and Australia.

In Australia the Medical Association for Prevention of War (MAPW) launched the report in Federal Parliament, Canberra at a press conference. MAPW President Dr Sue Wareham launched the report at the event hosted by the Australian Greens Senator Kerry Nettle. Former Chief of the Australian Defence Forces, General Peter Gration, also provided a letter of commendation for the report, which is available below.

Up to four million people could die in a war on Iraq involving nuclear weapons. A more contained conflict could cause half a million deaths and have a devastating impact on the lives, health and environment of the combatants, Iraqi civilians, and people in neighbouring countries and beyond. It could also damage the global economy and thus indirectly harm the health and well-being of millions more people across the world.

Researched and written by health professionals, this evidence-based report examines the likely impact of a new war on Iraq from a public health perspective. Credible estimates of the total possible deaths on all sides during the conflict and the following three months range from 48,000 to over 260,000. Civil war within Iraq could add another 20,000 deaths. Additional later deaths from post-war adverse health effects could reach 200,000. If nuclear weapons were used the death toll could reach 3,900,000. In all scenarios the majority of casualties will be civilians.

The aftermath of a 'conventional' war could include civil war, famine and epidemics, millions of refugees and displaced people, catastrophic effects on children's health and development, economic collapse including failure of agriculture and manufacturing, and a requirement for long-term peacekeeping.

Destabilisation and possible regime change in countries neighbouring Iraq is also possible, as well as more terrorist attacks. Global economic crisis may be triggered through trade reduction and soaring oil prices, with particularly devastating consequences for developing countries.

The financial burden will be enormous on all sides, with arms spending, occupation costs, relief and reconstruction possibly exceeding $150-200bn. The US is likely to spend $50bn - $200bn on the war and $5bn - 20bn annually on the occupation. As the report points out, $100bn would fund about four years of expenditure to address the health needs of the world's poorest people.

The avowed US aim of regime change means any new conflict will be much more intense and destructive than the 1990-91 Gulf War, and will involve more deadly weapons developed in the interim. Furthermore, the mental and physical health of ordinary Iraqis is far worse than it was in 1991, making them much more vulnerable this time round, and even less able to muster the resources needed for recovery and reconstruction.

Thanks to the oil revenues and social policies of Saddam Hussein's dictatorship, Iraq pre 1991 had become a reasonably prosperous, urbanised, middle-income country with a modern social infrastructure and good public services. The combined effects of war and sanctions, only partly offset by the humanitarian relief of the Oil-for-Food programme, relegated it to a pre-industrial age, and it now occupies a lowly 126th place out of 174 in the UN Human Development Index

The report bases its estimates on data from the earlier Gulf War, from comparable conflicts and crises elsewhere, and from the most reliable recent information on the health status of Iraq. It hypothesises a credible war scenario from current US military strategy, which envisages four different elements: sustained and devastating air attacks on government and military facilities and infrastructure in Baghdad and other major urban centres; landing of ground forces to seize oil-producing regions in the south east; gaining control of north Iraq; and rapid deployment forces backed by air attacks to take Baghdad.

The US goal of leadership change is counterbalanced by Saddam Hussein's goal of survival, so a short, clinical campaign is probably wishful thinking. The options open to Saddam Hussein include:

-firing oil wells and using radiological or chemical missiles to pollute the sites

The report considers the circumstances in which more substantial use of chemical, biological and nuclear weapons may occur. An Iraqi CBW attack on Israel or elsewhere could provoke immediate nuclear retaliation from Israel, the US and/or UK, while the UK and US have not ruled out the nuclear first-strike option. Many questions remain unanswered about the aftermath and the likelihood of installing a stable new regime. The current problems of Afghanistan provide a reminder of the huge investment required to rebuild a shattered country, and the reluctance of the global community to support such long-term development.

As an objective report by health professionals, the report does not take a political stance on the alternatives to war on Iraq. Its main goal is to aid decision-making and encourage informed public debate by spelling out the true cost of a new war, against which any potential gains from going to war must be weighed. It lists non-violent strategies that have not yet been fully explored - some relating specifically to Iraq, and some to improving the international security context. It concludes that there is an urgent need for humane and wise global leadership which recognises that national security is impossible without international security.

Came across this on Andrew Sullivan's blog. Always nice to revisit what the "experts" had to say about things.

Leaving aside how insanely wrong they were about casualties, note the fact that Iraq having WMDs is not even questioned.

OK gang, a little Sunday morning schadenfreude. Have at it.

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