Gut-Wrenching

Kelley Beauchar Vlahos writes:

In this year’s State of the Union address, President Barack Obama declared, “the Iraq war is coming to end”—at least for Americans, leaving “with their heads held high” because “our commitment has been kept.” For millions of Iraqis, however, the war is far from over—in fact, for a growing number of families in cities that were nearly destroyed during the years of insurgency and counter-insurgency, the crisis is only beginning. Whether we take responsibility for our role in it will determine whether we can hold our “heads high” in foreign policy ever again. As one Iraqi-American told TAC, “just because we don’t pay attention, doesn’t mean the rest of the world isn’t paying attention.”

According to studies and eyewitness accounts over the last few years, Fallujah, an Iraqi city that was practically obliterated by U.S. heavy artillery in two major offensives in 2004, is experiencing a staggering rate of birth defects among its local population. The situation echoes similar reports from Basra that began to circulate after the first Gulf War in 1991. The litany of horrors is gut-wrenching: babies born with two heads, one eye in the middle of the face, missing limbs, too many limbs, brain damage, cardiac defects, abnormally large heads, eyeless, missing genitalia, riddled with tumors. Upon touring a clinic in Fallujah in March of last year, the BBC’s John Simpson reported, “we were given details of dozens upon dozens of cases of children with serious birth defects … one photograph I saw showed a newborn baby with three heads.” Later, at the main U.S.-funded hospital in the city, “a stream of parents arrived” with children who had limb defects, spinal conditions, and “other problems.” Authorities in Fallujah reportedly warned women to hold off on having babies at all.

Dr. Ayman Qais, the director of Fallujah’s general hospital, told The Guardian that he was seeing two affected babies a day, compared to two a fortnight in 2008. “Most [deformities] are in the head and spinal cord, but there are also many deficiencies in lower limbs,” he said. “There is also a very marked increase in the number of cases of [children] less than two years with brain tumours. This is now a focus area of multiple tumours.” The pictures and video available with a quick Google search are simply shocking. But there is nothing simple about this issue. On one hand, it is widely accepted among scientists, doctors, and aid workers that war is to blame. The presence of so much expended weaponry, waste and rubble, massive burn pits on U.S. bases, and oil fires has left a toxic legacy that is poisoning the air, the water, and the soil in Iraq. Add highly controversial armaments that the U.S. has only hinted at using in this war—such as depleted uranium—and you get a potentially radioactive landscape giving rise to doomed children and stillborn babies.

“I think we have destroyed Iraq,” says Dr. Adil Shamoo, a biochemist at the University of Maryland who specializes in medical ethics and foreign policy. Shamoo, an Iraqi-American, believes it’s “just common sense” to link Iraq’s troubled health situation to the relentless bombing of its towns and cities and the polluted aftermath of fighting and occupation. The Department of Defense disagrees, rejecting claims that the military is to blame for chronic illnesses, birth defects, and high rates of cancer among the local population and its own service members exposed to the same elements in theater. (DoD officials did not return calls and e-mails to respond to the specific charges made in this story.)

Meanwhile, the Iraqi government has done little to address the public-health crisis in Fallujah and elsewhere. Authorities cannot afford, and seemingly lack the will, to clean up the festering pollution around the country’s population centers while many Iraqis still clamor for clean drinking water and basic medical supplies. “It’s not even on their radar,” offered Geoff Millard, an Iraq War vet who was about to embark this winter on an aid mission with Iraqi Health Now, which raises money for hospitals, clinics, and refugee camps. “If you have a mature democracy with a stable government, you can start to think about the environmental impact. You don’t talk about environmental impact when there are death squads roaming the streets.”

Nevertheless, a joint study by Iraq’s environment, health, and science ministries last summer found 40 sites in the country that are contaminated with high levels of radiation and dioxins—residue, the study claims, from three decades of war. Critics believe there are hundreds of other locations just like these. Areas around urban centers like Fallujah and Basra accounted for 25 percent of the contaminated sites. The pollution of Basra dates back to at least 1982, when Operation Ramadan, the biggest land battle of the Iran-Iraq War—in which the U.S. was on Iraqside, supplying Saddam Hussein with billions in weapons, “dual-use” materials, training, and support—shook the desert outside the city. But in the 20 years since the first Gulf War, Basra has seen a marked increase in childhood illnesses. According to researchers at the University of Washington School of Public Health, the rate of childhood leukemia doubled in Basra from 1993 through 2007.

“This is a serious public health crisis that needs global attention. We need independent and unbiased research into the possible causes of this epidemic,” declared American environmental toxicologist Mazhgan Savabieasfahani, co-author of the most recent report on birth defects in Fallujah. But fathoming the source of this scourge is hard; Iraq is a quick study in environmental malpractice. For example, reports indicate that waste from heavy industry, tanning and paint factories, and hospitals—even raw sewage—is still being dumped into the Tigris and Euphrates rivers and seeping into drinking water. Yet there is little doubt about the toll that 30 years of war and economic sanctions has taken here. Looking at the photographs of babies barely recognizable as human, of toddlers frighteningly tiny, limp from their own deformities, the toll of war and the conditions it creates is evident.

What Happened to Fallujah?

In December, a report in the International Journal of Environmental Research and Public Health declared that since 2003 “congenital malformations” were observed in 15 percent of all births in Fallujah in 2010. Heart defects were the most common, followed by neural tube defects, which cause irreversible and often fatal deformities such as anencephaly, in which the infant is born with parts of the brain and skull missing. By comparison, major birth defects affect only an estimated 3 percent of every live birth in the U.S. and an average of 6 percent of all births worldwide.

The December study focused on births in Fallujah General Hospital during the first half of 2010. In May, it found that 15 percent of all 547 deliveries presented birth defects. That month there were also 76 miscarriages, 60 premature deliveries, and one stillbirth. Researchers saw similar numbers in the first four months of 2010. The study explored the health histories of four families in Fallujah—four fathers, each with two wives, and their 39 offspring. Of the children, three were miscarried, three were stillborn, eight had birth defects and skeletal malformations, and three—by the same mother and father—had leukemia. All of these abnormal births occurred after 2003, save for one child born with leukemia in 2002 and two miscarriages for one mother in 1995.

“The timing of the birth defect occurrences suggests that they may be related to war-associated long-term exposure to contamination,” the report states. “Many known contaminants have the potential to interfere with normal embryonic and fetal development.” The report also suggests that metals such as depleted uranium associated with “augmented” and “targeted” weapons “are potential good candidates to cause birth defects,” but the authors insisted further research was needed to establish a direct cause.

Another recent article, “Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005–2009,” published in the International Journal of Environmental and Public Health last July, undertook a door-to-door survey of 4,843 Fallujah residents in 711 houses. Acknowledging that such surveys have their limits—responses cannot be independently verified, for example—the authors nonetheless highlighted three compelling findings, including a significant 18 percent reduction in the male births in the group after 2004 and a spike in infant mortality—13 percent of live births from 2009 to 2010, compared to 2 percent in Egypt and 1.7 percent in Jordan. Lastly, the frequency of cancers related to radiation exposure, particularly leukemia, between 2005 and 2010 was “alarming” in comparison with national rates in Egypt and Jordan. (The study noted that Iraq still doesn’t keep official cancer statistics.)

“The results reported here do not throw any light upon the identity of the agent(s) causing the increased levels of illness and although we have drawn attention to the use of depleted uranium as one potential relevant exposure, there may be other possibilities,” wrote the authors. Indeed, other possible contaminants are manifold—but depleted uranium has long been a prime suspect.

Depleted Uranium

Depleted uranium (DU) is a dense, highly toxic, radioactive heavy metal that is regularly used by the military for shielding and penetrative capabilities. The Army’s Abrams tanks and Bradley fighting vehicles have it in their armor and in their ammunition. In addition to their long-range penetration abilities, DU-tipped weapons can cause further damage by instantaneously setting their targets on fire. According to GlobalSecurity.org: “On impact with a hard target (such as a tank) the penetrator may generate a cloud of DU dust within the struck vehicle that ignites spontaneously, creating a fire that increases the damage to the target.”

After battle, the carcasses of tanks and remains of exploded or unexploded DU munitions produce radiation, while tiny particles of heavy metal get into the dust and can travel long distances in the air. This dust can be deadly when inhaled, doctors and environmental scientists say. While minimizing the external radiation dangers of DU, a 1994 U.S Army Environmental Policy Institute study conducted in the wake of fears that Gulf War soldiers had been contaminated in “friendly fire” incidents acknowledged that “toxicologically, DU poses a health risk when internalized” and that “using DU on the battlefield poses potential environmental consequences.” It ultimately recommended, however, further study and risk-management, rather than forgoing the use of DU altogether.

The U.S. left an estimated 320 metric tons of DU on the battlefield after the first Gulf War. DU rounds conferred a distinct advantage over the Iraqis, destroying some 4,000 of their tanks, many which still pollute the desert landscape. “The invisible particles created when those bullets struck and burned are still ‘hot.’ They make Geiger counters sing, and they stick to the tanks, contaminating the soil and blowing in the desert wind, as they will for the 4.5 billion years it will take the DU to lose just half its radioactivity,” wrote Scott Peterson in the Christian Science Monitor.

Later Peterson documented evidence of DU in Baghdad after the 2003 war, checking “hot spots” around battle debris with a Geiger counter. He noted that the Air Force had admitted that its A-1 “Warthog” planes had shot 300,000 rounds during the “shock and awe” phase of the invasion. Typically, the “normal combat mix” for the 30-mm cannon on the A-1 is five DU bullets to one high-explosive incendiary round. “The children haven’t been told not to play with the radioactive debris,” Peterson wrote. He saw only one site where U.S. troops had put up handwritten warnings in Arabic for Iraqis to stay away. “There, a 3-foot-long DU dart from a 120 mm tank shell, was found producing radiation at more than 1,300 times background levels. It made the [Geiger counter] staccato bursts turn into a steady whine.”

Getting an accurate picture of how DU has been used by American forces in Iraq since 2003 has been impossible. But the military hasn’t always been so tight-lipped. On the eve of the war, noted California-based researcher Dan Fahey, the Pentagon was engaging in its own pro-DU propaganda. “The campaign had two goals: to justify the use of DU munitions as a military necessity, and to dismiss concerns about the health and environmental effects of use,” wrote Fahey in 2005. Indeed, in a March 18, 2003 press briefing, two days before the invasion, Col. James Naughton of the U.S. Army Material Command boasted that Iraqis “want [DU] to go away because we kicked the crap out of them” in the tank battles of 1991.“Their soldiers can’t be really amused at the idea of going out in basically the same tanks with some slight improvements and taking on Abrams again.”

The bragging stopped after “shock and awe.” Officials now merely insist that DU exposure is not responsible for serious health problems in Iraq. When confronted with the evidence of birth defects in Fallujah, Pentagon spokesman Michael Kilpatrick told the BBC last year, “no studies to date have indicated environmental issues resulting in specific health issues.” The Pentagon is backed up by selected studies, like the one conducted by the International Atomic Energy Agency in 2010, which examined soil, water, and vegetation in four areas—including Basra but not Fallujah—and concluded “the radiation doses from DU do not pose a radiological hazard to the population at the four studied locations in southern Iraq.” The report takes for granted that DU was indeed used throughout the war theater. Interestingly, both the IAEA and the Army have acknowledged the importance of handling weapon fragments and vehicle scraps as radioactive waste. “They specifically told us not to climb on tanks that have been shelled,” says Geoff Millard, who got a brief warning about DU as a young soldier in 2000.

The exact composition of the munitions expended during the fighting in Fallujah in late 2004 remains unknown. But the scale of the pollution can be gauged by the magnitude of the bombardment. According to Rebecca Grant, writing for Air Force Magazine in 2005, the U.S. conducted relentless air assaults in the First Battle of Fallujah from March through September 2004 and launched a second phase that November. She describes a “steady pace of air attacks” in a mostly urban “manhunt” using AC-130 gunships and fixed-wing aircraft, even after commanders were told early on to scale it back due to political considerations over collateral damage. F-15 jets would swoop down and strafe insurgents to provide ground cover while Marines called in strikes on cornered insurgents from GPS-guided missiles like the new 500-lb GBU-38 JDAM (Joint Direct Attack Munition), which could “pluck” buildings “right out of the middle of very populated areas.”

What Grant’s account does not include is the use of DU and even white phosphorous, which, when it comes into human contact, sizzles flesh right off the bone. A year after doctors in Fallujah began reporting the telltale burns, a Pentagon spokesman admitted to the BBC that that white phosphorus was indeed “used as an incendiary weapon against enemy combatants” in 2004. (Initially, the military had insisted it was only used for battlefield illumination.) “When they went in they basically pulled out all the stops,” said investigative journalist Dahr Jamail, who was on the ground in Fallujah in late 2004. He told TAC that he is not surprised by the birth defects in Fallujah today, having seen the aftermath of presumed DU use in “massive quantities.”

As for its effect on reproductive development in Fallujah, there is no consensus among researchers, but there is plenty of material to pore over. Critics among the scientific community can point to a decade of studies about DU’s detrimental effects upon health, including a 2006 report that found DU exposure led to gene disruption in laboratory rats and similar experiments suggesting exposure could lead to low birth weight and skeletal malformations.

Other Contaminants

The problem with trying to identify a primary contributor to birth defects in Iraq is that the country is a cauldron of contamination. Aside from the polluted water, there are the ubiquitous toxic plumes from burning waste on U.S. bases, as well as oil and gas fires dotting the landscape. (No fewer than 469 incidents of oil and gas blazes, mostly from insurgents blowing up pipelines, were recorded between 2003 and 2008.) Military researchers have also been looking to heavy metals—both naturally occurring and otherwise—in the dust kicked up in the desert after so many battle-driven ruptures of the earth. Saddam himself used chemical weapons against his own people and allegedly directed his men fleeing the 2003 invasion to sabotage the old water treatment plant at Qarmat Ali, just north of Basra where the Tigris and Euphrates Rivers meet, by littering it with an anti-corrosive powder containing huge amounts of hexavalent chromium, a chemical known to cause cancer.

Some of the Oregon National Guard soldiers who later worked and lived at the plant—assured by defense contractor Kellogg, Brown, and Root that Qarmat Ali was safe—are now so sick they can barely walk. “This is our Agent Orange,” veteran Scott Ashby told The Oregonian in 2009, referring to the herbicide sprayed by U.S. forces over huge swaths of the Vietnamese countryside from 1961 to 1971. A 2003 Columbia University study estimates upwards of 4.5 million people were exposed; the Vietnamese government has estimated 480,000 deaths and 500,000 born with birth defects as a result. American veterans had to sue to get attention for illnesses relating to AO exposure.

In a sense, what is happening throughout Iraq today is the 21st-century’s Agent Orange. As in Vietnam a generation earlier, Americans have rushed to the emotional exits in Iraq, chalking the war up to a blunder best resigned to the history books. Ignoring the “steady whine” of their moral Geiger counters, the U.S. public neatly tucks away photographs of deformed Iraqi babies next to the fading memories of Vietnamese children and American veterans scarred by battlefield chemicals. Collective denial has turned out to be empire’s best friend, as a Southeast Asian foreign-policy disaster has given way to a 30-year catastrophe in the Middle East.