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ATTACKING THE WATER


The following reports, recently declassified, were prepared by the US Defence Intelligence Agency.

The first, 'IRAQ WATER TREATMENT VULNERABILITIES' was circulated to all major allied commands on January 22nd 1991, seven days after the bombing of Iraq began.

It states clearly and equivocally that the destruction of Iraq's water supply and treatment capability was of prime concern to military planners. The document was obtained by Professor Thomas J. Nagy, Professor of Expert Systems at George Washington University, and excerpts were first published in The Sunday Herald on September 17th 2000. At a House hearing on June 7th 2001, Representative Cynthia McKinney, Democrat of Georgia, referred to the document 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 civilised nations."

Contaminated drinking water produced the epidemics of typhoid and cholera that the report referred to, with 10 and 20 fold increases respectively by June 1991. Diarrhoea became the primary cause of infant mortality. The 'knock-on' effect of damage to industrial capacity that the report mentioned also became a reality.

I have highlighted crucial points of the document in red.

Additional reports indicating the US opinion that health care standards were generally poor or politically biased in pre-war Iraq are vehemently denied by health care workers in the country.

Professor Nagy has since unearthed further DIA documents, excerpts of which feature in his article for THE PROGRESSIVE magazine. I have reproduced both his article and the documents beneath. They were first disclosed on the GulfLink web site. Professor Nagy provides links and instructions on how to see these documents for yourself.


IRAQ WATER TREATMENT 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 TREATMENT VULNERABILITIES (U) AS OF 18 JAN 91 - KEY JUDGEMENTS.

1.     IRAQ DEPENDS ON IMPORTING SPECIALISED EQUIPMENT AND SOME CHEMICALS TO PURIFY ITS WATER SUPPLY, MOST OF WHICH IS HEAVILY 
MINERALISED AND FREQUENTLY BRACKISH TO SALINE.
2.     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.

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, FERTILISERS, PETROLEUM REFINING, ELECTRONICS, PHARMACEUTICALS, FOOD PROCESSING, TEXTILES, CONCRETE
CONSTRUCTION, AND THERMAL POWER PLANTS.

4.     IRAQ'S OVERALL WATER TREATMENT CAPABILITY WILL SUFFER A SLOW DECLINE, RATHER THAN A PRECIPITOUS HALT, AS DWINDLING
SUPPLIES AND CANNIBALISED PARTS ARE CONCENTRATED AT HIGHER PRIORITY LOCATIONS. 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.

5.     UNLESS WATER TREATMENT SUPPLIES ARE EXEMPTED FROM THE UN SANCTIONS 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 CHARACTERISE 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. 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 MINERALISED WATER COULD RESULT IN DIARRHOEA AND, OVER THE LONG TERM, STONES FORMING WITHIN THE BODY. FOR 
INDUSTRIAL APPLICATIONS, PIPES AND OTHER EQUIPMENT WOULD SCALE (BECOME ENCRUSTED), EVENTUALLY CAUSING PLANTS TO
SHUT DOWN. SCALING IN BOILERS WOULD CAUSE EXPLOSIONS IF NOT PREVENTED OR REMOVED.

8.     MUCH OF IRAQ'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 
IRAQIS MUST REDUCE THE WATER VOLUME IN THE LAKES DURING THE LOW-WATER SEASON. Evaporation DURING THE SUMMER ACCOMPLISHES 
THIS IN PART. 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 SPECIALISES IN SALINE-RESISTANT CROPS SUCH AS BARLEY
AND DATES) AND URBAN AREAS, INCLUDING BAGHDAD. THE KARKH WATER TREATMENT PROJECT FOR WESTERN BAGHDAD HAS AN IN-TAKE POINT 
ABOUT 40 KILOMETRES NORTH OF BAGHDAD, UPSTREAM FROM WHERE LAKE THARTHAR DISCHARGES INTO THE TIGRIS. WATER BELOW THE 
DISCHARGE POINT REQUIRES DESALINISATION.

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 DESALINISATION 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 ORGANISATION STANDARD FOR HUMAN
CONSUMPTION IS 500 PPM OR LESS. GROUND WATER IN IRAQ'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.   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 IRAQIS 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 NORMALLY IS ACCOMPLISHED DURING SEVERAL STAGES OF PURIFICATION, INCLUDING THE INITIAL 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 LIQUID, OR CALCIUM HYPOCHLORITE, A POWDER. IF THEY ARE EQUIPPED WITH
INJECTORS, LOW-CAPACITY PLANTS CAN USE CHLORINE GAS DIRECTLY. IRAQ'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
IRAQ, AND SUPPLIES OF COPPER SULPHATE ARE UNKNOWN. SULPHURIC 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 IRAQ HAS NOT BEEN DETERMINED. LOCAL COMPANIES SELL BOTTLED SOFT WATER IN IRAQ, 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 IRAQI 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 PRE-TREATMENT 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 IRAQI WATER SUPPLIED FOR INDUSTRIAL AND HUMAN CONSUMPTION REQUIRES DESALINISATION. IRAQ
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
REQUIRED. PREVIOUS IRAQI USE OF SUBSTITUTES HAS NOT BEEN SATISFACTORY. IRAQ 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 CORRESPOND 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 IRAQ USES IN SOME DESALINISATION EQUIPMENT, DETERIORATE WHEN EXPOSED TO CHLORINE
IONS. PRIOR TO PASSING THROUGH THE MEMBRANE, WATER IS TREATED WITH SODIUM METABISULPHITE TO REMOVE THE CHLORINE USED IN
PRE-TREATMENT. 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. IRAQ ALSO USES
CELLULOSE ACETATE MEMBRANES (AN OLD TECHNOLOGY), WHICH HAVE AN EXCEPTIONALLY SHORT LIFE AND ARE SUSCEPTIBLE TO BIOLOGICAL
CONTAMINATION. IRAQ REPORTEDLY CAN MANUFACTURE CELLULOSE MEMBRANES, BUT THE AVAILABILITY OF PRECURSOR STOCKS IS
PROBABLY LOW.IRAQ HAD BEEN ACQUIRING REVERSE ELECTRODIALYSIS ION EXCHANGE MEMBRANES PRIOR TO THE UN SANCTIONS. HOWEVER,
MOST SYSTEMS USE REVERSE OSMOSIS OR UNIDIRECTIONAL ELECTRODIALYSIS, WHICH, UNLIKE REVERSE ELECTRODIALYSIS MEMBRANES 
REQUIRE 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 DESALINISATION 
ARE REQUIRED TO PREVENT PIPES AND EQUIPMENT FROM CORRODING OR SCALING. IN THE PETRO CHEMICAL INDUSTRY, WATER USED FOR
COOLING IS PARTIALLY TREATED TO PREVENT SCALING. WATER USED IN THERMAL POWER PLANTS 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 REQUIRE EXTREMELY PURE WATER THAT IS FREE FROM
BIOLOGICAL CONTAMINANTS. LARGE INDUSTRIAL PLANTS, INCLUDING PETROCHEMICAL, REFINING, AND FERTILISER PLANTS, COLLOCATE
THEIR WATER TREATMENT FACILITIES. TURNKEY CONTRACTORS BUILT THESE FACILITIES, AND THE PARTS ARE SPECIFIC TO EACH SYSTEM,
WHICH COMPLICATES THEIR REPLACEMENT. THE IRAQIS 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 ADEQUATE FOR THEIR NATIONAL REQUIREMENTS.

21.     VARIOUS IRAQI INDUSTRIES HAVE WATER TREATMENT CHEMICAL SAND EQUIPMENT ON HAND, IF THEY HAVE NOT ALREADY BEEN CONSUMED
OR BROKEN. IRAQ POSSIBLY COULD CANNIBALISE 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 CONTAINERISED REVERSE OSMOSIS MODULES FOR LOCALISED USE THAT COULD BE RELOCATED. WITHOUT CHEMICALS AND
REPLACEMENT MEMBRANES, THESE UNITS WHERE EVENTUALLY WOULD BECOME USELESS. HOWEVER, CONSOLIDATING CHEMICALS OR CANNIBALISING
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 EQUIPMENT.

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.     IRAQ HAS INSTALLED A PIPELINE FROM THE DOHA DESALINISATION PLANT IN KUWAIT THAT CONNECTS WITH DISTRIBUTION
PIPES AT A WATER TREATMENT 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 QUANTITY PRODUCED WOULD BE INADEQUATE FOR NATIONAL
REQUIREMENTS. 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 DESALINISATION PROCESS, WHICH REQUIRES ACID DOSING OR THE ADDITION OF POLYMERS TO PREVENT
SCALING OF THE HEAT EXCHANGES. THE UN SANCTIONS MAY PREVENT RE-SUPPLY OF THESE CHEMICALS. INTENSIVE MAINTENANCE ALSO IS
REQUIRED TO KEEP THE UNITS OPERATING, AND THAT PROBABLY WOULD REQUIRE 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 MINERALISATION AND
SALINITY ARE WITHIN ACCEPTABLE LIMITS. FOR THE SHORT TERM, IRAQ 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 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.

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 REQUIRED CHEMICALS AND
DESALINISATION 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 DESALINISATION 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. 
CANNIBALISING LOWER PRIORITY OPERATIONS WILL ACCELERATE THE TREND.

28.     THE ENTIRE IRAQI 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, IRAQ'S
LARGEST WATER TREATMENT 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 CENTRALISED 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 ADEQUATE STOCKPILING PRIOR TO THE INVASION OF KUWAIT. SOME CHEMICALS ARE DEPLETED OR ARE NEARING DEPLETION, AND OLDER
MEMBRANES ARE NOT BEING REPLACED ON SCHEDULE. CONSEQUENTLY, 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.

 

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

by
Professor Thomas J. Nagy

Published in THE PROGRESSIVE magazine
August 2001


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.

 

See for Yourself

All the DIA documents mentioned in this article were found at the Department of Defense's Gulflink site.

To read or print documents:

1. go to

2. click on "Declassified Documents" on the left side of the front page

3. the next page is entitled "Browse Recently Declassified Documents"

4. click on "search" under "Declassifed Documents" on the left side of that page

5. the next page is entitled "Search Recently Declassified Documents"

6. enter search terms such as "disease information effects of bombing"

7. click on the search button

8. the next page is entitled "Data Sources"

9. click on DIA

10. click on one of the titles

It's not the easiest, best-organized site on the Internet, but I have found the folks at Gulflink to be helpful and responsive.
Thomas J. Nagy

 


 

File: 950901_0504rept_91.txt
Page: 91
Total Pages: 1

DISEASE INFORMATION

Filename: 0504rept.91


From: [   (b)(6)   ]             
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 receipt 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 area 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 Diarrhea - 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 long 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 andconsidered 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 Domestic 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.

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.

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.


IIR 6 898 0446 91 / STATUS OF DISEASE AT REFUGEE CAMPS

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.


[   (b)(2)   ]


BT

#5947


INFODATE:        0

 


(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.


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DEPARTMENT OF DEFENSE
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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
MEDICALNEEDS 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


NOTE: I was unable to find the document "Iraq: Assessment of Current Health Threats and Capabilities" that Professor Nagy mentioned in his article, but instead found an additional document.


File name: 0131pgv.91d

Subject:       HEALTH CONDITIONS IN IRAQ AND PROSPECTS FOR THE FUTURE

The increased disease incidence in Iraq should stabilize over
the next six months. Overall improvement in the medical.conditions
in the civilian population will be determined by how quickly
essential supporting services (water, sanitation, and electricity)
are restored. Iraq's healthcare infrastructure essentially
remained intact during DESERT STORM and during the civil unrest, improving
the future outlook.


Iraqi healthcare capabilities prior to August 1990, while on
the ascent,  suffered significant deficiencies, particularly in
quality and quantity of healthcare staffing, and the availability
and distribution of medical material. Modern medical treatment
protocols, equipment, and medicines were limited to only a- few
premier hospitals, primarily because of financial constraints,
military priorities, and to a general lack of governmental concern
and support. Current restoration efforts are likely to be limited
by the same factors.

The  extent  of  direct  damage  to  Iraq's  healthcare
infrastructure during DESERT STORM cannot be fully assessed at
this time.  However  significantly more  damage  occurred  during   the
subsequent civil war. A number of hospitals located in cities that
were sites of the heaviest fighting were reportedly shelled and
the interiors looted and healthcare workers routed. Overall, most of
the country's medical treatment facilities are believed intact and
operational. These include an estimated 18 new, potentially full
service hospitals (15 civilian and the military) constructed in
major cities since the early 1980s. The loss of electrical power
and water significantly reduces hospital treatment capabilities
and increases the potential for hospital acquired infection.  While
these services are being restored to Baghdad hospitals; hospitals
outside Baghdad are likely to remain without power and water for
quite some time to come.

During the 1980s, communicable disease incidence in Iraq was
lowered primarily through improved sanitation and health care
delivery. The breakdown of public services (water purification and
distribution,  waste disposal,  electricity,  communication,  and
transportation)  has been the primary cause for degradation of
health conditions in post-war Iraq. As a result, the incidence of
communicable diseases (primarily diarrleal and acute respiratory
diseases) in civilian populations has increased.

However, the disease situation cannot be precisely determined.
There is no reliable baseline for determining the magnitude of
increased disease occurrence in Iraq, as pre-crisis Iraqi disease
surveillance  reports were insufficient  for determining normal
disease levels. Post-crisis reports will remain incomplete and
probably will be politically biased. For example, although cholera
is known to be endemic in Iraq, no cases were reported between
1978 and the end of DESERT STORM. Therefore, initiation of cholera
reporting in May 1991 may be an attempt by the Iraqi Government to
gain international sympathy.

Current and forecasted morbidity and mortality estimates
provided by international and private medical Organizations are
based  on  incomplete  data  and  may  be  misleading.   Based  on
information obtained during late March to early May 1991,
estimates on the amount of increased diarrheal cases' have range from two to
tenfold  above normal  levels.  However,  the  Iraqi   government
continually has restricted foreign observers' access to locations,
facilities, and medical records, thereby limiting the quantity and
quality of collected data. Even if accurate, the recent
projections by a Harvard medical team of an increased 170,000 child deaths in
1991 only represent an increase of the 5 percent pre-crisis child
mortality rate to 10 percent. Additionally, the projections may be
an over-estimate because their data only covered a two week period
and they assumed that health and living conditions would not
improve during the summer.

Health conditions can be expected to improve as public
services are restored and the population learns to cope with the
current situation. Moreover, Iraq has received massive amounts of
aid in the form of power generators, water, water purificatio
sewage equipment, food, and medicines from international
assistance agencies. The bulk of initial Iraqi government and
international public service and medical reconstruction efforts,
however, appears to have been primarily limited to Baghdad and the
capital region.

Over the next six months, AFMIC analysts expect disease
incidence in Iraq to stabilize above pre-crisis levels, but below
the levels projected by the Harvard team. Although disease
outbreaks are expected, actual morbidity and mortality rates will
not be known. Communicable diseases with the highest potential
public health impact (in descending order) include acute
diarrheas, acute respiratory infections, typhoid and paratyphoid fevers,
childhood diseases, hepatitis A, and cholera; children and the
elderly are at increased risk.  Populations most likely to be
severely  affected  are  the  Shiites  in  southern   Iraq,  lower
socio-economic groups in major urban areas, and the Kurds in the
north.

                             (Epidemiology Branch)


ARMED FORCES MEDICAL INTELLIGENCE CENTER


 

INDEX