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Wednesday, 12 August 1999: The
first surveys since 1991 of child and maternal mortality in Iraq reveal
that in the heavily-populated southern and central parts of the country,
children under five are dying at more than twice the rate they were ten
years ago. UNICEF Executive Director Carol Bellamy said the findings reveal
an ongoing humanitarian emergency.
The surveys, released today by the children's agency, also cover the autonomous
northern region of Iraq. They were carried out between February and May
1999 by UNICEF, together with the Government of Iraq in the southern and
central parts of Iraq and with local authorities in the autonomous northern
region of the country. Technical support for both surveys was provided
by the World Health Organization (WHO). As a consequence of the findings,
UNICEF recommended an immediate implementation of specific proposals made
in United Nations Secretary-General's reports and by the Security Council's
Humanitarian Review Panel. Among the specific proposals are the following:
- The international community should provide additional funding for humanitarian
efforts in Iraq.
- The Government of Iraq should urgently expedite implementation of targeted
nutrition programmes.
- Both the Government of Iraq and the U.N. Sanctions Committee should give
priority to contracts for supplies that will have a direct impact on the well-being
of children.
The surveys reveal that in the south and center of Iraq -- home to 85 per cent
of the country's population -- under-5 mortality more than doubled from 56 deaths
per 1000 live births (1984-1989) to 131 deaths per 1000 live births (1994-1999).
Likewise infant mortality -- defined as the death of children in their first
year -- increased from 47 per 1000 live births to 108 per 1000 live births within
the same time frame. The surveys indicate a maternal mortality ratio in the
south and center of 294 deaths per 100,000 live births over the ten-year period
1989 to 1999.
Ms. Bellamy noted that if the substantial reduction in child mortality throughout
Iraq during the 1980s had continued through the 1990s, there would have been
half a million fewer deaths of children under-five in the country as a whole
during the eight year period 1991 to 1998. As a partial explanation, she pointed
to a March statement of the Security Council Panel on Humanitarian Issues which
states: "Even if not all suffering in Iraq can be imputed to external factors,
especially sanctions, the Iraqi people would not be undergoing such deprivations
in the absence of the prolonged measures imposed by the Security Council and
the effects of war."
UNICEF, as a member of the UN family, recognizes that economic sanctions are
an instrument intended by the international community to promote peace and security,
Ms. Bellamy added. "But our concern is that whenever sanctions are imposed
they should be designed and implemented in such a way as to avoid a negative
impact on children," she said. "Surveys on the situation of children
and women are essential to the ongoing monitoring of the humanitarian situation
there."
Ms. Bellamy also said that the surveys' findings cannot be easily dismissed
as an effort by Iraq to mobilize opposition to UN sanctions.
"The large sample sizes -- nearly 24,000 households randomly selected from
all governorates in the south and center of Iraq and 16,000 from the north --
helped to ensure that the margin of error for child mortality in both surveys
was low," she noted. "Another important factor was the fact that,
in the survey completed in the south and center of Iraq, all the interviewers
were female and all were medical doctors. In the survey done in the northern
autonomous region, fully 80 per cent of interviewers were female -- each team
had at least one female interviewer - and all interviewers were trained health
workers."
UNICEF was involved in all aspects of both surveys, from design to data analysis.
The agency had full access to the hard copies of the interview records and the
complete data sets for the surveys at all times.
"We are happy with the quality of these surveys. They have been thoroughly
reviewed by a panel of independent experts and no major problems were found
with either the results or the way the surveys were conducted," Ms. Bellamy
stated.
UNICEF also said that a dramatic increase in bottle-feeding of infants has occurred
in Iraq. Given the contribution of bottle-feeding to higher levels of malnutrition
and child mortality, UNICEF is urging the Government to remove breastmilk substitutes
from the rations and replace them with additional food for pregnant and lactating
women. UNICEF has also called on the Government to promote exclusive breastfeeding
of infants as a national policy.
In addition, the children's agency stressed the need for the full rehabilitation
of Iraq's education sector, and urged a focusing on quality of education, infrastructure
rehabilitation and planning for the future.
Among the report's additional findings in the south and central areas of Iraq:
- Current levels of under-5 mortality -- as between girls and boys -- reveal
that girls have a slightly lower rate, 125 deaths per 1000 live births as
opposed to 136 deaths per 1000 live births among boys.
- Children who live in rural areas have a higher mortality rate than children
living in an urban area: 145 deaths per 1000 live births as opposed to 121
deaths per 1000 live births.
- In the autonomous northern region, under-5 mortality rose from 80 deaths
per 1000 live births in the period 1984-1989 to 90 deaths per 1000 live births
during the years 1989-1994. The under-5 rate fell to 72 deaths per 1000 live
births between 1994 and 1999. Infant mortality rates followed a similar pattern.
Today's under-5 mortality rate of 131 per 1000 in south and central Iraq is
comparable to current rates in Haiti (132) and Pakistan (136).
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