BBC: major Iraq birth defect study expected to show increase linked to conflict

The BBC has reported that a much anticipated study by the WHO and Iraqi Ministry of Health will show that rates of birth defects in Iraq are higher in areas that were subject to heavy fighting in 2003.

22 March 2013 - ICBUW

The report, broadcast on BBC World and available online features an interview with researchers at the Iraqi Ministry of Health (MoH). The researchers indicate that the report, which has been produced jointly by the WHO and MoH, will find that rates of birth defects are higher in areas of Iraq that were subjected to heavy fighting in the 2003 war. The publication of the final report, scheduled for early this year has been delayed, but the BBC's report offers a first glimpse at the results.

“The BBC’s report fits with our expectations from smaller localised studies and the reports of healthcare professionals in Iraq,” said an ICBUW spokesperson. “Naturally we will await the publication of the full report but should the findings and methodology prove to be robust, the study could add considerably to the pressure for action to reduce the legacy of modern conflict on public health. However more research will be needed to establish the precise risk factors responsible.”

The study was launched after concern was generated by reports from medical staff in cities such as Fallujah and Baghdad of spiralling rates of congenital birth defects. Fallujah, which lies in Anbar province, has become particularly notorious and medical staff and civil society organisations have argued that the increases are linked to environmental contamination from the US led attacks on the city in 2004.

Speaking at a workshop for the project in early 2012 Dr Hawrami Minister of Health of the Kurdistan Regional Government said: “There is a need for a comprehensive programme to learn more about birth defects in Iraq that could shed light on the incidence of various conditions, such as congenital heart defects and neurological defects, in different geographic areas over time in Iraq.” 
According to the WHO, the governorates in which the study has been conducted are Baghdad (Karkh and Rafafa), Diyala, Anbar (including the district of Fallujah), Suleimaniyah, Babel, Basrah, Mosul and Thi-Qar. Two districts were selected from each governorate (one as high risk and the other as a control).

The criteria for declaring a district as high risk is based on existing statistics showing a high number of congenital birth defect cases. A total of 10,800 households from 18 districts of the 8+1 governorates were selected as a sample size making it uniformly 600 households per district. All mothers in these households who were married, between the ages of 15 and 49 years, and who had a child with any congenital birth anomaly were included as respondents. Two-stage sampling was undertaken for each child; one before the onset of the 2003 war and the other after the onset of 2003 war.
The WHO in Iraq prioritised measuring the magnitude and trend of congenital birth defects at selected district level, identifying possible risk factors of congenital birth defects and assessing the burden of these conditions and impact on the health status of care providers.

Notes:

BBC World: Doctors in Basra report rise in birth defectshttp://www.bbc.co.uk/news/world-middle-east-21873892
WHO: Congenital birth defect study in Iraq: frequently asked questionshttp://www.emro.who.int/irq/iraq-infocus/faq-congenital-birth-defect-study.html

Mystery in Iraq

Are US Munitions to Blame for Basra Birth Defects?

By Alexander Smoltczyk

Christian Werner/ DER SPIEGEL

The guns have been silent in Iraq for years, but in Basra and Fallujah the number of birth defects and cancer cases is on the rise. Locals believe that American uranium-tipped munitions are to blame and some researchers think they might be right.

It sounds at first as if the old man were drunk. Or perhaps as though he had been reading Greek myths. But Askar Bin Said doesn't read anything, especially not books, and there is no alcohol in Basra. In fact, he says, he saw the creatures he describes with his own eyes: "Some had only one eye in the forehead. Or two heads. One had a tail like a skinned lamb. Another one looked like a perfectly normal child, but with a monkey's face. Or the girl whose legs had grown together, half fish, half human."

The babies Askar Bin Said describes were brought to him. He washed them and wrapped them in shrouds, and then he buried them in the dry soil, littered with bits of plastic and can lids, of his own cemetery, which has been in his family for five generations. It's a cemetery only for children.

Though they are small, the graves are crowded so tightly together that they are almost on top of one another. They look as if someone had overturned toy wheelbarrows full of cement and then scratched the names and dates of death into it before it hardened. In many cases, there isn't even room for the birth date. But it doesn't really matter, because in most cases the two dates are the same.

There are several thousand graves in the cemetery, and another five to 10 are added every day. The large number of graves is certainly conspicuous, says Bin Said. But, he adds, there "really isn't an explanation" for why there are so many dead and deformed newborn babies in Basra.

Others, though, do have an idea why. According to a study published in September in the Bulletin of Environmental Contamination and Toxicology, a professional journal based in the southwestern German city of Heidelberg, there was a sevenfold increase in the number of birth defects in Basra between 1994 and 2003. Of 1,000 live births, 23 had birth defects.

Double and Triple Cancers

Similarly high values are reported from Fallujah, a city that was fiercely contested in the 2003 war. According to the Heidelberg study, the concentration of lead in the milk teeth of sick children from Basra was almost three times as high as comparable values in areas where there was no fighting.

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