Interview with Carel de Rooy, Unicef representative in Iraq

This means a more than twofold increase in under-five child mortality! The main causes are complications of diarrhoea and acute respiratory infections, with malnutrition as underlying cause. One in every eight Iraqi children die before they reach there first birthday.

We asked mr. de Rooy if he could make an estimation of the total amount of victims (children) since the beginning of this embargo and the war. He answered that an exact figure is not known, but that by statistic extrapolation of the known figures of child mortality, one cane make calculations to get an approximate figure.

The next survey will be carried out for the period 1999-2003.

2)Short overview of socio-economic history of Iraq

In 1968 the oil production was nationalised.

Between 1975 and 1985 the Iraqi government spend a huge part of their oil incomes to social investments. When compared to other oil producing countries ( mr. de Rooy live a.o. in Venezuela, Colombia and some Arab oil producing countries) Iraq spent a very high percentage of these incomes at education, health infrastructure, employment which led to an increase of the (welvaart) and education of the population.
In the late 70's Iraq found itself at the high border of the middle income class. (low, middle and high income class countries)

In 1985 the war between Iran and Iraq reaches it peak, and some 1 billion dollars are spent to military expenses per year, so that less can be spent to social investments.
Between 1989 and 1991 Iraq mainly pays off war-dept, and in 1991 the sanctions are imposed.
In the child mortality figures there is an increase from 1991 on.
The period 1991-1996 was due to the very strict sanctions a humanitarian disaster, with fats and high increase in child mortality due to malnutrition.

3)The Oil-for-Food program

The OFF program , stresses mr. de Rooy, is a humanitarian intervention and not a developmental program!! It aims not at a global improvement of the country by improving the income and employment of families, education, …but only just those improvements to prevent people from dying.
Therefore, the OFF program resulted in a stagnation and later a very minor improvement of the number of malnutritioned children.

Iraq's oil-incomes are being put on an escroll account in the US, Iraq has no free access to this cash.
30% of these incomes goes to paying off war-dept,
13% goes to the Koerdish in the North ( Autonome Regio, governed by US and GB)
2,2% to the UN and 0,8 % to the weapon-inspectors.
The remaining 54 % can be used for food, medication and other equipments.
Everything that comes in through this OFF program should be approved by the committee 661; at this moment 5,5 billion dollar contracts or on hold due to veto of this committee.

The Iraqi government has always put priority to contracts for food and medication, no matter how high or low the incomes are.
In 1999, the OFF program was in stage 6 ( 1 stage per 6 months) there was an income of 10 billion dollar /6 months. In stage 11 this was only 4,5 billion dollar. Nevertheless the expenses for food remained 1,4 dollar/6m and for medication 250 million dollar/6m!

The ‘food basket' contains rice, oil, wheat, sugar, tea, milk-powder, salt.
Iraq is internationally recognised for its very efficient food distribution system. Every month 24 million people are provided with food rations for about 2300kcal/day/p!! No other country has ever had such a well functioning food distribution system in such circumstances.
In Northern Iraq the food is distributed by the WFP. In southern and central Iraq it is organised by 20000 public councils (possibly linked to the Baath party) that additionally organise everything that pertains to family's basic needs, such as electricity, water and sanitation. This large scale food distribution entails some 350000metric tons/month in the south/centre.

Due to logistic problems ( houdbaarheid) it is virtually impossible for Iraq to put this food basket also fruit, vegetables or meat.
Traditionally the Iraqi people get the proteins in their diet out of meat. The lack of meat since 1991 is due to the difficulties to distribute them with the food basket, but also due to the very low income of most of the Iraqi fqmilies.
If you know that the salary of a teacher is 3 to 5 dollar/ month, and a chicken costs 2 dollar, than you can understand that the malnutrition arises mostly from a shortage of proteins. The shortage of fruit and vegetables gives vitamin shortage. The Iraqi people survive on a diet of sugars and fat.

About 70 % of the necessary medication is provided, in the north as well as in the south. There are no signs of discrimination of the north.
Some life saving medication, e.g. chemotherapy, are contracts on hold and thus they are either short or completely absent. Most vaccines are delivered.
The distribution of the food and medication shows no major problems. If there are some, then this is mostly due to the lack of any (informatisering), everything is still written down and controlled manually…

The food basket contains also infant formula ( milk-powder for baby bottle food). Unicef would like to retain this because of the harm it possibly causes to baby's: breastfeeding is much better because of immunity of the mother being directly transferred to the child, the lower risk of diarrhoea by using infected water to prepare the bottles. Due to the bad economic situation of Iraq, a lot of women are forced to have one or more jobs. Many of them are malnurrished and have anaemia, both of these factors make it difficult for the women to breastfeed…
In 1996 Unicef wanted to remove the infant formula from the food basket. This led to a lot of protest from women all over the country, and the government decided not to remove it. Instead, a large-scale media campaign was set up to promote breastfeeding, with linked to it a program to improve the malnutrition and anaemia of pregnant and lactating mothers. As soon as the population has been sensitised sufficiently, the proposition can be made again.

In short, mr. de Rooy says that the Iraqi, with such a very low income ( devaluation since the eighties of the Iraqi Dinnar from 1ID=3$ to 2000ID= 1$, i.e. more than 6000%!!!) are almost completely depending on this program. Dependency of a school teacher on the food ration has increased from 65% (1990) to over 83% of her/his income today. Every intervention that could interfere with the supply or distribution of these goods would mean a new humanitarian disaster.

4)The Unicef program in Iraq.

- Unicef works together with the Iraqi government. Unicef provides cash to pay contracts for the rebuilding of schools, hospitals, water sanitation, primary health care centres, training of people to become teachers, health workers, …
- In the south and central, Unicef controles the food that enters the country for the OFF program.(control of medication is being done by the WHO)
- In the North Unicef also ensures the implementation of the OFF program in the name of the Iraqi government.
- Morbidity and mortality surveys, mapping malnutrition, vaccination-campaigns, …

5)Cooperation of the Iraqi government.

The cooperation with the Ministery of health, and of Water and Sanitation, is very efficient. Mr. de Rooy states that he has free access to where ever he likes to go, and has never experienced any difficulties in obtaining the information he needed.

The result of this cooperation ( efficient vaccination programs)is that polio and neonatal tetanus have almost disappeared, and they have started the procedure for certification of eradication of these two diseases. (January 2003)
Within the Ministery of education there has been an crisis: a lower bidget goes to education because of priorities being given to health, water and sanitation. There is also a great shortage of teachers, because of the low income. The priority of the Ministery is to rebuild the schools, whereas that of Unicef is to train new teachers first… So in this department there are some discussions.

It is the WHO that covers this subject. Mr. de Rooy states that he knows that the Iraqi government had asked for an independent studie by the UN to the effects of DU on health, but that this investigation has been (tegengehouden) by the US.

When we asked for his opinion on these sanctions, mr. de Rooy said that ‘ the function of Unicef in Iraq is to see to the children's rights. Our studies show the critical situation of the Iraqi people. We give the information about the problems of health and the possible causes. Unicef is part of the UN. Your governments have the opportunity to vote against these sanctions.
As I said before, a new war could interfere with the food distribution, which would be a new humanitarian disaster. The government of Iraq has done in the past a lot of good interventions, but made mistakes that or comprehensible but not excusable. But in Iraq today I see no better alternative than this government. The US are obsessed by overruling this government, but they don't seem to have thought about the consequences, and about the future… and the first victims will again be the women and children of Iraq! This is not a solution…'

In a personal note, dated 20/02/2002, he states as follows:
‘One must ask:
- What is the likelihood of the food distribution system in south/central Iraq being interrupted in the near future?
- What would happen in terms of security if food distribution were interrupted?
- Does the WFP have the capacity to rapidly distribute 350 000 metric tons/month in south/central Iraq if required?

We believe that interruption of food distribution is possible. Pregnant and lactating women as well as very young children are the most likely victims. Chaos would be the immediate effect. Very rapid intervention by the WFP would be required to avoid further deterioration of malnutrition and even famine on a large scale.'

arch/ive/ief (2000 - 2005)