The Health Effects of War: Conversations with an Iraqi Doctor

By Mary Anne Mercer, senior lecturer, University of Washington Department of Global Health

Obstetrician Dr. Muhsin Al Sabbak of Basrah, Iraq, accompanied by an environmental toxicologist, Dr. Mozhgan Savabieasfahani, recently spoke in Seattle on increases in birth defects since the US-sponsored wars in Iraq.  The presentations were sponsored by the University of Washington and various community groups.

Dr. Al Sabbak is chair of the Department of Obstetrics and Gynecology at the Basrah Maternity and Children’s Hospital in southern Iraq and has served on the faculty of the Basrah Medical School for nearly three decades. After the first US-Iraq war in 1991, he began to track birth defects among the infants he delivered. The rates began to rise in the late 1990s, increasing from 1.37 infants with obvious defects for every thousand women he delivered from October 1994 to 1995 up to 23 per thousand in 2003, a 17-fold increase.  Alarmed at the growing numbers, he carefully photographed several thousand newborns with anomalies of many types. His presentation included pictures of a few of the tragic conditions he faces with his patients, some of them with such extreme or unusual deformities that neonatologists could not classify them.

There is growing evidence that a major cause of the increases in birth anomalies comes from environmental contamination with heavy metals and other toxins that were generated by US military bases during burning of waste in open air pits, and by heavy bombardment of Iraqi cities. Exposure to fine particulates of heavy metals –that become airborne during and after bombing explosions– is thought to be a main cause of the rise in newborn anomalies. Pregnant women and their growing fetuses are highly sensitive to exposure to metals which could lead to birth defects and neurodevelopmental disorders that have become common in Iraq after 2003. Metals enter the body mainly by inhalation and their levels build up over time. Heavy metals are known to wreak havoc on the human genome, damaging the DNA of egg and sperm cells. Dr. Savabieasfahani has collected hair, nail and deciduous tooth samples from the parents and the children themselves who were born with birth defects and has found unusually high concentrations of various heavy metals such as titanium, magnesium, lead, and mercury — all heavily used in the production of US weapons.

Of particular interest is the finding that US soldiers who served in Iraq and had numerous medical problems as a result of their service were also found to have high levels of titanium in body tissues. In addition to the contaminated dust of military bombardment, soldiers were exposed to smoke from massive open-air burn pits that were used to destroy the waste products generated by the occupation. Some of the burn pits were as large as 10 acres, and around the clock burned items that might include batteries, electronics, plastics, asbestos products and the corpses of dead animals and humans. Samples tested from the smoke of one burn pit contained a highly poisonous mixture of dioxins, furans, volatile organic compounds, poly-aromatic hydrocarbons, and other poisonous particulate matter. The US corporations Halliburton and KBR used the pits as an economical method of waste disposal on the bases that they supplied.

How to address environmental devastation of this magnitude is a major challenge, and one that the international public health community has not yet begun to address. Because most of the burn pits are still in place and still contain high levels of toxic chemicals, they continue to expose the Iraqi population to their pollutants. One approach that could be a small step in both acknowledging the devastation that US wars have caused and helping to ameliorate its effects would be requiring that the army or its contractors clean up the burn pits. Much more research is badly needed, however, and funding for that research will likely be available only when we recognize our responsibility for causing the devastation in the first place.