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Public health at risk as aid agencies pull out of Iraq

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7414.522-d (Published 04 September 2003) Cite this as: BMJ 2003;327:522
  1. Upasana Tayal
  1. BMJ

    Four major non-governmental organisations are scaling down their operations in Iraq amid security concerns after the bombings of the UN headquarters and the Jordanian embassy in Baghdad.

    The International Committee of the Red Cross, Oxfam, Save the Children, and Merlin have withdrawn their international staff from Baghdad.

    “The decision to temporarily withdraw our international staff from Iraq comes from a general insecurity since the end of the war,” said Brendan Cox, a spokesman for Oxfam.

    A car bombing of the Jordanian embassy on 7 August killed at least 11 people, and on 19 August a suicide bomb attack on the UN headquarters killed at least 23 people and wounded more than 100. Recently a series of grenade and bomb attacks have been directed at foreign journalists and aid workers

    Brendan Paddy, a spokesman for Save the Children, said: “There is a clear pattern of events—the bombings—showing that humanitarian workers are not being treated as impartial.”

    Commenting on the impact of the withdrawal of the charity, he said: “We are concerned about the spread of communicable disease, diarrhoea, and cholera and that the situation is deteriorating and not getting better. The level of assistance in Baghdad is decreasing at a time when the Iraqi people need all we have to offer and more.”

    Both agencies are demanding that the US and UK governments take action. Mr Cox said, “We are calling for the coalition and the UN to take urgent action to stabilise the situation so aid agencies can do their work.”

    Mr Paddy added: “Ultimately the occupying powers are responsible for the health of Iraqi people, and they must create a safe space for independent agencies.”

    Merlin, a UK based medical relief agency, has relocated its international staff to Amman in Jordan. Gerson Brandao, head of Merlin's mission in Iraq, spoke from Jordan: “Merlin is now keeping a low profile in Iraq. Most of our activities are carried out by local Iraqi staff.” He expressed concern for his colleagues in Baghdad: “They are also being harassed by the US military at checkpoints. Sometimes it's quite aggressive. For them we are the enemies.”

    The International Committee of the Red Cross has been reducing staff numbers since late July, when a staff member was murdered outside Baghdad.

    However, some aid agencies, such as the Catholic Agency for Overseas Development (CAFOD), Unicef, and Care, are staying. Bjarne Jorgensen, CAFOD's emergency coordinator in Baghdad, spoke of the health situation in Iraq: “If they [the aid agencies] stop their activities it has an impact on public health. The quality of the health service is affected by the general situation.” He cites security, especially for medical staff, and clean water supplies as the biggest health concerns.

    Médecins Sans Frontières is also staying. Marc Joolens, the charity's Iraqi operations coordinator, said: “We decided not to leave because we still see humanitarian and medical needs in Baghdad. We provide primary care services, with up to 2500 consultations per week.” He admitted, though, that safety was as bad as during the war.