The Great War for Civilisation

by Robert Fisk

  Latif Abdul Sattar was playing with a small electric car when I first caught sight of him. His smile, beneath the dome of his baldness, suggested life. But he would die.159

  I walked with Dr. Ismael on his morning rounds. Youssef Abdul Raouf Mohamed from Kerbala—close to military bases bombed in 1991—has gastrointestinal bleeding. He still has his curly hair and can talk to his parents but has small blood spots on his cheeks, a sure sign of internal bleeding. And Dr. Ismael is bothered by a memory. “Since the UN embargo, patients often die before they can even receive induction treatment,” he says, looking at the floor because he knows his story is going to be a terrible one. “They get thrombocytopenia, a severe reduction of blood platelets. They start bleeding everywhere. We had another child like Youssef. He was called Ahmed Fleah. And after we started the cytotoxin treatment, he started bleeding freely from everywhere—from his mouth, eyes, ears, nose, rectum. He bled to death in two weeks.”

  Dr. Ismael, who is resident doctor in the cancer ward, sat down in his office, staring in front of him. “When Faisal Abbas died two days ago, I came here, closed the door, sat down and cried,” he said. “I gave drugs to him from my own hands. He was like a brother to me. He was only ten years old. He was diagnosed with leukaemia three years ago and we treated him with drugs—he received treatment, but it was only partial because we lack so many drugs.”

  Dr. Ismael blamed the sanctions, of course, for blocking the medicines; and he blamed the 1991 war for turning his paediatric cancer ward into a way-station for dying children, for the infants who—given their first medicines—bleed to death in front of the doctors. “In three years, I have seen hundreds of children with leukaemia and last year there was a dramatic increase,” Dr. Ismael said. “This month we diagnosed twenty new cases, mostly from the south—from Basra, Nasiriyah, Kerbala and Najaf. It’s mainly caused by radiation.” The doctors here had an odd way of expressing themselves, in a kind of scientific-emotional grammar. “We have palliative treatment but not curative treatment,” one of them said.

  When I walk into the child cancer ward across the hall, I understand what this means. Little Samar Khdair lies in what the doctors quite casually call the “ward of death.” She is only five years old but looks much younger, lying shrivelled on her bed, her eyes squeezed shut with pain, her large, unwieldy father—massive in his grey galabiya robe amid such frailty and pain—gently placing a damp yellow compress on her face. She comes from al-Yussfiya on the road to Babylon, the target of regular allied raids in February 1991.

  Samar’s father, Jaber, looks poor because he is. He spent 15,000 dinars to buy cytotoxins for his dying daughter—more than three months’ wages for Jaber. “I sold my car to buy the medicine for her,” he tells me quietly. And how would he pay for the next dose? we ask. “I will borrow the money.” Dr. Ismael listens in silence, then he says to me in English: “I’ve seen these patients’ families so many times. They sell everything in their house, even their beds—and then their child dies anyway.”

  You could not move through Baghdad’s “ward of death” without two emotions—a deep sense of unease, even shame, that “our” 1991 military victory over the cruel Saddam might well have created this purgatory of the innocent by poisoning both the air they breathe and the land they try to grow up in; and a profound admiration for the dignity of the poor Iraqis who sometimes sell their own clothes in a vain effort to save the children who die in their arms. And no one could remain unaffected by the bravery of the victims.

  Dr. Selma al-Haddad is the kind of doctor whom you would select for your own terminal illness. My notes, scribbled in near-incredulity into my pocketbook that year, fill dozens of pages. In the Saddam Hussein Medical Centre in Baghdad—it is necessary to adopt a semantic amnesia with the names of so many institutions in Iraq—Dr. al-Haddad cuddles the children who she knows will soon die. She jokes with thirteen-year-old Karrar Abdul-Emir, who is frightened of his own leukaemia but too frightened to take the drugs which may save him. She introduces me to each child by name without ever looking at the chart at the bottom of the beds to check their identity. “Now here is Cherou Jassem and she has put on a party dress for you to take her picture,” Dr. al-Haddad laughs.

  And the beautiful girl in the sun bonnet—her name means “budding rose” and she has acute myloblastic leukaemia—smiles with delight. Amna Ahmed sits, bald, radiant, a kind of tranquillity about her baby face, framed in my camera lens by the electric fan that cools her fever. The machine, fighting the heat of the Baghdad afternoon, becomes a kind of halo round her head, an angel from Babylon who is dying of an abdominal mass. “Yes, of course I’m depressed and frustrated,” Dr. al-Haddad says. “I can’t save many of these children—but what can I do? I have a sense of responsibility towards these poor children. Most times, I feel helpless.” She asks if I will send the copies of my photographs of the children to Baghdad as soon as I can. In a month or two, Amna may well be dead. Cherou too. Dr. al-Haddad wants them to see my photographs before they die.

  What was one to make of the words of mothers and fathers standing by the beds of their dying children? Seven-year-old Youssef Mohamed, a handsome little boy in a blue-and-white pyjama top—unrelated to the child from Kerbala—has acute leukaemia and his mother, Hassiba, thinks she knows why. “There was a military base near our home in Baghdad,” she says. “It was bombed heavily by the Americans, also the local telephone exchange. We felt ill with the choking smoke at the time. I already had a healthy child, born before the war. But when I became pregnant after the war, I had a miscarriage. Then I had Youssef, who has leukaemia, then another miscarriage. Why should this have happened to me? My brother-in-law, Abdul-Kadem Mooushed, died of leukaemia two years after the war. He had been a soldier; he was only thirty-six. How could my family—which never had a history of cancer—suddenly suffer like this?”

  Ashwark Hamid is thirteen, with acute leukaemia, a quiet, gentle-faced girl in a yellow patterned scarf. She needs a bone marrow transplant—for which there is no hope in Iraq. Her grandmother Jasmiya sits on her bed. “We are from Diyala in eastern Iraq,” she says. “The bombing was very near to us—the airport and the agricultural factory was heavily bombed. We smelled strange fumes, like the smell of gas.” What, one wondered, was the “agricultural” factory making? Pesticides or gas? Or what were the American or British bombs made of?

  Oulah Falah is four, born four years after the Gulf conflict, and has a kidney tumour; her father was a soldier in the 1991 war—there are many rumours in Baghdad that Iraqi veterans are dying in large numbers from cancer—and her mother, Fatin, still shakes her head at her daughter’s fate. “Still I am surprised why my child got cancer,” she says. A few feet away, Dhamia Qassem is in critical condition after suffering heart failure during recent treatment for acute leukaemia. She is thirteen. Mysteriously, her aunt died of cancer only forty days ago. The aunt was just thirty-six years old. Ahmed Walid’s case is much more disturbing.

  He was diagnosed as having chronic myeloid leukaemia just three years ago and was only a baby during the bombing of his home town in Diyala. But his mother tells a frightening story. “We all smelled the strange fumes after the bombing and then the children round about started bringing in pieces of rockets and shells as souvenirs. They were very bright—a light, bright silver colour—and they played with them in our house. A neighbour of ours was killed when a rocket hit his farm and the children brought big iron pieces of the rocket into our home.”

  One evening, after spending ten hours in the children’s “ward of death” in Baghdad, I visit the Iraqi government’s press centre where the Western agency journalists are filing their latest reports on the negotiations between Kofi Annan and Saddam. I walk through the shabby hall to the AP office, a rectangular booth with hardboard walls, and tell a long-standing American colleague and friend what I have been discovering. He listens patiently, recalls the Iraqi “empty coffin propaganda” and gives me his slightly irritated response. “Robert,” he s
ays. “I am not writing Iraqi baby stories!” But what I am hearing is unending, consistent and undoubtedly true, since the often uneducated parents do not know I am going to visit their children, let alone ask about the 1991 war. Again and again, I hear the same thing.

  Tareq Abdullah is thirteen, again with acute leukaemia. He himself tells me how neighbours “brought bright pieces of bombs into our home. They were very heavy, like iron.” Tareq was diagnosed just a year ago. Karrar Abdul-Emir, the boy even more frightened of the drugs that may save him than he is of his own leukaemia, comes from Kerbala in southern Iraq. His mother, Ihlass, remembers the bombs falling close to their home. “Some scattered pieces fell nearby. I tried to find them and they were very sharp, like razor blades. I didn’t allow the children to touch them in case they cut themselves. There was a very harsh smell; it made our eyes swell.” Rasha Abbas from Basra has leukaemia, fifteen years old with a fever and a declining blood count, with mouth lesions, unable to talk, her father a fatality in the earlier Iran–Iraq War. “In 1991,” her mother, Hasna, tells me—slowly, wondering what happened to her family—“our house was bombed. It burned and the explosion ruptured Rasha’s ears. Pieces of rocket came right into our house. All the children were running to touch these pieces . . .”

  Of course, children were not the only victims, in Baghdad or in the south of Iraq. In the corner of the cancer ward at the Basra teaching hospital, the wreckage of Matar Abbas’s emaciated body seems to mock the broad, blue Shatt al-Arab outside the window. He has already lost an eye and is hawking mucus into a handkerchief, his scarf slipping from his head to reveal the baldness of chemotherapy treatment, part of his face horribly deformed by the cancer that is now eating into his brain. He comes from Nasiriyah, the city whose outskirts were shelled and bombed by the allied forces in the last days of the 1991 war.

  His wife, Ghaniyeh, is a peasant woman with tattoos on her face, and stayed throughout the war with Matar—a sixty-year-old former taxi-driver with nine children—on the road between Amara and Misan. “We saw the flashes of the bombs but nothing was bombed near us,” she recalls for me, speaking carefully, as if her memory might somehow save her doomed husband. “We were safe.” But Dr. Jawad Khadim al-Ali, a member of the Royal College of Physicians, begs to disagree. “We rarely saw these types of tumours before the war,” he says, gently touching Matar’s right ear. Dr. al-Ali smiles a lot, although—from time to time— you notice tears in his eyes and realise that he might also be a spiritually broken man. He looks a little like Peter Sellers, physically small with thinning hair and a drooping moustache. But there is nothing funny about his commentary.

  “Because of the tumour in his ear, Matar Abbas is now unable to talk or take food and is deaf,” he said. “He came for his first treatment only on January sixteenth, with a swelling and an inability to talk or drink. The biopsy showed cancer. I am giving him cytotoxic chemotherapy—but later on, the cancer will go to his brain and lungs. He will probably live one year, not more.” The doctor leads me across the room to where Zubeida Mohamed Ali lies, chadored, on her bed. She comes from Zubayr—close to the Iraqi air base that was saturated with allied bombs in a series of raids that started on the night of 13 February 1991. “She has tumours of the lymph nodes and they have infiltrated her chest,” Dr. al-Ali says. “She is suffering shortness of breath.” Zubeida is seventy.

  Opposite lies fifty-five-year-old Jawad Hassan, diagnosed with cancer of the stomach two years ago. He lived very close to the Basra television station that was the target of allied bombing. “He was exposed to fumes and bombs at his home,” Dr. al-Ali continues. “He was also close to the river bridges that were bombed. He is losing weight despite our treatment, which makes his prognosis very bad.” The man, prematurely aged, looks at me with a blank expression. “Ever since I was exposed to the fumes of the bombings,” he says, “I complained about pains in my abdomen.”

  The implications of what these cancer victims were saying were so terrible that I almost wished my visit had been the result of a feeble attempt by the authorities to set up a visiting journalist with an easy-to-expose lie, a crude attempt by Saddam’s regime to raise a grave moral question over the entire 1991 war. But again, Dr. al-Ali had no idea I was visiting him until the moment I walked into his Basra office. His patients did not expect visitors. And if some of them were—like so many cancer victims elsewhere in the world—elderly, what was to be made of the flock of men and women, young and old, who were waiting outside his oncology department when I arrived? “It’s a tragedy for me,” Dr. al-Ali said, pointing to a tall, handsome youth standing amid a group of women. “I’m losing friends every day—this boy has Hodgkin’s lymphoma. This girl is suffering lung cancer.” She was small, petite, with a big, smiling, moon-like face. Another, Fawzia Abdul-Nabi al Bader, was a fifty-one-year-old English teacher who walked into the department office and pulled her collar down to show a suture on her neck and then opened her blouse to show the scar where her right breast should have been. “Why should this have happened to me?” she asked. “My first operation was in 1993. Until then, my health was very good.”

  In his office, Dr. al-Ali’s maps tell their own story: “Number of cancer patients of all kinds in the Basra area,” it says over a map of the Basra governorate, sliced up into yellow, red and green segments. The yellow, mainly to the west of the city, represents the rural and desert areas that were battlefields in 1991. A green area to the north indicates an average incidence of cancer. But a large blood-red rectangle in the centre stands for the almost 400 cancer patients whom Dr. al-Ali had to treat in 1997. It is his thesis that the old Gulf War battlefields in the yellow area to the west contaminated the water, the fields, even the fish with depleted uranium and nitrate, contaminating the land not only for survivors of the war but for those still unborn.

  Back in the last days of the conflict, U.S. strategists were debating whether the damage to Iraq’s infrastructure—the bombing of water pipes, power plants and oil refineries—would take the lives of Iraqis in the months or years to come. But never did they publicly suggest that a policy of bomb now, die later would ever involve cancer. Many of the hundreds of children in Baghdad who have died of leukaemia and stomach cancer since the war came from the south and were sent north by Dr. al-Ali. “Every one of us is in despair,” he said. “It is a great burden on me—I am losing many of these patients every day. They need bone marrow transplants but we cannot give these to them. I cannot sleep at night for thinking about them.”

  Armed with one of Dr. al-Ali’s cancer cluster maps, Lara, Alex and I drive south of Basra, back to those fields in which the last tank battles of the 1991 war were fought. We travel with a goon from the Ministry of Information, a “minder,” but a man who has long ago been suborned by us, who is now paid more by us in a day than he earns from the ministry in a month. When we need to travel somewhere that might not be permitted—or when we wish to ask something that might not meet with the ministry’s approval—he suffers a cold and returns to his hotel or moves to the other side of the room. But we need him south of Basra, an Iraqi military area which overlaps with the operational area of the UN’s frontier peacekeeping force.

  I had always thought that the last battles of the 1991 Gulf conflict were fought in the desert, in the thick sand of northern Iraq which tormented us in February 1991. But the countryside through which we are driving is pasture-land. There are streams and cows grazing, fields of vegetables and—scattered amid this bucolic landscape—the burned-out hulks of Iraqi tanks. Some had exploded into pieces, bent iron that was now lying in ditches or half buried in the earth. Others are remarkably intact, their gun barrels still pointing south and west towards the American enemies that destroyed them.

  We drive on for another 15 kilometres. At first glance, the Adwan family’s tomato plantation doesn’t look like a killing field. The polythene covers reflect the high, bright winter sun. And when I ask sixteen-year-old Imad Adwan what happened here during the Gulf War, he glan
ces at the man from the Ministry of Information beside me and says he cannot remember. It pays, you see, to have a short memory in Iraq—and to lie. As water trickles through the ditches between the rows of pale green bushes, a sharp wind blows out of the desert to the west, just as it did in February 1991 when Major General Tom Rhame’s U.S. 1st Infantry Division—the “Big Red One”—swept up the highway to Safwan, shelling the retreating columns of the Iraqi Republican Guard with DU rounds. Imad Adwan is watching me to see if I have understood his amnesia.

  “Don’t worry,” the ministry man says, and produces an identity card. The boy grins. “The battles were all around us here—we didn’t even stay in the house because we knew it would not give us cover. But we didn’t leave. The wrecked tanks are over there.” Far beyond the barbed wire surrounding the farm, beyond a stand of trees and another plantation, the rusting victims of General Rhame’s attack are settled deep in the damp earth. Imad’s mother has appeared beside us, a scarf around her head, a black dress tugged by the breeze. She is holding a pale green tomato in her hand. “Please,” she says. “It is for you.”

  The tomato is small, plucked from the bush in front of us, a poisoned fruit— according to the Basra doctors—from a poisonous war, grown on a dangerous stem, bathed in foetid water. “The soldiers died on this road,” she says, gesturing towards the highway behind us which leads south-west towards Safwan and the new Kuwaiti frontier. “The battles went on for hours. People still get killed—two boys were blown up by mines over there last July.” The outline of a collapsed trench shows the fatal spot. But it is other deaths that we have come about. Are the Adwans worried about their land? Do they know what the doctors say about it? Imad’s mother has heard of cancer cases in the farmlands but none in her family.