Five children die a day

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By Paul Eedle

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Dr Samir Kalander, Director of the Saddam Central Teaching Hospital for Children.

I've been fairly wary of sob stories about Iraqi hospitals and was ready for a flood of propaganda when I visited the Saddam Central Teaching Hospital for Children. In fact, the two doctors who talked to me barely touched on politics. They spent two hours explaining how eight years of sanctions have disrupted supplies of medicines and equipment, but they never tried to say who was to blame. If this had been revolutionary Iran, I would probably have been surrounded by an instant crowd in the hospital lobby chanting "Death to America".

Nor did the Director of the Hospital, Samir Kalander, or the paediatrician who took me round, Ala Abdel-Hussein, try to disguise the fact that conditions in the hospital have improved since the UN's oil-for-food agreement was approved in April 1995 - although it took two years for the first medicines to arrive. Kalander said a Spanish charity, MPDL, had renovated the emergency ward with European Union money, and the hospital was receiving at least some drugs every month.

I had an Information Ministry 'guide' tagging along but that's the deal for a foreign journalist to visit anywhere other than obviously public places such as shops and restaurants. He didn't make much effort to listen to my conversations and only butted in with some patriotic comments when we left.

So I think what follows is a fairly accurate picture...

Kalander said about five children a day were dying, often children who could have been saved.

"We are losing 5 patients in the hospital, especially in the premature unit and in the other general wards such as oncology," he said. "We are losing patients because of some small items. In the premature unit, we have a small valve to change their blood when they have severe jaundice. They haven't been available for months. We have been fighting to get them."

Upstairs with Abdel-Hussein, I saw a newborn baby yellow with jaundice being taken for a blood transfusion with improvised equipment. "We have a certain type of tube for feeding. We open it up and instead we put it in the umbilical vein," he said. "Instead of putting the old blood in a bag, we put it in the bin."

In the emergency ward, there are intravenous drips but they are not the right formula for treating dehydration in starving children. Abdel-Hussein said they had bags of glucose fluid and saline solution, but not the mixture of the two which they need.

The saddest cases are in the cancer wards. If you're rich, you have a chance. If you're poor, you have to be very lucky. The reason is an almost total shortage of the best drugs. Abdel-Hussein showed me a 2 year-old with leukaemia who was nearly bald from chemotherapy but cheerful and lively, playing around her father's feet in the entrance lobby of the hospital. He said the parents had paid 40,000 dinars - $30 - for four 1mg vials of a drug called vincristine, 1mg a week for four weeks. Upstairs in a corridor, we met a chubby teenager in a black chador whose parents had paid 600,000 dinars - $460 - for a course of chemotherapy. She was up and walking around.

But in a bed nearby, a girl lay whose family could not afford to pay for drugs on the open market. "If the parents have no money, we have to give substitutes. The substitutes have more side effects and are less efficient," Abdel-Hussein said. On the girl's yellow treatment card, he showed several occasions when she had been due to receive chemotherapy but it had been postponed because earlier doses of the substitute drug, viniblastine, had left her too weak to cope with more.

A lot of the 370 beds in the hospital are taken up by children who wouldn't be there at all if sanctions weren't in force. Abdel-Hussein said they're admitting 15 to 20 children a day at the moment with complications from measles - usually pneumonia - because the infant vaccination programme has broken down. And there are any number of children whose real problem is simply that their parents can't afford to give them enough to eat. The doctors can re-hydrate them with intravenous drips and try to feed them for a few days, but then they have to send them home to starve again.

A woman called Samia was standing by the bed of her only son, Hussein, who was 18 months old but weighed only 4.25 kg. She said he had been 6.5kg - the weight my daughter is at only six months - but had got thinner and thinner.

"My husband lost his job. We can't afford enough to eat," she said. "What can we do? He was fine until he was about five months old. When he stopped feeding from the breast, we didn't have enough food to feed him."

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 Sanctions tImeline
 Five Children a Day
 Oil For Food