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The Toxicity of Everyday Survival in Iraq

[Relatives wait with the coffin of a girl who died of cancer, outside Saddam Medical City in central Baghdad, 17 April 2003. AP Photo/Lefteris Pitarakis.] [Relatives wait with the coffin of a girl who died of cancer, outside Saddam Medical City in central Baghdad, 17 April 2003. AP Photo/Lefteris Pitarakis.]

For more than two decades, Iraq has been the subject of a large-scale toxic warfare experiment. Operation Desert Storm, fought in 1991, was the first time in military history that depleted uranium (DU)—a nuclear waste by-product—was systematically employed against both military and civilian targets. US forces used DU on a much larger scale during the war and occupation that started in 2003.

The effects of this toxic and biological experiment go beyond body counts and the epidemiological evidence of illnesses. They also go beyond the environmental contamination caused by DU-laden weapons. Toxicity has penetrated the quotidian realities of life in Iraq.  It is what Iraqis have to endure and negotiate every day in the face of physical, political, social, and environmental degradation—what I call here the “toxicity of everyday survival.”

From Cold to Hot Wars

The original research on the use of DU in warfare dates back to the Cold War era. In the 1970s, US military laboratories began experimenting with alternative heavy metals and alloys to use against the Soviets’ newly developed line of military armor and tanks that were resistant to conventional lead- and steel-based anti-tank ballistics. Depleted uranium is 2.5 times heavier than steel and 1.5 times heavier than lead. It is also relatively cheap because it is produced from processed uranium nuclear industrial waste. It has many of the “penetrating qualities” that were sought at the time. Thus, projectiles were given the sexually charged name “DU penetrators.” Moreover, DU was superior to other heavy metals and alloys for its incendiary effects.

While uranium exists in nature in various forms and is used in a number of building products, its use in warfare in high concentrations unleashes a spectrum of toxicity. The bio-toxic life of the DU projectile is released on high-speed impact with the surface of its target. The collision produces colossal kinetic heat, which causes metal to disband and flesh to burn and disintegrate. When the DU projectile pierces a target, such as a vehicle with passengers, its explosive heat carbonizes all forms of life and machinery.

As DU disintegrates under the high heat of the explosion, it turns into its particle form, uranium oxide, which lingers in the vicinity. These particles are water insoluble and their size can be about one-hundred times smaller than a white blood cell. They contaminate water and soil and enter into the food chain. The particles are so small that they can be blown by wind for tens of kilometers. The uranium aerosol enters the body through ingestion or inhalation, or through coming in contact with an open wound.

The toxicity of DU does not come only from its capacity to kill life, but also its ability to create an array of pathologies and afflictions. In the lungs, the radioactive uranium dust has a bio-toxic life span of close to one year. It can cause many acute symptoms due to its immediate chemical toxicity, which irritates and destroys lung tissue. As it makes its way to the blood stream, the uranium oxides bind with organic compounds to form chemical and organic complexes that deposit in the bones, lymphatic system, liver, and kidneys. DU’s radioactive toxicity, more than its chemical toxicity, affects the development of different kinds of malignancies and genetic mutations. Still, the chemical and irradiation toxicity happen simultaneously to produce a series of acute, chronic, and deadly ailments.

Empire’s Toxic Laboratories

One tragic irony in the DU toxicity that afflicts Iraq is that while the US developed this weapon for Cold War purposes, it was used for the first time after that war ended. Operation Desert Storm was the first post-Cold War war, and the first occasion for the US to experiment with its DU arsenal. Since then it has been a weapon of choice for imperial adventurism and military operations elsewhere as well.

The US military deployed hundreds of tons of DU during the forty-day military campaign, Operation Desert Storm. Much of its use was concentrated in the south of Iraq, as well as in Kuwait and Saudi Arabia, where the main combat between Iraqi military and American-led coalition forces took place. Doug Rokke, the former head of the Pentagon’s Depleted Uranium Project, described Operation Desert Storm as “the most toxic war known to man.”

The force of this toxic storm was emblematic in images of incinerated bodies and the miles of destroyed military vehicles on Highway 80 (the “Highway of Death”) between Kuwait and Basra. The US military used DU-laden weapons to target alleged storage sites and depots of chemical and biological weapons that released more toxicity in the air. The DU arsenal was also used to hit many civilian targets, such as power supply and water purification plants across the country. 

The US military used DU-laden weaponry even more systematically and expansively during the 2003 invasion and throughout the occupation. In urban warfare, it was fired at vehicles and buildings in highly populated civilian areas. It was employed in “counter-insurgency operations,” such as the two battles of Fallujah in 2004. 

For two decades, the use of DU and its effects have been a subject of political and scientific controversy. In the US, this controversy played out in scientific evidence of the links—and official denial of those links—between DU and the variety of inexplicable conditions that afflicted US veterans. These conditions, loosely termed the “Gulf War Syndrome,” affected up to one in four Gulf War veterans. The Pentagon criticized scientific research-based evidence as inadequate, and continued to deny veterans’ healthcare claims based on exposure to DU. The Pentagon asserted the “safety” of DU-weaponry on the basis of a number of questionable reports by the RAND Corporation and the Institute of Medicine, a non-profit organization. 

In 2004, the results of a five-year Pentagon-sponsored study insisted that DU was neither sufficiently toxic nor radioactive to cause health threats to soldiers. One official involved in the study reported that DU is “a lethal, but safe weapons system.” The study has been criticized as a cover-up, including by the US National Academy of Science. The Pentagon maintains that the destructive capacity of DU is militarily advantageous, and therefore a legitimate and necessary element of the US arsenal. 

Since 1991, American and British DU weaponry has been deployed in a number of military operations. It was used during the 1999 NATO bombing of Kosovo and in the invasion and occupation of Afghanistan. Concerns over the rise of cancer rates and other DU-related afflictions have also been on the rise in these countries. Israel also allegedly used DU weaponry in Operation Cast Lead in Gaza in 2008 – 2009, and its recent airstrike on targets in the Syrian capital Damascus.

At present, there are no international laws or treaties banning the use of depleted uranium. Therefore, it is up to individual states whether to acquire and use DU-laden weapons. Countries including Germany, Canada, Czech Republic, Norway, and the Netherlands have pledged not to use depleted uranium. Only the US and Britain have admitted to using DU in their military operations.

The Breakdown of Health Care in War-Torn Iraq

In the aftermath of the 1991 war, Iraq witnessed a surge of unexplained cases of physical deformities in both human and nonhuman lives in areas that were subjected to heavy bombardment and shelling by the US military. Farmers complained about genetically mutated livestock and crops. There was a rise in unexplained miscarriages, birth defects, and cancer among infants and children. In the words of one Iraqi pediatrician working in Basra, “Something happened to our environment during that war.”

Most research and observations by Iraqi doctors and scientists were dismissed by the US as regime propaganda. Still, the transformations in Iraq’s environment transcended the breakdown of physical life; it generated shifts in structures of health care in the country. The UN-imposed sanctions compounded the impact and effects of environmental toxicity plaguing the country.

Across Iraq, cancer wards became emblematic of this breakdown of the depleted capacity of medicine and science to save and revitalize life. In the capital’s main pediatric hospital, families from all over the country rushed their infants and children to seek treatment for different kinds of complex conditions. Doctors nicknamed the cancer ward “The People’s Republic of China” in reference to its overcrowded and congested conditions. Often, more than one child shared the same bed in the six-bed-occupancy rooms. Mothers and relatives slept on the hospital’s floor next to their sick children. 


[Baghdad hospital cancer ward, 2002. James Longley/Daylight Factory]

 In this mélange of care and toxicity, doctors struggled to save lives in the face of lack of basic supplies, shortages of cancer medications, and the deterioration of care facilities and economic conditions brought on by the sanctions. Over the course of a decade and in the face what I call “ungovernable life”—life that is reduced to its mere vital survival and stripped of its potential for revitalization—many doctors fled the country in search of better careers, and to escape the precariousness of Iraq. 

This breakdown of structures of care still lingers more than ten years after the US invasion. Every year, tens of thousands of Iraqis have to travel abroad to seek medical care. Their therapeutic itineraries take them to various regional private medical hubs such as India, Iran, Turkey, Jordan, and Lebanon. Unlike the caricature of the medical tourist who travels for cosmetic surgery or other elective procedures, many Iraqis sell belongings or depend on assistance from family, friends, tribes, and political parties to fund treatment for critical health problems.

In Beirut, the American University Medical Center (AUBMC) buzzes with Iraqi patients seeking critical medical and surgical care. They come from all ages, social backgrounds, and governorates. Close to one-third of the approximately five thousand Iraqi patients who have frequented this one hospital since 2003 come for cancer surgeries, radiation, or chemotherapy. Although cancer care is free in Iraq, patients opt to pursue costly survival options abroad because of the unwieldy bureaucracy and the shortages of cancer medication and technology at home.

Over the past ten years, the Iraqi leadership and corrupt government institutions have been unable or unwilling to provide basic healthcare to citizens, especially for the rising numbers of cancer cases. In the south of Iraq, even poor families from the impoverished rural areas are left with no option but to seek care in neighboring Iran. 

The collapse of medical care also has been mirrored in the breakdown of trust between doctors and patients; this is another essential reason that patients seek care abroad. Iraq’s health system is plagued by mis-diagnosis, mistreatment, and neglect. Patients accuse doctors in Iraq of being incompetent, greedy, and indifferent. One patient, commenting on the lack of trust in medical doctors, summed it up: “All the good doctors have left, and the ones who remain have lost their humanity.” While Iraq was once celebrated as one of the leading countries in the region for its medical capacities and infrastructure, the degeneration of Iraqi health care began under the effects of the 1991 war and twelve years of sanctions.

Thousands of Iraqi doctors and specialists have escaped the country to seek security and careers elsewhere. Since 2003, this exodus has increased due to ongoing violence that targets doctors directly. Hundreds, if not thousands, of doctors have been threatened, kidnapped for ransom, and/or assassinated. Some doctors have refused to perform surgical operations on patients for fear of retribution or demands for “blood money” from angry family members who might not accept unfavorable outcomes. The Iraqi Parliament recently passed a law allowing doctors to carry arms for their own protection.

Injury and Survival

The political and social malaise continues to be shaped by the failure of the political leadership to rebuild the country’s infrastructure. In Iraqi cities, people are forced to deal with paralyzing traffic congestion, security checkpoints, concrete walls, and the noisy hum and fumes of diesel generators that are used to compensate for war-caused electricity shortages. Poverty, disability, and unemployment are rampant. Sectarian violence in the form of car bombs, suicide bombers, and militia attacks hit streets, neighborhoods, markets, and religious sites, turning the urban space into a slaughter spectacle. Killers are elected to parliament, and religious and political leaders incite violence as they secure wealth, property and power. Corruption festers in this everyday toxic environment.

The injury and survival journey of Abu Ahmed, a thirty-five-year-old man from Fallujah, illustrates this everyday toxicity.[i] In July 2006, during the height of the sectarian violence, Abu Ahmed was shot in the face by an American paramilitary sniper who, he presumes, was a Blackwater contractor because of their presence in Fallujah at that time. The bullet pierced his windshield and ripped through his face. He was rushed by passers-by to the nearest hospital in Fallujah. There, doctors replaced lost blood and cleaned his wound. The bullet, which was extracted from his face, destroyed large parts of his left cheekbone, leaving a two-inch crater which makes it impossible for him to close his mouth fully. Abu Ahmed had to readapt slowly to the most basic daily functions of drinking and chewing food.

The hospital in Fallujah could do only so much. Abu Ahmed was told that he needed a more specialized hospital and surgeons capable of providing facial reconstructive surgery. At the time, he would not dare to venture to the capital because of the violence. Patients were being kidnapped from hospital beds and killed by a Sadrist militia group that had infiltrated the management of the Ministry of Health. His only alternative was to seek care outside the country.

Abu Ahmed’s extended family managed to raise some money by selling a small piece of land. With that and his own savings, Abu Ahmed decided to head to Amman to seek the opinion of a specialist. During that period, waves of Iraqis displaced by the sectarian violence were leaving the country for Jordan and Syria. Jordanian officials systematically denied entry to Iraqi Shi’a forcing them to settle temporarily in the more hospitable Syria.

Abu Ahmed, a Sunni from the province of Anbar, had been working as a driver between Amman and Fallujah for years. Indeed, he had been driving back from Jordan when he was shot. When he went to seek medical treatment, however, Jordanian customs officers denied him entry. Trying to explain the reason for his trip, he removed the yeshmagh (kuffiyah) wrapped around his face to show them his injury. After listening to his story, the customs officers were even more insistent on rejecting him. Surveying his wound, they expressed their suspicion about Abu Ahmed’s involvement with a “terrorist group.” From their point of view, what else could explain why US paramilitaries shot him in the first place!

When Abu Ahmed returned to Fallujah, he was advised to try Syria, where medical and surgical treatment was much cheaper than Jordan. After receiving his first reconstructive surgery in Syria, his family pressed him to make repeat trips for cancer tests because his injury is, both literally and figuratively, an open wound and therefore all the more vulnerable to toxicity. Abu Ahmed’s family, like many Fallujah residents, was concerned about the rising cancer rates following injuries from American ammunition.

According to Abu Ahmed, this kind of risk management practice has become common knowledge as people experience and deal with rising cancer rates, genetic mutations, birth defects, and disabilities. In 2003, his tribe was targeted in a full-scale US air strike that killed eleven people and injured dozens, including women and children. A number of those who were injured fell sick shortly thereafter and died from rapidly developing cancers or other unexplained conditions. The tribe was attacked by US forces on a number of other occasions as well.

In 2012, Abu Ahmed underwent surgery at AUBMC to reconstruct his facial injury with bone and skin grafts. While the surgery restored his functionality and some of the cosmetic aspects of his wound, he lives with the fear and prospect of developing cancer. For him and his extended family, war injuries and cancer are tightly knit phenomena in these webs of toxicity. His wound is not a mere metaphor of the precariousness of the social body; it is the interstitial materialization of war in his everyday survival.

Conclusion

Since 1991, Iraq has been one of the main sites for a US war experiment that has exported toxicity and disability across the world. Hundreds of known sites are contaminated with DU in Iraq. According to one report, the cleanup costs are estimated at thirty million dollars. Recent medical and environmental research in Iraq have just begun to officially document links between the high rates of cancer and congenital birth defects in a number of Iraqi cities to exposure to DU and other toxic weapons. Still, with the ongoing US denial of the lethal and lingering toxicity of DU, and the current political disarray in Iraq, there is little hope that this issue will be addressed anytime soon.

Iraq’s toxicity and the resultant social scars run as deep as the molecular and genetic makeup of society and will afflict generations to come. Despite the end of the occupation in 2011, toxicity still shapes everyday survival in Iraq. The body of Abu Ahmed and millions of Iraqis continue to endure America’s poisonous gift of liberation. Their lives and wounds might be vulnerable to toxicity, but they are open, and shared. They seek everyday survival under conditions that stand as a testament to the horrors of empire’s toxic experiment.


[i] The information about Abu Ahmed is derived from interviews for my current book project, Ungovernable Life: War and Mandatory Medicine in Iraq

 

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