Mystery in Iraq
Are US Munitions to Blame for Basra Birth Defects?
By Alexander Smoltczyk
December 18, 2012
The guns have been silent in Iraq for years, but in
Basra and Fallujah the number of birth defects and
cancer cases is on the rise. Locals believe that
American uranium-tipped munitions are to blame
and some researchers think they might be right.
It sounds at first as if the old man were drunk. Or
perhaps as though he had been reading Greek
myths. But Askar Bin Said doesn't read anything,
especially not books, and there is no alcohol in
Basra. In fact, he says, he saw the creatures he
describes with his own eyes: "Some had only one
eye in the forehead. Or two heads. One had a tail
like a skinned lamb. Another one looked like a
perfectly normal child, but with a monkey's face. Or
the girl whose legs had grown together, half fish,
The babies Askar Bin Said describes were brought
to him. He washed them and wrapped them in
shrouds, and then he buried them in the dry soil,
littered with bits of plastic and can lids, of his own
cemetery, which has been in his family for five
generations. It's a cemetery only for children.
Though they are small, the graves are crowded so
tightly together that they are almost on top of one
another. They look as if someone had overturned toy
wheelbarrows full of cement and then scratched the
names and dates of death into it before it hardened.
In many cases, there isn't even room for the birth
date. But it doesn't really matter, because in most
cases the two dates are the same.
There are several thousand graves in the cemetery,
and another five to 10 are added every day. The
large number of graves is certainly conspicuous,
says Bin Said. But, he adds, there "really isn't an
explanation" for why there are so many dead and
deformed newborn babies in Basra.
Others, though, do have an idea why. According to a
study published in September in the Bulletin of
Environmental Contamination and Toxicology, a
professional journal based in the southwestern
German city of Heidelberg, there was a sevenfold
increase in the number of birth defects in Basra
between 1994 and 2003. Of 1,000 live births, 23
had birth defects.
Double and Triple Cancers
Similarly high values are reported from Fallujah, a
city that was fiercely contested in the 2003 war.
According to the Heidelberg study, the concentration
of lead in the milk teeth of sick children from Basra
was almost three times as high as comparable
values in areas where there was no fighting.
Never before has such a high rate of neural tube
defects ("open back") been recorded in babies as in
Basra, and the rate continues to rise. The number of
hydrocephalus ("water on the brain") cases among
newborns is six times as high in Basra as it is in the
United States, the study concludes.
Jawad al-Ali has worked as a cancer specialist at
the Sadr Teaching Hospital (formerly the Saddam
Hospital), housed in a sinister-looking building in
Basra, since 1991. He remembers the period after
the first Gulf war over Kuwait. "It isn't just that the
number of cancer cases suddenly increased. We also
had double and triple cancers, that is, patients with
tumors on both kidneys and in the stomach. And
there were also familial clusters, that is, entire
families that were affected." He is convinced that
this relates to the use of uranium ammunition.
"There is a connection between cancer and
radiation. Sometimes it takes 10 or 20 years before
the consequences manifest themselves."
The term uranium ammunition refers to projectiles
whose alloys or cores are made with "depleted," or
weakly radioactive uranium, also known as DU.
When German soldiers are deployed overseas, they
are given the following information: "Uranium
munitions are armor-piercing projectiles with a core
of depleted uranium. Because of its high density,
this core provides the projectile with very high
momentum and enables it to pierce the armor of
When DU explodes, it produces a very fine uranium
dust. When children play near wrecked tanks, they
can absorb this dust through their skin, their
mouths and their airways. A 2002 study at the
University of Bremen in northern Germany found
that chromosomal changes had occurred in Gulf war
veterans who had come into contact with uranium
The German Defense Ministry counters that it isn't
the radiation that constitutes a health threat, but
the "chemical toxicity of uranium."
Living in a Garbage Dump
London's Royal Society presented one of the most
comprehensive studies on the issue in 2002, but it
only addressed the potential threat to soldiers. It
concluded that the risk of radiation damage is "very
low," as is the risk of chronic kidney toxicity from
This may reassure soldiers, but not Mohammed
Haidar. He lives in Kibla, a district in Basra which,
like others in the city, resembles nothing so much
as a garbage dump. Kibla is a neighborhood of
squalid, make-shift shops and shacks -- with
shimmering, greenish liquid flowing through open
sewers and plastic containers filled with rotting
Haidar, who teaches mathematics at a high school,
could afford to live in a better neighborhood. But he
spends every spare dinar on treatment for his
daughter Rukya. The three-year-old is sitting on his
lap, resembling a ventriloquist's doll. She is an
adorable little girl with pigtails and ribbons in her
hair. But she can't walk or speak properly.
When Haidar turns his daughter around, two
openings in her back become visible. She has a cleft
spine, the externally visible sign of hydrocephalus,
as well as an implanted drainage tube to remove
excess cerebrospinal fluid. In Germany, children
with cases like hers are often treated with prenatal
surgery, but not in Basra. In fact, Haidar and his
wife are glad that Rukya is even alive. She is their
first and only child. "We both grew up in Basra. I
hold the United States responsible. They used DU.
My child isn't an isolated case," Haidar says.
The term "DU" seems to be just as widespread in
Basra as birth defects are.
DU ammunition was used twice in the Basra
district: outside the city in the 1991 war, and in the
city proper in 2003, when British troops were
advancing toward the airport. West Basra is the
urban district with the highest incidence of
leukemia among infants.
"Those who were children in the first war are adults
today," says Khairiya Abu Yassin of the city's
environmental agency. She estimates that 200 tons
of DU ammunition were used in Basra. The Defense
Ministry in London claims that British troops used
only about two tons of DU ammunition during the
war. Either way, the remains of tanks destroyed in
the war with the help of DU ammunition littered the
streets until 2008.
It was impossible to keep children and salvagers
away from the wrecks, says Abu Yassin. "We
installed signs that read: Caution -- Radiation. But
people don't take a threat seriously when it doesn't
act like the bullet from a gun."
DU is a sensitive issue, and not every doctor in
Basra is willing to go on record commenting on it.
The reasons for the reticence have to do with the
dictatorial regime of Saddam Hussein: The alleged
radiation threat coming from remnants of armor-
piercing ammunition provided popular propaganda
In the United States, no major newspaper has yet
published a story on the genetic disorders in
Fallujah. Britain's Guardian, on the other hand,
criticized the silence of "the West," calling it a moral
failure, and cited chemist Chris Busby, who said
that the Fallujah health crisis represented "the
highest rate of genetic damage in any population
ever studied." Busby is the co-author of two studies
on the subject.
Still, it is difficult to precisely pinpoint the cause of
the defects. Spinal chord abnormality can also be
triggered by a folic acid deficiency at the beginning
of pregnancy, for example. Furthermore, very few
Iraqis can afford regular pregnancy exams. As a
result, many defective embryos are carried to full
term, in contrast to what normally happens in
Europe or the US.
Wolfgang Hoffmann, an epidemiologist at the
University of Greifswald in northeastern Germany,
has been collaborating with fellow scientists in
Basra for years. "Birth defects often look very
disturbing in photos," he says. "But they are always
isolated cases and are not necessarily useful for
Hoffmann cites the lack of comprehensive data and
questions the epidemiological reliability of reports.
He does believe, however, that indications of
increasing rates of cancer in Basra should be taken
very seriously, partly because the data for Basra is
Searching for the Truth The "plausible risk factors"
for childhood leukemia, says Hoffmann,
"undoubtedly include the contaminated
environment, but also the lack of prevention, the
trauma suffered by parents and the devastated
medical infrastructure." The statistical increase in
the number of children with leukemia since 1993 is
also a function of cases not having been fully
documented before 2003.
Janan Hassan, an oncologist with the Basra
Children's Hospital, participated in a study that was
just published in the Medical Journal of the Sultan
Qaboos University in Oman. It states that although
the rate of childhood leukemia in Basra remained
stable between 2004 and 2009, compared with other
countries in the region, there is a trend toward very
young children contracting the disease.
As such, she believes that objections are only
partially applicable. There is a "strong increase" of
genetic defects as a cause of leukemia, she notes.
"And the cases are coming from precisely the areas
where there was heavy fighting. How do you explain
that? By saying that reporting requirements have
Sabria Salman named her son Muslim, but it didn't
protect him. Muslim, now 10, recently underwent
surgery to remove a 500-gram tumor on his upper
arm. He doesn't scream in pain anymore. Instead,
the boy has a permanent grin on his face, as if he no
longer had the strength to change his expression.
He perspires heavily and has trouble breathing.
There is a drain tube protruding from his left arm,
and the right arm is wrapped in a dressing that's
stained red along the edges.
Salman calls it "cancer in the muscles." The boy
broke his shoulder two years ago, and since then
his body has made little progress towards healing.
'Bombs in Our Neighborhood'
The hospital pays for the chemotherapy, although
radiation therapy would be more effective for his
tumor. But radiation is only available abroad or in
Baghdad, where there is a five-month waiting list --
and the family doesn't have that much time
anymore. The mother prays to Allah, and when the
interpreter asks her who is to blame for her son's
affliction, she says: "The war is to blame. The
pollution. There were many bombs in our
Uranium may be a factor, but other substances used
in the production of ammunition and bombs are
also implicated, toxic heavy metals like lead and
mercury. "The bombardment of Basra and Fallujah
may have increased the population's exposure to
metals, possibly resulting in the current increase in
birth defects," states the Heidelberg study.
Furthermore, when the Rumaila oil field near Basra
was set on fire in 2003, a cloud of soot full of
carcinogenic particles drifted across the city. And
another factor could also be at play. Since Saddam
was overthrown, Iraq's neighbors, Iran, Syria and
Turkey, have diverted substantially more water from
the Euphrates and Tigris Rivers. The current in the
Shatt-al-Arab, formed by the confluence of the two
rivers, is now so weak that salt water penetrates
inland from the Persian Gulf all the way to Basra.
This means that wastewater from industrial facilities
downstream from Basra, like the Iranian oil refinery
in Abadan, are no longer being adequately diluted,
increasing the concentration of heavy metals in
Abu Ammar lives with his family on the grounds of
Saddam's former navy command center. The
quarters are cramped, with 10 people in a room, and
the situation of several other families on the
grounds is no better. It is yet another impoverished
Basra neighborhood -- the riches of the Basra oil
wells, omnipresent in the neighborhood in the
shape of stinking fumes, have yet to trickle down to
Three Eyes for Three Children
Ammar has spread out a plastic rug on the floor and
placed a can of 7-Up and a pastry for each of his
visitors on the rug. The family -- or what is left of it
-- squats around the rug. Saddam's thugs executed
two of Ammar's brothers. The cousin sitting next to
him still has a piece of shrapnel from an attack
wedged behind his eye, the mother died of grief, his
wife no longer goes outside -- "and these are our
children.," he says.
He points to a 21-year-old woman, a seven-year-old
girl and a little boy, sitting next to each other. They
don't have the same parents, but all three have the
same narrow faces, and together they have only
The sockets of their missing eyes look like the inside
of an oyster, milky and shapeless. The young
woman, Madia, attends the local college. She doesn't
like going there, she says, even though she covers
half of her face with her veil. "What caused this? I
think my mother inhaled something chemical when
I was inside of her," says Madia.
It's easy to assign the blame for these eerie birth
defects to something called "DU ammunition," made
in the USA. It's easier than thinking about the
deleterious effects of lead and mercury in the soil
and the tomatoes, or of the soot in the air and the
toxic materials in the water. But that doesn't relieve
those involved in the war from responsibility. It isn't
enough to declare a war to be over. Even though
Iraq now has elections and the tyrant has been
hanged, the war is still in the soil, in the air and in
Omran Habib heads the Basra Cancer Research
Group. He earned his Ph.D. in London and now
works as an epidemiologist at the University of
Basra Hospital. "The war did an enormous amount
of damage here," he says. "DU is certainly not good
for our health. Nevertheless, even the presence of
uranium in the urine of patients doesn't imply
A Bundle in White
The World Health Organization (WHO) is currently
assembling a report on DU ammunition. It will
reflect the current state of research on the issue, but
it will hardly provide any new insights. With the
help of the University of Greifswald, a cancer
registry has been developed for the Basra region and
will serve as the basis for all future study. Still, even
as further research is needed, if only for the
children's sake, it will come too late for many.
It's certainly too late for the body lying inside a little
white bundle of material, tied together at both ends
like a piece of candy, lying on a pile of dirt along the
edge of the children's cemetery in Basra. It was
supposed to be his first son, says the father,
standing next to the body. Yesterday the child was
still moving inside the mother's stomach. Today the
father was simply handed a bundle.
The body-washer on duty sighs loudly while digging
the grave, hoping to increase his baksheesh. Then
he places the bundle into the hole, says a few words
of prayer, makes some adjustments to the bundle
and covers it with earth. Off to the side, a chicken is
pecking at a piece of a "Capri Sun" container
sticking out of the soil.
Afterwards the men smoke. The father is given a
piece of cardboard and writes down the name of his
son, copying it from the combined birth and death
certificate they gave him at the hospital. The
gravedigger will scratch the name into the cement.
The boy was going to be named Hussein Ali. The
father writes the name of his dead child for the first
and last time.
The man remains motionless. Who wonders about
blame at such a moment? He seems empty,
completely at a loss and robbed of a tiny life.
Translated from the German by Christopher Sultan
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