The destruction of Iraq's water purification system during the 1991 Gulf War was no accident. It was deliberately intended, as a way to induce ill health in the population
A formerly classified US document, 'Iraq Water Treatment Vulnerabilities,' provides evidence that ill health was knowingly induced in the population of Iraq by means of ruining that country's water purification system. We believe that the uncovering of this document should stimulate the public health community to clarify principles of public health ethics and to formulate statements giving voice to these principles.
The attempt to gain control over water was closely connected to the emergence of cities in the ancient world. Hydro-technology, addressing chiefly the problems of irrigation and potable water supply, was crucial to successful urbanization. Mesopotamia, located mainly in the region now known as Iraq, was a key contributor to early hydro-technology. The region's irrigation techniques were among the most impressive in antiquity, while its advances in the provision of large quantities of drinkable water were equally remarkable.
In the second half of the twentieth century the government of Iraq created a reasonably efficient water purification system for the country, in addition to modern public services and health care facilities. Despite the country's costly eight-year war with Iran, its infant mortality rate dropped steadily during the years before 1990. But on August 2, 1990 Iraq invaded Kuwait, and on August 6 the United Nations Security Council passed Resolution 661, which initiated international sanctions against Iraq. Then, on January 16, coalition forces began a military assault, and between this date and February 27, 1991 they subjected Iraq to one of the most intensive bombings in history. Violating international law, US forces targeted water treatment facilities, reservoirs, and water distribution systems as well as the electrical power plants crucial to the water treatment system. Following the war and Iraq's withdrawal from Kuwait, the sanctions were maintained, and severe restrictions were imposed on Iraq's access to water purification chemicals and technology. In the years that followed, these materials were permitted entry only intermittently, with the result that Iraq recovered only a small portion of its pre-sanctions water service. It has been estimated that whereas 90 per cent of the population had access to safe drinking water before the sanctions were imposed in 1990, by 1999 the figure stood at 41 per cent.
Child mortality in Iraq was studied at various points during the 1990s--by the International Study Team in 1991, by the Food and Agriculture Organization in 1995, and by UNICEF in 1999. While scholars differ over methodology and interpretation of these surveys, few doubt that hundreds of thousands of excess deaths in the under-five population occurred. The 1999 UNICEF survey showed an increase in under-five mortality from 56 to 131 per thousand over the decade, except in the autonomous provinces, where rates improved in recent years. While many factors combined to cause these excess deaths, there is no reasonable doubt that the economic sanctions were a major factor. Water-borne disease, made more prominent by the sanctions, played a crucial role. The 1995 FAO survey in Baghdad showed a three-fold increase in deaths of under-fives from diarrhoeal diseases.
Even if 'Iraq Water Treatment Vulnerabilities' had not come to light it would be extremely difficult to argue that increased mortality from water-borne disease was an unknown or unforeseen effect of bombing and sanctions. The discovery of this and related documents, however, seems to us to make such an argument impossibly weak.
During the controversy in the United States over the exposure of US military personnel to chemicals during the 1991 Gulf War, President Bill Clinton required the Department of Defense and the Central Intelligence Agency in 1995 to declassify a huge mass of documents bearing on Gulf War Syndrome. 'Iraq Water Treatment Vulnerabilities' was one of about 40,000 documents dumped onto the Internet at that time. It was made public in 1998 when Felicity Arbuthnot interviewed one of the authors of the present article (TN) for the Sunday Herald of Scotland. He had come across the document during research on a related issue, and was astonished to learn that:
* this study of Iraq's water treatment system, issuing from the Defense Intelligence Agency, US Department of Defense in January 1991 and apparently copied to the Royal Air Force Strike Command in the United Kingdom, reveals a detailed knowledge of Iraq's water treatment methods.
* The study concludes that Iraq's water treatment system is vulnerable to sanctions and is, already in January 1991, showing signs of deterioration; and it further concludes that 'it probably will take at least six months (to June 1991) before the system is fully degraded.'
* It notes, in a discussion of chemicals crucial to Iraq's water purification system, that 'aluminum sulphate supply levels are known to be critically low' and that 'recent reports indicate the chlorine supply is critically low. Its importation has been embargoed...').
* The study predicts increased incidence of disease, and notes the possibility of epidemics ('epidemics of such diseases as cholera, hepatitis, and typhoid could occur'), if sanctions targeting the water treatment system remain in place.
* Although the study does not itself make any recommendations (at least in the redaction made available to the public--the document is still partially classified), it by no means laments the weakening of the Iraqi water purification system: on the contrary, it apparently assumes that creating pressure on Iraq in this way is acceptable strategy.
Although Nagy attempted to gain serious public attention for this document, his efforts met with little success, and it was not until August 2002 that a major US news agency (Gannett) showed interest in the material. Since that time the document, and other related documents uncovered at the same time, have received some coverage, but public discussion has remained limited. We believe that those concerned with public health have a special role to play in this discussion.
The water study document is relevant to public health ethics because it provides evidence that the forcible lowering of the standards of health of Iraqi citizens through the ruination of their water treatment system was carried out knowingly. The health effects of the destruction of the water treatment system were not merely foreseeable in principle but were actually foreseen.
In discussions beginning in 1999 with the Joint Services Conference on Professional Ethics, with ethicists, members of the US armed forces, and others, we have listened to a number of arguments against our accusations. These include the following: the authors of 'Iraq Water Treatment Vulnerabilities' are anonymous and we do not know their original intentions; what matters ethically is not the existence of a document predicting a possible scenario but, rather, the actual, historical events that have occurred since the creation of the document; the responsibility for the health of the Iraqi people lies with the government of Iraq, which could have chosen since 1991, and especially since the institution of the Oil for Food Program in 1996, to repair the country's water treatment facilities; and, finally, the water treatment materials whose entry has been hampered are 'dual use' materials that could be used for military purposes. Our brief answers to these arguments are as follows.
First, although we are certainly interested in the identity of the authors of 'Iraq Water Treatment Vulnerabilities' (we are particularly concerned that the authors may have included health professionals), neither their identity nor their intentions is crucial to our argument. We are primarily interested in the government (or governments) that received the study. We hold that governments had a moral responsibility to take the document into account in their subsequent actions.
Second, we disagree that only events that occurred after the receiving of the document are ethically relevant. Both the document -- its contents and the act of receiving it -- and subsequent actions are morally relevant. Only by examining them together can we make an informed decision about the ethical quality of the actions of the governments enforcing the sanctions. The discovery of the document tells us that the effects of sanctions on water-borne disease and the health of the Iraqi population were well known from a very early date. This makes it more sinister that the US government, through its dominant role in the nature, maintenance and policing of the economic sanctions against Iraq, played a key role in impeding the repair of Iraq's water treatment system.
Tony Hall, Democratic Representative from Ohio, who visited Iraq in the summer of 2000 as the first member of the US Congress to visit Iraq since 1991, wrote on his return:
The prime killer of children under five years of age -- diarrhoeal diseases -- has reached epidemic proportions, and they now strike four times more often than they did in 1990...Holds on contracts for the water and sanitation sector are a prime reason for the increases in sickness and death. Of the eighteen contracts, all but one hold was placed by the US government. The contracts are for purification chemicals, chlorinators, chemical dosing pumps, water tankers, and other equipment...I urge you to weigh your decision against the disease and death that are the unavoidable result of not having safe drinking water and minimum levels of sanitation.
Third, we do not believe it is true that the government of Iraq could have repaired its water treatment system. The dependence of the Iraqi water treatment system (carefully noted in 'Iraq Water Treatment Vulnerabilities') on materials from outside the country, the importation of which has been repeatedly interfered with since 1990, has greatly limited the capacity of the government of Iraq to rehabilitate the system.
Fourth, the claim that materials denied entry to Iraq are 'dual use' appears to us neither factually credible nor morally adequate as an excuse for the weakening of the country's water treatment system. The factual dispute goes beyond the limits of this paper. As for the moral issue, it is our view that those concerned about public health and public health ethics must reject unconditionally the knowing destruction of a population's water treatment system -- that is, public health ethics must reject such destruction regardless of the purposes for which it is carried out or the military justifications offered.
We believe that the actions of the US government, supported to various degrees by other governments and legitimized by the UN Security Council, violate the basic values of public health. We have formulated a statement dealing with war and water purification, in the hope that we can encourage greater public awareness of this issue, and, in time, exert sufficient pressure to prevent the repetition of this illegal and immoral method of waging war. We have formulated this statement for health professionals, but we encourage readers to adapt it as necessary for other groups and organizations:
Consistent with Article 54 of the 1977 Geneva Protocol I Additional to the Geneva Conventions of 12 August 1949, and Relating to the Protection of Victims of International Armed Conflicts, health professionals shall not countenance, condone, or participate in acts which they know or should know will imperil the health of a population, or part of a population, through the destruction, damaging, or rendering useless, for any purpose whatsoever, of a population's water purification system; moreover, health professionals have a positive duty to make public any credible information regarding such knowing imperilment of the health of a population.
Notes:#Excerpted from a longer paper; contact Peace Magazine for further information. The declassified US government report "Iraq Water Treatment Vulnerabilities" can be read at www.gulflink.osd.mil/declassdocs/dia/19950901/950901_511rept_91.html.
Graeme MacQueen is a specialist in religious studies and a member of McMaster University's Centre for Peace Studies.
Thomas J Nagy is associate professor of expert systems at The George Washington University, Washington DC. He broke the story detailed in this article in September 2001 in The Progressive.
Joanna Santa Barbara is a child psychiatrist and peace researcher at McMaster University, Hamilton, Canada.
Claudia Raichle is a medical student at the University of Ulm, Germany.