Baby Seif in Fallujah, born with spina bifida. Credit: Donna Mulhearn
Human rights and health observers have been waiting a year for the results of a World Health Organization/Iraqi Health Ministry study that would, at last, shed some “official” light on a problem that local doctors and journalists have been reporting for years: that a disproportionate number of babies in areas that saw heavy western bombardment during the war are being born with horrifying birth defects.
Well, after a summer of anticipation, a “summary” of the report was quietly released on Sept. 11 and it says the complete opposite of what health officials — even the Iraqi ministry officials in charge of the study! — have been saying:
The rates for spontaneous abortion, stillbirths and congenital birth defects found in the study are consistent with or even lower than international estimates. The study provides no clear evidence to suggest an unusually high rate of congenital birth defects in Iraq.
The full summary report can be found in .pdf form, here.
Using 72 local teams, the ministry last year conducted a survey of Iraqi women of child-bearing age and their households in 18 districts across Iraq (two districts in each governorate). The districts represented those that “had or had not been exposed to bombardment or heavy fighting” during the war. Out of the 10,800 households visited, 95 percent or 10,355 had responded, according to the summary. The questionnaire was chiefly concerned with determining the number of stillborns, spontaneous abortions and birth defects among live births, the presence, magnitude and trends of birth defects and “limited risk factors” involved. On all counts, the summary report seems to find no evidence of a high incidences of birth defects or of babies born dead.
Antiwar has been covering this story for years now. Where the WHO/Ministry of Health report laughingly refers to the lack of study on this issue, we know that prominent doctors like US-based Dr Mozhgan Savabieasfahani have been working on this and have done several studies indicating a “epidemic of birth defects,” demanding more study on the link to war pollutants, like heavy metals, radiation from depleted uranium (DU) and other contaminants left over from the war. Savabieasfahani has already found higher levels of lead and mercury in children in Basra, which could account for the reported higher rates of cancer there.
There is the testimony from activist Donna Mulhearn who has been there. Even the ministry officials who went on record with BBC last spring said the study would confirm the worst and blamed it on the war. Why are they changing their stories now?
There are many questions to be asked. Why does WHO suddenly take a tiny role in this study, resigned to providing “technical assistance” to the MOI when it was originally billed as a “collaboration,” “co-financed” by both organizations?
Dr. Savabieasfahani published a response to the summary on Sept. 16 raising a number of questions about the methodology, the preliminary results, and wondering, too, about the “reviewers” — all British and American researchers — as well as the apparent anonymity of the report’s authors:
Another unusual and outrageous feature of this report is its anonymity. No author(s) are listed or identified. An anonymous report is rarely seen in epidemiological reporting given the multiple questions that often arise when interested readers examine complicated study designs, large data sets, and multiple analysis. Identification of corresponding authors is critical for the transparency and clarity of any report. Without author names and affiliations, without identified offices in the MoH, the reader must ask, who is responsible to answer for this report? To whom must the public direct their questions and concerns about this report?
Media Lens has also published a lengthy article on the subject, interviewing a number of interested parties, including former WHO advisors who are obviously disgusted with the way things have gone so far.
Dr Keith Baverstock, the former WHO adviser on radiation and public health mentioned earlier, told (Media Lens):
‘I have not had time to study this report in detail so I will not comment on the scientific aspects. However, there are aspects which cause me very considerable concern. Firstly, this is not the independent academic analysis that is required – it certainly would not find a place in a reputable scientific journal. So it is strange to my mind that apparently reputable scientists have, through what is purported to be a peer review process, endorsed this study. I would have several questions for these people, none of whom I know. For example, how did they ensure that there was no selection bias: why was such a simplistic approach taken to the statistical analysis of the results. The implication is that these people were appointed by WHO although WHO does not appear to be a co-author, or in other ways connected with the report. If this peer review group have had access to information not in the report where and when will this information be made public?’
The summary is a big disappointment and and even greater mystery, considering those WHO officials who reportedly spoke to BBC last March with assurances that the report would find obvious rates of increased birth defects in Fallujah and Basra. There have been reports of government/western pressure on local physicians, but this is too much. Seeing the full report now is even more essential, but can we trust what it says?