The Politics of Dead Children

Have sanctions against Iraq murdered millions?

Are "a million innocent children...dying at this time...in Iraq" because of U.S. sanctions, as Osama bin Laden claimed in his October 7 videotaped message to the world? Has the United Nations Children's Emergency Fund (UNICEF) discovered that "at least 200 children are dying every day...as a direct result of sanctions," as advocacy journalist John Pilger maintains on his Web site? Is it official U.N. belief that 5,000 Iraqi children under the age of 5 are dying each month due to its own policy, as writers of letters to virtually every U.S. newspaper have stated repeatedly during the past three years?

The short answer to all of these questions is no. The sanctions, first imposed in 1990 after Iraq's invasion of Kuwait, are administered by the U.N., not the U.S. They were first imposed on all exports from Iraq and occupied Kuwait, and all non-humanitarian imports, in an effort to persuade Saddam Hussein to retreat within his own borders. After the Gulf War, they were broadened to include a dismantling of Iraq's biological, chemical, nuclear, and missile-based weapons systems, out of fear that Hussein would otherwise lash out again. Estimates of sanctions-era "excess" child deaths -- the number above the normal mortality rate -- vary widely due to politics and inadequate data, especially concerning children older than 5. The dictatorial Iraqi government, which has blamed nearly every civilian funeral since 1991 on sanctions, claims there have been more than 600,000 deaths of under-5-year-olds these past 11 years (4,500 per month) and 1.5 million deaths overall.

While firefighters were still pulling out warm body parts from Ground Zero, foreign policy critic Noam Chomsky and his followers on college campuses and alternative-weekly staffs nationwide were insisting that it was vital to understand the "context" of the September 11 massacre: that U.S.-led sanctions were killing "5,000 children a month" in Iraq. Meanwhile, on the Iraqi government's own Web site, the number of under-5 deaths from all causes for the month of September was listed as 2,932.

Arriving at a reliable raw number of dead people is hard enough; assigning responsibility for the ongoing tragedy borders on the purely speculative. Competing factors include sanctions, drought, hospital policy, breast-feeding education, Saddam Hussein's government, depressed oil prices, the Iraqi economy's almost total dependence on oil exports and food imports, destruction from the Iran-Iraq and Persian Gulf wars, differences in conditions between the autonomous north and the Saddam-controlled south, and a dozen other variables difficult to measure without direct independent access to the country.

Confusing the issue still further are basic questions about the sanctions themselves. Should the U.N. impose multilateral economic sanctions to keep a proven tyrant from developing weapons to launch more wars against his neighbors? If sanctions are inherently immoral, what other tools short of war can the international community use? Is this particular sanctions regime more unreasonable than others that haven't triggered humanitarian crises? How much should we blame Saddam Hussein for rejecting the U.N.'s "oil-for-food" humanitarian offer for six years, and expelling weapons inspectors in 1998? Most important, has Iraq made headway since then in pursuing nuclear and biological weapons?

Yet all this murkiness has not deterred advocates of sanctions from claiming absolute certainty on the issue. The warmongering New Republic, for example, announced in October that the notion that "sanctions have caused widespread suffering" was simply "false." Writing in National Review in December, former army intelligence analyst Robert Stewart asserted that "resources are available in Iraq. Even under the sanctions, Iraq's people need not starve."

The chasm between claims made by sanction supporters and opponents is enough to make inquisitive people throw their hands up in the air. Such despair is not exactly conducive to healthy debate, which is especially important at a time when President Bush has made it clear that Iraq must cooperate with weapons inspection or become the next target of the War on Terrorism. A closer look at the controversy over dead Iraqi babies shows that opponents of sanctions have a compelling case to make. Although they often undermine their own position with outrageous exaggerations, their critics show a similar disregard for the facts when they blithely dismiss concerns about the impact of sanctions on innocent people.

Origins of a Whopper

The idea that sanctions in Iraq have killed half a million children (or 1 million, or 1.5 million, depending on the hysteria of the source) took root in 1995 and 1996, on the basis of two transparently flawed studies, one inexplicable doubling of the studies' statistics, and a non-denial on 60 Minutes.

In August 1995, the U.N. Food and Agriculture Organization (FAO) gave officials from the Iraqi Ministry of Health a questionnaire on child mortality and asked them to conduct a survey in the capital city of Baghdad. On the basis of this five-day, 693-household, Iraq-controlled study, the FAO announced in November that "child mortality had increased nearly five fold" since the pre-sanctions era. As embargo critic Richard Garfield, a public health specialist at Columbia University, wrote in his own comprehensive 1999 survey of under-5 deaths in Iraq, "The 1995 study's conclusions were subsequently withdrawn by the authors....Notwithstanding the retraction of the original data, their estimate of more than 500,000 excess child deaths due to the embargo is still often repeated by sanctions critics."

In March 1996, the World Health Organization (WHO) published its own report on the humanitarian crisis. It reprinted figures -- provided solely by the Iraqi Ministry of Health -- showing that a total of 186,000 children under the age of 5 died between 1990 and 1994 in the 15 Saddam-governed provinces. According to these government figures, the number of deaths jumped nearly 500 percent, from 8,903 in 1990 to 52,905 in 1994.

Somehow, based largely on these two reports -- a five-day study in Baghdad showing a "five fold" increase in child deaths and a Ministry of Health claim that a total of 186,000 children under 5 had died from all causes between 1990 and 1994 -- a New York-based advocacy group called the Center for Economic and Social Rights (CESR) concluded in a May 1996 survey that "these mortality rates translate into a figure of over half a million excess child deaths as a result of sanctions."

In addition to doubling the Iraqi government's highest number and attributing all deaths to the embargo, CESR suggested a comparison that proved popular among the growing legions of sanctions critics: "In simple terms, more Iraqi children have died as a result of sanctions than the combined toll of two atomic bombs on Japan." The word genocide started making its way into the discussion.

Still, the report might well have ended up in the dustbin of bad mathematics had a CESR fact-finding tour of Iraq not been filmed by Lesley Stahl of 60 Minutes. In a May 12, 1996, report that later won her an Emmy and an Alfred I. DuPont-Columbia University Journalism Award, Stahl used CESR's faulty numbers and atomic-bomb imagery to confront Madeleine Albright, then the U.S. ambassador to the United Nations. "We have heard that a half million children have died," Stahl said. "I mean, that's more children than died in Hiroshima. And -- and you know, is the price worth it?" Albright replied, "I think this is a very hard choice, but the price -- we think the price is worth it."

It was the non-denial heard 'round the world. In the hands of sanctions opponents and foreign policy critics, it was portrayed as a confession of fact, even though neither Albright nor the U.S. government has ever admitted to such a ghastly number (nor had anybody aside from CESR and Lesley Stahl ever suggested such a thing until May 1996). The 60 Minutes exchange is very familiar to readers of Arab newspapers, college dailies, and liberal journals of opinion. Ralph Nader and Pat Buchanan mentioned it several times during their respective presidential campaigns.

After September 11, the anecdote received new life, as in this typically imaginative interpretation by Harper's Editor Lewis Lapham in the magazine's November issue: "When Madeleine Albright, then the American secretary of state [sic], was asked in an interview on 60 Minutes whether she had considered the resulting death of 500,000 Iraqi children (of malnutrition and disease), she said, 'We think the price is worth it.'"

Albright has been dogged by protesters at nearly all her campus appearances the past several years, and rightly so: It was a beastly thing to say, and she should have refuted the figures. Quietly, a month after the World Trade Center attack, she finally apologized for her infamous performance. "I shouldn't have said it," she said during a speech at the University of Southern California. "You can believe this or not, but my comments were taken out of context."

The other, far more credible source of the 500,000 number is a pair of 1999 UNICEF studies that estimated the under-5 mortality rates of both Iraqi regions based on interviews with a total of 40,000 households. "If the substantial reduction in the under-five mortality rate during the 1980s had continued through the 1990s," the report concluded, "there would have been half a million fewer deaths of children under-five in the country as a whole during the eight year period 1991 to 1998." If the expected mortality rate had stayed level rather than continuing its downward slope, the excess death number would be more like 420,000.

Significantly, UNICEF found child mortality actually decreased in the autonomous north (from 80.2 per 1,000 in 1984-89 to 70.8 in 1994-98) while more than doubling in the south (from 56 per 1,000 to 130.6). This is Exhibit A for those who, like The New Republic, argue that Saddam alone is responsible for Iraq's humanitarian crisis. When the report was released, UNICEF Executive Director Carol Bellamy attributed the difference in mortality trends to "the large amount of international aid pumped into northern Iraq at the end of the [Persian Gulf] war."

The UNICEF report took pains to spread the blame for increased mortality in the south, mentioning factors such as a dramatic increase in the bottle-only feeding of infants in place of more nutritious (and less likely to be tainted) breast milk. "It's very important not to just say that everything rests on sanctions," Bellamy said in a subsequent interview. "It is also the result of wars and the reduction in investment in resources for primary health care."

But in the hands of sanctions opponents and some news organizations, these findings were translated into a U.N. admission that sanctions were "directly responsible" for killing half a million children (or even "infants"). In September 2001 alone, the UNICEF report was mischaracterized in The Boston Globe, The Buffalo News, The Akron Beacon Journal, The San Diego Union-Tribune, The Charleston Gazette, the Wilmington Sunday Star-News, and The Chicago Tribune (by a Northwestern University journalism professor, no less).

By November, UNICEF was annoyed enough with the frequent misinterpretations to send out regular corrective press releases, saying things like: "The surveys were never intended to provide an absolute figure of how many children have died in Iraq as a result of sanctions." Rather, they "show that if the substantial reductions in child mortality in Iraq during the 1980s had continued through the 1990s -- in other words if there hadn't been two wars, if sanctions hadn't been introduced and if investment in social services had been maintained -- there would have been 500,000 fewer deaths of children under five."

Sanctions critics almost always leave out one other salient fact: The vast majority of the horror stats they quote apply to the period before March 1997, when the oil-for-food program delivered its first boatload of supplies (nearly six years after the U.N. first proposed the idea to a reluctant Iraqi government). In the past four years of oil-for-food, Iraq has exported around 3 billion barrels of oil, generating $40 billion in revenue, which has resulted in the delivery of $18 billion of humanitarian and oil-equipment supplies, with another $16 billion in the pipeline. (The rest is used to cover administrative costs and reparations to Kuwait.)

As the U.N. Office for the Iraqi Program stated in a September 28, 2001 report, "With the improved funding level for the program, the Government of Iraq is indeed in a position to address the nutritional and health concerns of the Iraqi people, particularly the nutritional status of the children." Even two years earlier, Richard Garfield noted in his survey that "the most severe embargo-related damages [have] already ended."

Anyone who tells you more children will perish in Iraq this month than Americans died on September 11 is cutting and pasting inflated mid-1990s statistics onto a country that has changed significantly since then. Knowingly or not, these critics are mangling the facts to prove a debatable point and in the process damaging their own cause.

The Truth is Bad Enough

Two weeks after the hijacked planes crashed into the World Trade Center and the Pentagon, I began looking in earnest for trustworthy sources of information about the effects of sanctions on Iraq. I was joined in my search by a half-dozen or so e-mail acquaintances who approached the question from a broadly similar viewpoint: If sanctions are killing Iraqi babies, then Osama Bin Laden has a legitimate propaganda tool, and the U.S. has blood on its hands that demands immediate attention. So let's find the facts, weigh them against Saddam's weapons capabilities, and proceed from there.

It immediately became obvious that sanctions opponents, especially in the U.S., would be a hindrance, not a help. "I'm a little disgusted at the way the Naderite left has used the issue, especially when they have no backup for the claims they are making," one of my co-conspirators, Eric Mauro, wrote me. "They may be right, but they are so inept at arguing that it's dangerous to take their word for it."

The man who launched the American anti-sanctions movement as we know it is a University of Texas journalism professor named Robert Jensen. His Web site's "factsheet" on Iraq contains two lies right off the bat. Citing WHO, he claims that "each month 5,000 to 6,000 children die as a result of the sanctions." And citing UNICEF, he asserts that "approximately 250 people die every day in Iraq due to the sanctions."

Jensen, who teaches "critical thinking," drifted onto the national radar screen days after the terrorist attacks, when he wrote a column published in ZNet, CommonDreams.org, and The Houston Chronicle titled "U.S. Just As Guilty of Committing Own Violent Acts." He has opposed the war against Afghanistan (not to mention Serbia), teaches the journalism of Mumia Abu-Jamal, and once wrote a column about how the "U.S. middle class, particularly the white middle class, is probably the single biggest impediment to justice the world has ever known."

Jensen's cohorts in kick-starting the anti-sanctions movement were intifada-supporting professor Edward Said, "people's historian" Howard Zinn, and Noam Chomsky, a man who has rarely met a foreign policy he couldn't describe as "genocide." The four issued a joint statement in January 1999 condemning the situation in Iraq as "sanctioned mass-murder that is nearing holocaust proportions."

These four men have authored reams of hyperbolic nonsense since September 11. Isn't it reasonable to conclude that anything they and Saddam Hussein agree upon must be false?

No, actually, it's not, and therein lies the problem. Any sustained inquiry into the sanctions issue runs up against waves of propaganda and reckless disregard for the truth, and it would be all too easy to declare the issue settled after a quick dismissal of the most glaring lies. But that would be an abdication of responsibility. Many of those who support continued pressure on Saddam Hussein tend to focus on a few key counterpoints while ignoring piles of haunting in-country surveys and the damning testimony of former U.N. officials who have quit to campaign full-time against U.S. policy in Iraq. Sanctions proponents, if they are not careful, run the risk of aping the foolish debate tactics of the critics they condemn.

Take, for example, the lowered mortality rates in the northern provinces of Dahuk, Sulaymaniyah, and Erbil -- the smoking gun of the sanctions-don't-kill crowd. The New Republic claims the autonomous Kurdish area "is subject to exactly the same sanctions as the rest of the country." This is false: Under the oil-for-food regime, the north, which contains 13 percent of the Iraqi population, receives 13 percent of all oil proceeds, a portion of that in cash. Saddam's regions, with 87 percent of the population, receive 59 percent of the money (recently increased by the U.N. Security Council from 53 percent), none of it in cash. (Of the rest, 25 percent goes to a Kuwaiti compensation fund, and the rest covers U.N. expenses.)

It just isn't true that the sanctions are "exactly the same" in both parts of Iraq. And there are other factors affecting the north-south disparity: International aid agencies have been active in the areas protected by no-fly zones since 1991, and the Turkish border is said to be suitably porous for smuggling (although Saddam has been caught smuggling several times in the past decade).

The get-Saddam camp also likes to point out that sanctions haven't seemed to inflict similar grief in countries such as Libya and Yugoslavia. To which Richard Garfield, who compared the various penalized countries, has an effective rebuttal: "Embargoes with the greatest impact on the health of the general population are usually those which are multilateral and comprehensive, occur in countries with heavy import dependence, are implemented rapidly, and are accompanied by other economic and social blows to a country. Iraq shared each of these characteristics."

Those who get past the initial frustrations of researching the topic usually end up on Richard Garfield's doorstep. His 1999 report -- which included a logistic regression analysis that re-examined four previously published child mortality surveys and added bits from 75 or so other relevant studies -- picked apart the faulty methodologies of his predecessors, criticized the bogus claims of the anti-sanctions left, admitted when the data were shaky, and generally used conservative numbers. Among his many interesting findings was that every sanctions regime except the one imposed on apartheid South Africa led to limitations of food and medicine imports, even though such goods were almost always officially exempt from the embargo. "In many countries," he wrote, "the embargo-related lack of capital was more important than direct restrictions on importing medicine or food."

Garfield concluded that between August 1991 and March 1998 there were at least 106,000 excess deaths of children under 5, with a "more likely" worst-case sum of 227,000. (He recently updated the latter figure to 350,000 through this year.) Of those deaths, he estimated one-quarter were "mainly associated with the Gulf war." The chief causes, in his view, were "contaminated water, lack of high quality foods, inadequate breast feeding, poor weaning practices, and inadequate supplies in the curative health care system. This was the product of both a lack of some essential goods, and inadequate or inefficient use of existing essential goods."

Ultimately, Garfield argued, sanctions played an undeniably important role. "Even a small number of documentable excess deaths is an expression of a humanitarian disaster, and this number is not small," he concluded. "[And] excess deaths should...be seen as the tip of the iceberg among damages to occur among under five-year-olds in Iraq in the 1990s....The humanitarian disaster which has occurred in Iraq far exceeds what may be any reasonable level of acceptable damages according to the principles of discrimination and proportionality used in warfare....To the degree that economic sanctions complicate access to and utilization of essential goods, sanctions regulations should be modified immediately."

Garfield's conclusion echoes that of literally every international agency that has performed extensive studies in Iraq. In 1999 a U.N. Humanitarian Panel found that "the gravity of the humanitarian situation of the Iraqi people is indisputable and cannot be overstated." UNICEF's Carol Bellamy, at the time her landmark report was released, said, "Even if not all suffering in Iraq can be imputed to external factors, especially sanctions, the Iraqi people would not be undergoing such deprivations in the absence of the prolonged measures imposed by the Security Council and the effects of war." The former U.N. humanitarian coordinator for Iraq, Denis Halliday, travels around the world calling the policy he once enforced "genocide." His replacement, Hans von Sponeck, also resigned in protest of the U.N.'s "criminal policy."

Losing the Loonies

There have been no weapons inspectors in Iraq since 1998. As a result it is exceptionally difficult to know with precision what nuclear and biological weapons Saddam actually has on hand or in development. From the beginning, economic sanctions have been tied to what foreign policy analyst Mark Phythian described in World Affairs as "the first attempt to disarm a country against its will." After September 11, the issue of an America-hating tyrant arming himself to the teeth has seemed more pressing than easing an embargo that blocks his access to money.

Yet the basic argument against all economic sanctions remains: namely, that they tend to punish civilians more than governments and to provide dictators with a gift-wrapped propaganda tool. Any visitor to Cuba can see within 24 hours the futility of slapping an embargo on a sheltered population that is otherwise inclined to detest its government and embrace its yanqui neighbors. Sanctions give anti-American enclaves, whether in Cairo or Berkeley or Peshawar, one of their few half-convincing arguments about evil U.S. policy since the end of the Cold War.

It seems awfully hard not to conclude that the embargo on Iraq has been ineffective (especially since 1998) and that it has, at the least, contributed to more than 100,000 deaths since 1990. With Bush set to go to war over Saddam's noncompliance with the military goals of the sanctions, there has never been a more urgent time to confront the issue with clarity.

That means losing the loonies on the left. Already there are signs of mounting liberal impatience with the routine smokescreens emanating from the usual anti-sanctions rabble. Slate, The Guardian, and even The Nation all published sober correctives of dead-Iraqi-baby inflation toward the end of 2001, decisively backing Richard Garfield over Robert Jensen. And if Noam Chomsky no longer leads this particular coalition of critics, maybe they're not so wrong after all.

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