Mar 172013


Collateral Damage:

The Health and Environmental Costs of War on Iraq

Collateral Damage: the health and environmental costs of war on Iraq was issued in London on 12 November 2002 by the global health organisation Medact, the UK affiliate of International Physicians for the Prevention of Nuclear War – winner of the Nobel Peace Prize in 1985. It was released on the same day in the US by IPPNW and its US affiliate Physicians for Social Responsibility, and by other IPPNW affiliates in over a dozen other countries, including: Australia; Denmark; France; Germany; Guatemala; Malaysia; Norway; Netherlands; Japan; India; Philippines; Canada; US; UK; and Australia.

In Australia the Medical Association for Prevention of War (MAPW) launched the report in Federal Parliament, Canberra at a press conference. MAPW President Dr Sue Wareham launched the report at the event hosted by the Australian Greens Senator Kerry Nettle. Former Chief of the Australian Defence Forces, General Peter Gration, also provided a letter of commendation for the report, which is available below.




Up to four million people could die in a war on Iraq involving nuclear weapons. A more contained conflict could cause half a million deaths and have a devastating impact on the lives, health and environment of the combatants, Iraqi civilians, and people in neighbouring countries and beyond. It could also damage the global economy and thus indirectly harm the health and well-being of millions more people across the world.

Researched and written by health professionals, this evidence-based report examines the likely impact of a new war on Iraq from a public health perspective. Credible estimates of the total possible deaths on all sides during the conflict and the following three months range from 48,000 to over 260,000. Civil war within Iraq could add another 20,000 deaths. Additional later deaths from post-war adverse health effects could reach 200,000. If nuclear weapons were used the death toll could reach 3,900,000. In all scenarios the majority of casualties will be civilians.
The aftermath of a ‘conventional’ war could include civil war, famine and epidemics, millions of refugees and displaced people, catastrophic effects on children’s health and development, economic collapse including failure of agriculture and manufacturing, and a requirement for long-term peacekeeping.

Destabilisation and possible regime change in countries neighbouring Iraq is also possible, as well as more terrorist attacks. Global economic crisis may be triggered through trade reduction and soaring oil prices, with particularly devastating consequences for developing countries.

The financial burden will be enormous on all sides, with arms spending, occupation costs, relief and reconstruction possibly exceeding $150-200bn. The US is likely to spend $50bn – $200bn on the war and $5bn – 20bn annually on the occupation. As the report points out, $100bn would fund about four years of expenditure to address the health needs of the world’s poorest people.

Conflict will be more destructive than 1990-1991 Gulf War

The avowed US aim of regime change means any new conflict will be much more intense and destructive than the 1990-91 Gulf War, and will involve more deadly weapons developed in the interim. Furthermore, the mental and physical health of ordinary Iraqis is far worse than it was in 1991, making them much more vulnerable this time round, and even less able to muster the resources needed for recovery and reconstruction.

Thanks to the oil revenues and social policies of Saddam Hussein’s dictatorship, Iraq pre 1991 had become a reasonably prosperous, urbanised, middle-income country with a modern social infrastructure and good public services. The combined effects of war and sanctions, only partly offset by the humanitarian relief of the Oil-for-Food programme, relegated it to a pre-industrial age, and it now occupies a lowly 126th place out of 174 in the UN Human Development Index.

The likely war scenario

The report bases its estimates on data from the earlier Gulf War, from comparable conflicts and crises elsewhere, and from the most reliable recent information on the health status of Iraq. It hypothesises a credible war scenario from current US military strategy, which envisages four different elements: sustained and devastating air attacks on government and military facilities and infrastructure in Baghdad and other major urban centres; landing of ground forces to seize oil-producing regions in the south east; gaining control of north Iraq; and rapid deployment forces backed by air attacks to take Baghdad.

The US goal of leadership change is counterbalanced by Saddam Hussein’s goal of survival, so a short, clinical campaign is probably wishful thinking. The options open to Saddam Hussein include: firing oil wells and using radiological or chemical missiles to pollute the sites paramilitary attacks on Kuwaiti and Saudi oil fields, pipelines and facilities paramilitary attacks on civilian centres in other Gulf states paramilitary attacks on targets in the US, UK and other Coalition countries selective use of chemical and biological weapons (CBW).

The report considers the circumstances in which more substantial use of chemical, biological and nuclear weapons may occur. An Iraqi CBW attack on Israel or elsewhere could provoke immediate nuclear retaliation from Israel, the US and/or UK, while the UK and US have  not ruled out the nuclear first-strike option.

Many questions remain unanswered about the aftermath and the likelihood of installing a stable new regime. The current problems of Afghanistan provide a reminder of the huge investment required to rebuild a shattered country, and the reluctance of the global community to support such long-term development.

Alternatives to war

As an objective report by health professionals, the report does not take a political stance on the alternatives to war on Iraq. Its main goal is to aid decision-making and encourage informed public debate by spelling out the true cost of a new war, against which any potential gains from going to war must be weighed. It lists non-violent strategies that have not yet been fully explored – some relating specifically to Iraq, and some to improving the international security context. It concludes that there is an urgent need for humane and wise global leadership which recognises that national security is impossible without international security.

Worldwide Release by medical groups to help stop war on Iraq

Collateral Damage: the health and environmental costs of war on Iraq

The report is produced by Medact, an organisation of health professionals that exists to highlight and take action on the health consequences of war, poverty and environmental degradation and other major threats to global health. Medact is the UK affiliate of International Physicians for the Prevention of Nuclear War (IPPNW), recipient of the 1985 Nobel Peace Prize. The report will also be released by other IPPNW affiliates in US (Washington), Canada, Australia and eight other countries.

The report contains new statistics of estimated casualties from the war, including those likely to follow the use of chemical, biological and nuclear weapons.

The report was issued in London on 12 November 2002 by the global health organisation Medact, the UK affiliate of International Physicians for the Prevention of Nuclear War – winner of the Nobel Peace Prize in 1985. It was released on the same day in the US by IPPNW and its US affiliate Physicians for Social Responsibility, and by other IPPNW affiliates in over a dozen other countries.


I am very pleased to lend my support to this Report launched by the Medical Association for the Prevention of War on the health and environmental consequences of a new war against Iraq.

All too often recent debate on possible war with Iraq has centred on strategic issues – on weapons of mass destruction, on the rationale or lack thereof for going to war, or on the outcomes of a war- without paying due regard to the monumental human and environmental costs of such a conflict.

This Report addresses these issues squarely and is therefore an important complement to the on-going debate. I commend it firstly to our decision makers, but also to those who simply wish to be better informed on the issue.

The Report is timely and sobering. It is timely in that it comes as the Security Council nears a decision point on a new resolution on Iraq, and when Australia may soon have to make its own decision on whether to join the United States in a pre-emptive strike. It is sobering in its presentation of the horrendous human and environmental cost of the 1991 Gulf War, and its analysis of the potentially catastrophic costs of a new war.

This is no exaggerated tract by a bunch of zealots. It is a coldly factual report by health professionals, who draw on the best evidence available, and in every case either show the range of credible estimates, or the most reliable estimate, erring on the side of caution.

The Report first catalogues the human and environmental costs of the 1991 Gulf War. Many of us think of that conflict as one with relatively low casualties. It was so for the Coalition, but not for the Iraqis. They sustained between 50,000 and 120,000 military deaths, with perhaps up to three times that number wounded. Direct civilian deaths numbered between 3,500 and 15,000 with a further 110,000 dying later from war related causes including economic collapse, infrastructure damage and the collapse of the health system. In the decade since 1991, the combined effects of the war and the subsequent sanctions have impacted heavily on the health of the Iraqi people, which remains poor. A new conflict would hit hard, as the baseline is far lower than in 1991.

The Report then postulates a credible hypothetical scenario from which to estimate the impact of a new war. Whatever the wider strategic aims, it is now well established that the immediate war aim would be regime change, and this would involve invasion, placing a puppet government in place, and supporting it with an occupation force. The scenario envisages a four-phase campaign, involving firstly widespread air attacks, then seizure of the oil fields in the southeast around Basra, seizure of the Kurdish region in northern Iraq, and finally an attack on Baghdad. This is militarily sound.

Such a campaign would take much longer and be much broader in scope than the 100 hours of Desert Storm in 1991, and new and more deadly weapons that have been developed in the interim would be used. A new conflict therefore seems certain to be more intense and destructive, and the human and environmental damage correspondingly much higher. Any idea of a short clinical campaign seems to be simply wishful thinking.

The Report makes it clear it is not developing a case to do nothing. The authors believe there are many options on the spectrum between “doing nothing” and “going to war” that have not yet been explored and should be. They echo the position of French President Chirac who said, “Let us give peace a chance. War is always the worst solution.”

I thoroughly commend this Report, and its call for humane and wise global leadership. By reminding us of the likely monumental human and environmental costs of a new war with Iraq, it has made a major contribution to the debate at a critical time.

Quoted by
No to War Movement




The date posted here is due to our website rebuild, it does not reflect the original date this article was posted. This article was originally posted in Yonip in 2003




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