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Susan Taylor Martin
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Story by SUSAN TAYLOR MARTIN
Photography by JAMIE FRANCIS
© St. Petersburg Times, published June 5, 2000
"This family near Kuwait had three children -- all the same, no genitalia," says Dr. Janan Hassan, flipping over page after page of stomach-turning photos. "You could not even tell the sex."
In the past nine years, Hassan and other doctors in this southern Iraqi city have seen what they say is an ever-growing number of babies with hideous birth defects. Last year alone, at least 137 were born with congenital malformities, five times as many as reported in 1991.
And that is not the only frightening trend. Iraqi authorities say the number of children and adults stricken with leukemia, lymphoma and other types of cancer has also soared since the 1991 Persian Gulf War.
To the Iraqis, there is a simple explanation. They blame the increases on exposure to depleted uranium, a radioactive substance used in weapons fired during the war by U.S.-led forces.
But many outside experts say the claim is premature. There have been no scientific studies in Iraq itself. The few conducted elsewhere have found that depleted uranium causes little risk of cancer and none at all of birth defects. Other hazards could be at fault, the experts say.
Thus continues a major medical mystery -- one of concern not only to Iraq but also the thousands of Gulf War veterans from the United States, Canada and other nations who have long complained of apparent war-related health problems.
"The issue has become polarized," says Dan Fahey, a U.S. Navy veteran who has spent years trying to prod the Pentagon into acknowledging the potential risks from depleted uranium.
"The danger with DU is mainly localized contamination in the immediate area, say within 150 feet of a tank that's hit. Some people make it sound like if you're 100 miles away you're breathing in the dust. In my opinion they are inflating the hazards, but it is a serious hazard and in terms of how this has impacted the health of vets and civilians it definitely needs more study."
Of the three types of uranium, two are fissionable and thus key in the making of nuclear bombs. The leftover material, called depleted uranium, is valuable in other types of weapons because it is so dense and heavy.
At high speed, a shell containing 10 pounds of solid DU can slice through tanks like "a hot knife through butter," in one apt description. It burns on impact, releasing particles that are toxic and remain radioactive for billions of years.
During the Gulf War, allied troops fired almost 1-million rounds containing an estimated 300 tons of depleted uranium. Most of those hit Iraqi tanks or fell on Iraqi soil. However, U.S. soldiers were also exposed, either wounded by "friendly fire" or from inhaling contaminated dust as they clambered over Iraqi tanks at war's end.
At the time no one -- neither Iraqis nor Americans -- knew much about the health risks from depleted uranium. But within a year, Iraqi doctors realized that something strange seemed to be happening.
Women who lived near the battlefields or whose husbands had fought in the war began having more and more babies with birth defects. Some survived, usually those with cleft palates or missing limbs. Others were stillborn, including some with tails, two heads, no brains or such terrible malformities they barely appeared human.
"I am a pediatrician but there is nothing even in the books about these kinds of things," says Dr. Hassan, a professor in the medical college of Basra University.
In 1991, her records show, 28 babies in Basra had birth defects, for a rate of 2.84 abnormalities per 1,000 births.
In 1998, the number of infants born with defects grew to 78 and the rate ballooned to 7.76.
"And the numbers will go up more and more," Hassan predicts. "The trend may continue forever. DU is radioactive and Basra is saturated with DU. This is a crime. What crime have our children done to deserve this?"
Along with the increase in birth defects has been a 262 percent percent jump in leukemia and other cancers nationwide, Iraqi authorities say.
In Basra, the hardest hit area, cancer strikes almost seven times as many people as it did in 1988, according to Dr. Jawa Kadhim Al-Alia, an oncologist at Saddam Teaching Hospital. Three of his best friends, two doctors and a pharmacist, have sons with leukemia.
"Everybody is afraid of getting cancer," Al-Alia says. For the first time in his long career, he is also seeing many "clusters" -- cancer striking several members of the same family.
Doctors at Saddam Central Teaching Hospital in Baghdad, where many young leukemia victims go for treatment, used to get only a few cases a year. Now two or three children are diagnosed every week.
"In Jordan and Egypt there is a very low incidence of leukemia," says Dr. Basim Al Abdili, the chief resident. "The cause of this is very clear: It's depleted uranium used during the war."
To some outside experts, though, the link between depleted uranium and cancer or birth defects is not at all clear. There are other factors, they say, that should be thoroughly studied:
Iraq's air is often hazy and hard to breathe, polluted by the thick black smoke that belches from oil refineries and countless brick factories. After the Gulf War, pollution was aggravated by the many oil-field fires set by Iraqi troops as they fled Kuwait.
In the 1980s, Iraqi President Saddam Hussein used mustard gas and other chemical weapons on rebellious groups in his own country as well as on Iranian soldiers who fought near Basra during the eight-year Iran-Iraq war. Scientists say mustard gas can cause genetic damage.
Years of war-related food shortages have left many Iraqis seriously malnourished. Pregnant women who do not get enough folic acid, an essential vitamin, have a greater chance of delivering babies with birth defects.
"The regular Iraqi people have suffered a lot and the situation is bad," says Dr. Kelley Brix of the U.S. Department of Veterans Affairs. "It is human nature to try to find reasons why the situation is bad, but the only way you're going to get the answer is by having a careful evaluation done by a group that is authoritative and balanced in its viewpoint."
Brix is among those working with the Persian Gulf Veterans Coordinating Board, created partly in response to complaints by U.S. soldiers that they have suffered a wide range of ailments since their Gulf War service. Like the Iraqis, many wonder if their problems are caused by depleted uranium.
Pentagon officials "have changed their story a lot in the past couple of the years," says Fahey, a researcher for the non-profit Military Toxics Project. "A couple of years ago, no one was exposed, now the line is that a lot of people might have been exposed but no one was exposed enough to cause any health problems. The problem is they don't have any data to support that because they didn't do any testing right after the war."
To date, officials say, there have been no reported cases of cancer, birth defects or even kidney problems, the main health risk observed in rats exposed to high levels of uranium.
"Despite the fact (the veterans) do have a high amount of uranium in their bodies, they are not showing any adverse effect so far," Brix says. "That's not to say they wouldn't show up down the line so the (Department of Defense) and the VA will keep a very careful look on these poor American soldiers for at least 10 years."
Since 1998, the government has offered medical evaluations to all Gulf War veterans, not just those hit by shrapnel. Hundreds of veterans might have come in contact with depleted uranium as they cleaned up after a large fire in Kuwait that burned tons of munitions.
Under pressure from critics, the Pentagon plans other research, including live-fire testing on tanks to get a better handle on the levels and range of exposure.
Only a few studies have been completed so far, and those found no greater rate of birth defects in the babies of Gulf War veterans. But can depleted uranium cause leukemia and other types of cancer? On that score, the evidence is more troubling.
Three years ago, researchers from the National Cancer Institute and other agencies exposed human cells to depleted uranium and injected them into mice. They developed tumors within four weeks.
Based on those results, the cancer-causing potential of DU "remains a concern and warrants additional studies," the reserachers said.
In the United States, depleted uranium is considered enough of a risk that the Environmental Protection Agency requires detailed plans for protecting people and the environment at the three sites where the material is stored.
No such precautions exist in southern Iraq. Children still play near burned-out tanks and farmers still grow tomatoes -- albeit stunted ones -- in fields they say were hit with missiles.
Although some residents have been moved out of the area, the Iraqi government says it has neither the resources nor the responsibility to clean up any uranium.
"The polluter pays. This is the principle in America," Khidhir Putres, a top environmental engineer, pointedly tells two American journalists.
The World Health Organization and Iraqi officials have discussed a study on the risks of depleted uranium, but the government has yet to make a formal request. In the meantime, W.H.O. has twice sent missions to Iraq to lay the groundwork for investigating the apparent rise in cancer cases.
The teams "found a lot of missing data in Iraq's health records," says Gregory Hartl, a spokesman for the Geneva-based agency. "What we need is to start at ground zero and re-establish a system for collecting scientific data."
Verifying Iraqi claims and tracking down victims can indeed be difficult. Hospitals do not require patients to give full names and exact addresses, let alone the exhaustive amounts of information required in the United States or Europe.
A Times reporter and photographer tried, for example, to find the woman whose three stillborn babies lacked sex organs. Dr. Hassan's notes showed only the mother's name and the fact she lived near the main school in a village near the Kuwaiti border.
However, no one in the area, including the village elders, said they could place the woman, explaining that they generally know families only by the husband's name. Nor could anyone recall three malformed babies born to one woman. Perhaps, they said, she was so ashamed she never told anyone other than close relatives.
Likewise, efforts to locate a family who "live across the bridge and near the market" in another village also came to naught.
"So many babies," one man said, glancing at the dozens of children playing in the street. "Who remembers the dead ones?"
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-- Times researchers Kitty Bennett and Cathy Wos contributed to this story.
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COMING TUESDAY: Are sanctions an effective club for getting Saddam Hussein to give up his weapons?
PART ONE: Iraq: Splendor to squalor
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