New report looks at food and nutrition in Iraq
The mission found that since the implementation of the oil-for-food programme in 1997, "child malnutrition rates in the centre/south of the country do not appear to have improved and nutritional problems remain serious and widespread. Survey results indicate that more than 10 percent of the children under five show signs of wasting (their weight is too low for their height), a symptom of acute malnutrition. These levels are "unacceptably high", states the mission's report and they represent "only a marginal decrease for these governorates since the 1995 FAO/WFP assessment."
The survey also measured the prevalence of stunting (when children are too short for their age), a symptom of chronic malnutrition. In Baghdad, 12 percent of the children under five showed signs of stunting - a significant improvement over 1995, when the rate of stunting stood at 28 percent. However, rural areas have experienced setbacks. In Diala, for example, the mission found that the prevalence of stunting had risen from 20.6 percent to 27 percent over the last four years.
The situation is brighter in Iraq's three northern governorates of Dohouk, Erbil and Al-Sulymeiniyah. In these areas, the report states that the oil-for-food programme has contributed to bringing about "significant improvements in health, mortality and nutritional status". In the north, wasting has almost been eliminated, and chronic malnutrition among children below five years old has fallen from 26 percent in 1996 to 18 percent in 1999. A 1999 UNICEF survey found that infant mortality rates had also declined, from 80 per 1 000 live births in 1984-89 to 72 in 1994-99. This progress is due not just to the oil-for-food programme rations but to overall economic growth in the area.
The monthly food basket
Since the oil-for-food programme came into effect in 1997, the nutritional quality of the monthly food basket provided by the government has improved significantly. However, the mission found that "the existing food rations do not provide a nutritionally adequate and varied diet."
Before the programme began, the energy content of Government rations was calculated at 1 295 kcal per person per day. Since then, the energy provided by the monthly food basket has increased steadily, to an average of 2 000 kcals and 43.3 grams of protein per person per day in 1998/99. During the last six months, the rations provided each person with 2 199 kcal and 48.2 grams of protein per day.
Those who can afford it supplement the rations with food bought at local markets. Prices for foods included in the rations are generally low but for other items, such as meat, dairy products and vegetables, costs are much higher. The mission calculated that the average household spends 1 068 Iraqi dinars or 53 US cents (2000 Iraqi dinars buy one US dollar) each day on food. With monthly incomes of many public servants as low as 5 000 to 10 000 Iraqi dinars, or US$2.50 to US$5.00, supplementing the rations is undoubtedly a considerable hardship for the poorest households.
Many families simply cannot afford to buy additional food. As a result these families remain particularly vulnerable to malnutrition.
Iraqi agriculture in crisis
Economic sanctions have limited Iraq's access to foreign investment and imported supplies, such as spare parts for farm machinery, fertilizers, pesticides and herbicides. To make matters worse the country is suffering through its second consecutive year of severe drought. As a result, "the agriculture sector has deteriorated significantly in the past few years, " says the mission's report.
During the drought, the central and southern parts of the country have received one half to one third of the average rainfall. Water levels have fallen drastically in the country's waterways, some of which have virtually dried up. The Tigris is reported to be flowing at 40 percent of its normal volume, and the Euphrates is also very low.
Poor water and sanitation increase malnutrition
Malnutrition is usually not just a consequence of hunger; it results from a complex combination of factors. The mission found that "poor water supply both in quantity and quality as well as inadequate sanitation are key causative factors of frequent and repeated infections resulting in infant and child malnutrition throughout the country".
A household nutrition survey found that half the children under five had recently suffered from diarrhoea, and around 40 percent had acute respiratory infections. The mission also found that major primary health centres were crowded with children suffering from malnutrition associated with infections.
"The addition of contaminated water to milk formula when bottle feeding young children is especially dangerous," warns the report. About 85 percent of children under six months are breastfed, but only 5 to 10 percent are exclusively breast-fed. More than 60 percent of the infants were given the infant formula distributed in the monthly food basket. Diluting the formula in order to make the supply last longer has contributed to infant malnutrition.
The prevalence of other serious water-borne disease is also on the rise in Iraq. Between 1997 and 1999, the Ministry of Health reported a 60 percent increase in cases of typhoid fever, and the number of cases of cholera rose from 486 to 2 398.
The other face of malnutrition
For Iraq's adult population, the mission found that the greatest cause for concern is overweight. More than half the adult population in Iraq is overweight to some degree. In Baghdad, 30 percent of the adults are severely overweight, while in Kerbala and Diala the rates are 27 and 18 percent respectively. Obesity is not just a 'disease of affluence'; it is found in both rich and poor communities, and it often results from diets high in carbohydrates and fats but lacking the diversity needed for good health, combined with a lack of physical activity. The report points out that "the major reported causes of death in adults are heart disease, hypertension and diabetes, all conditioned by obesity."
13 September 2000