Children of Sadr City bear brunt of crisis made worse by war

It is hardly surprising that listless six-month-old Sajad Abbas has been suffering from diarrhoea and vomiting for the past 10 days.

For an outbreak of gastroenteritis in Sadr City (formerly Saddam City) – asprawling and for-decades wilfully neglected Shia suburb to the north-east of Baghdad – owes almost everything to a chronic shortage of clean water, which has been suddenly intensified by the war.

And, in Sajad's case, the problem has been made worse as his desperate parents, like many others with children in the overcrowded and underpowered Qadisiyah Hospital, have been using the kind of cheap Chinese-made electric pump you can buy in local markets to suck water from taps that otherwise would provide little more than a few dismal drops.

But the paediatric house officer Dr Ahmed Abdul Hassan wearily explained yesterday that the pump also sucks out in concentrated form all the impurities, including residual sewage, that have contaminated the decrepit pipes. Others, he said, buy cheap water of dubious quality at 250 Iraqi dinars a barrel from local entrepreneurs in the belief that it is much purer.

"We are supposed to have a maximum capacity of 80 but we have 100 children in the wards," he said. "Ninety per cent of the cases are gastroenteritis, many with complications of dehydration. This is an old problem of quality and quantity of water, which the war has made worse." The reason, of course, is the devastating impact of war-caused electricity shortages on water treatment and supply.

Indeed, the hospital, the biggest in this city within a city, is a microcosm of the urgent humanitarian tasks.

Carel de Rooy and Ramon de Silva, Unicef's top two representatives for Iraq, will be discussing the crisis with the US military today. They returned to Baghdad yesterday for the first time since leaving with the agency's other international staff as war loomed in mid-March.

The gastroenteritis outbreak started at about the same time that much of the world was celebrating the fall of Baghdad, on 9 April, and when the hospital was working flat out to cope with civilian injuries inflicted by Allied cluster bombs.

Nor is that problem over. The Qadisiyah is still admitting between six and 16 cases a day of children injured by unexploded ordnance. And, although it has its own generating plant, it can no longer carry out surgery because a part in the generator that served the theatre burnt out a week ago and no replacement has been found. So the children are given first aid and transferred by ambulance if one is available and by private car if it isn't.

The hospital also lacksproperly sterilised instruments and other necessary materials,along with drugs such as injectable antibiotics.

"This is a big risk. You can do more damage than the original injury," said Dr Mohammed Abdul Rahman. Like all his colleagues Dr.Mohammed takes a fierce pride in his work – as anyone would have to do who was paid under Saddam a paltry $15 (£9.30) a month and worked, as all the young doctors did, throughout the war, sleeping in the hospital without time off.

"But this is psychologically traumatic for us. This is a hospital. Our job is to help people, and if we can't, we suffer too."

The US-led Organisation for Reconstruction and Humanitarian Assistance has not provided any help, so it is the Islamic scholastic group Hawza that is paying the doctors, has hired the man at the door with the AK-47 to keep out looters, and is shipping in from Najaf what little medical supplies it can. Green and black flags now fluttering above almost every other building in Sadr City testify to this as a Shia stronghold. Dr Rahman and Dr Hassan readily praise Hawza for their help but say they yearn for a new and elected Iraqi government – not run by rich exiles who have not shared their problems over the past decade. Although he is happy to see the back of Saddam, Dr Rahman said: "What I don't see is any sign of anything else in our lives that has been made better by the arrival of the Americans."

Which goes to the heart of the vacuum, humanitarian as well as political, in the running of Baghdad, let alone of the country as a whole. There is, for example, no mayoralty.

The Iraqi officer in charge of Unicef, George Hatim – who with 73 local technical staff has strived to maintain some water supply in the city – won't be drawn on tensions between the UN and the US impeding progress. But he said: "What I know is that Iraq's children are in deep crisis. Every day brings with it an increase in child morbidity and mortality."