Physicians for Human Rights Statement on War in Iraq

paul illich paul_illich at
Sat Feb 8 16:00:18 MST 2003

Physicians for Human Rights Statement on War in Iraq

December 23, 2002

John Heffernan, Senior Communications Associate: 617-413-6407

Physicians for Human Rights (PHR) is gravely concerned
about the potential for loss of life on a large scale and
serious risk to health and human rights of the Iraqi people
and others in the region should a war ensue. We urge continued
efforts to avoid war, but if a war is waged, we urge the US
Government to take crucial steps to protect the civilian
population and captured combatants through scrupulous compliance
with international humanitarian law, including the Geneva
Conventions, by prohibiting the use of antipersonnel landmines,
through protection of Iraqi citizens against reprisals by
their own government and care for refugees and displaced persons,
and through provisions for the health needs of the people of
Iraq and others who may be affected by the conflict.

Below we explain our position and outline the areas of
potential impact of the war on the inhabitants of the region.
These include the consequences of war on the availability of
food, clothing, shelter and medical care; the likelihood of
civilian deaths as "collateral damage"; and the possibility
of war crimes and crimes against humanity taking place during
the war.


Physicians for Human Rights is a US-based organization that
promotes health by protecting human rights. Since its
inception in 1986, PHR has investigated and reported on
violations of human rights in times of peace and monitored
adherence to international humanitarian law and human rights
law during armed conflict. As health professionals, we have
witnessed and documented the physical and mental suffering
inflicted on both military and civilians during wars. We have
documented mass killings, torture, and maiming by indiscriminate
weapons in conflicts on four continents during the past decade.
We have reported on the death, hunger, disease and
psychological trauma caused by massive dislocation of peoples
during armed conflict. We have uncovered the brutal treatment
of prisoners of war and civilians captured by parties to
conflicts, and we have worked aggressively to uphold the right
to receive and the obligation to provide medical care
regardless of one's side in a conflict.

Physicians for Human Rights was one of the first organizations
to document Saddam Hussein's use of chemical weapons against
his own population, and in 1988 testimony before the United
States Senate we concluded that the massacres of Kurds and
destruction of thousands of their villages amounted to genocide.

The United States Government has decided that Iraq's possession
of weapons of mass destruction, and their concealment, pose
such an overwhelming threat to international security that it
warrants military action against Iraq if disarmament cannot
be achieved in any other way. Neither human rights nor
international humanitarian law prohibit war, nor do they provide
any guidance on the evaluation of claims of security threats
the Bush Administration makes to justify a military attack.
As a human rights organization, focused as we are on compliance
with human rights and international humanitarian law and without
special expertise in evaluating security threats, we have
traditionally not taken a position on whether such military
intervention is justified. Rather, PHR has demanded that during
the course of war, human rights law, the Geneva Conventions, and
other aspects of international humanitarian law be respected and
that violators be held accountable, including criminally
accountable where warranted.

PHR does believe, however, that in extreme situations and as a
last resort when all diplomatic and other means have failed,
military intervention may be necessary to save people from
genocide and crimes against humanity committed on a massive
scale. We called for such intervention in Bosnia, Rwanda, and
Kosovo. In the late 1980s a military intervention to stop
genocide against the Kurds would have been justified. Should
Saddam Hussein once more commit crimes against humanity,
including by using chemical or biological weapons against
his own people or others, or if such use were imminent, military
intervention could well be justified if other means of stopping
or preventing these actions proved fruitless.

The regime of Saddam Hussein continues to commit systematic
human rights abuses against the Iraqi people, including denial
of free expression, imprisonment without trial, torture, and
extrajudicial execution of political opponents. These are
serious violations of human rights, and need to be opposed and
ended. However, PHR has seen no evidence that the regime of
Saddam Hussein is committing or is about to commit genocide and
crimes against humanity against the people of Iraq or others
today. In fact, while the Bush Administration has cited the
horrific human rights record of Saddam Hussein in its advocacy
for a war, it has not explicitly made prevention of genocide or
crimes against humanity against a primary reason for military

Regardless of any justification put forth for war, we must
recognize in all circumstances that armed conflicts in the
modern era have posed grave threats to the health and well-
being of civilian populations from death, injury, trauma,
and displacement. They inevitably are accompanied by human
rights violations that result in loss of life. The enormous
costs to human rights and well-being war poses must be
considered in two ways as the US and the UN deliberate in the
days ahead. First, a realistic assessment of the humanitarian
consequences of this war should be taken into account in the
decision to attack, that is, how they compare to the costs of
not acting militarily against Saddam Hussein should diplomacy
fail. Second, in the event of war, the possible risks to the
population of Iraq and its neighbors must be identified and
steps taken by the United States and its allies to avoid them
and assist all those affected adversely by armed intervention.

The following discussion outlines some of the humanitarian
and human rights threats that a war in Iraq poses.

Civilian Casualties:
Precision weapons will likely be among those used in Iraq.
However, even with these sophisticated weapons, civilian death
and casualties will be difficult to avoid in cities like
Baghdad. Civilian vulnerability is dramatically enhanced by
Saddam Hussein's use of human shields and the illegal placement
of military targets in densely populated areas or placement of
civilians near military targets. Moreover, even precision
weapons can be directed at improper targets and kill and maim
noncombatants. Accidents such as those that occurred in
Afghanistan in which civilian facilities were mistakenly
targeted in US air strikes must be scrupulously avoided.

Also, the use of air power to destroy the command and control
systems of the Iraqi military (that would include dual-use
electrical circuits and grids) could destroy power supply in
most parts of the country. New US military means of temporarily
disabling power grids could obviate long-term damage to
infrastructure. But even temporary loss of electrical power,
including for water pumping stations and sewage treatment
plants, as well as health infrastructure, will have a profound
impact on the civilian population. A public health emergency
created by impaired infrastructure exacerbates the Iraqi
population's vulnerability to disease and hunger, given the
already degraded condition of health facilities, potable water,
and limited food supply discussed below. A US military campaign
must not disable the power supply necessary for civilian life
and health.

Reprisals During the Conflict and Post-conflict Retribution
and Civil War:

An attack on Iraq may unleash violent reprisals by the regime
of Saddam Hussein against internal opponents, including the
Kurds in the North and Shiite Muslims in the South, but also
against perceived political opponents as well as military
deserters. These individuals and groups must be protected in
the event of a US incursion into Iraq. The US Government must
also ensure that proper security arrangements are instituted
in Iraq during and after a war to ensure that victims of the
Baath regime of Saddam Hussein do not themselves become aggressors
and engage in violent acts of revenge. As the post-liberation
histories of Romania, Kosovo, and most recently Afghanistan
indicate, if firm leadership and sound security measures are not
instituted promptly, there is the potential for retribution and
violence. The possibility of the Shiite Muslims seeking revenge
for all the atrocities committed against them by the ruling Baath
party; efforts by the Kurds to seek independence; a struggle for
Kirkuk by the Kurds; the Turkish backed Turkmen and the Iraqi
Arabs or the Shiite Government in Iran trying to 'reclaim' the
southern districts of Iraq in which fellow Shiites live are
situations that should be anticipated in the context of war with

Landmines and Cluster Bombs:
Recent reports indicate that the US military is storing
antipersonnel landmines in Qatar, Kuwait, Saudi Arabia, Oman,
Bahrain, and Diego Garcia, and is preparing to use them in Iraq.
The US military last used antipersonnel landmines during the
1991 Persian Gulf War, which occurred before the majority of the
world banned the weapon through the 1997 Mine Ban Treaty. Though
the US is not party to the Treaty, all other NATO nations have
embraced this Convention because antipersonnel mines have limited
military utility and do not distinguish between soldiers and
non-combatants. Any United States' allies that are party to the
landmine ban treaty are legally prohibited from engaging in any
military activities that include the use, transfer, or stockpile
of any antipersonnel landmines, including those that self-destruct
or self-deactivate. Both "smart" and "dumb" antipersonnel landmines
pose unacceptable risks and costs to civilians and deminers. The
presence of new US antipersonnel landmines in Iraq -in addition to
the untold numbers of landmines left unexploded from the Iran-Iraq
and Persian Gulf wars-would threaten the lives and limbs of both
US soldiers and innocent Iraqi civilians and should not be used.

Cluster bombs, which were used extensively by NATO in Kosovo and
by the United States in Afghanistan, pose a similar problem for
non-combatants. Dud bomb-lets within the cluster canister that
fail to detonate on contact are picked up or stepped on later by
children or other non-combatants and can explode on contact,
making them, in effect, like antipersonnel landmines, yet with
an even more dangerous fragmentation radius. The deployment of
antipersonnel landmines and cluster bombs in Iraq would, in all
likelihood, maim and kill far more innocent civilians than

We strongly urge the US government to block the use of
antipersonnel landmines in Iraq. We also urge the US government
to avoid the use of cluster bombs in areas where civilians may
be harmed.

Consequence on Health as a Result of Disruption of Basic

The consequence of another war on the health of the Iraqi people
could be disastrous. Twenty years of war and misrule, and over
a dozen years of sanctions and economic isolation have crippled
the economy and infrastructure of the country. The health of
the Iraqi people has severely deteriorated over the past decade.
A study conducted by UNICEF, in cooperation with the government
of Iraq and the local authorities in the Northern Kurdish region
in 1999, revealed that following the Persian Gulf War, childhood
mortality in south/center Iraq increased more than two-fold in a
span of just 10 years to levels above those recorded 20-24 years
earlier. Infant mortality rates more than doubled from 47 to 108
deaths per 1000 live births for the period roughly between
1984-89 and 1994-99, while under-5 mortality rates increased during
the same time from 56 to 131 per 1000 live births .

Since the implementation of the Oil-for-Food Program administered
by the United Nations over the past six years, infant deaths have
been reduced and nutritional levels in the general population have
improved. The Government of Iraq has periodically been distributing
food rations to its people. Today, Iraq's 23 million people are
almost entirely dependent for daily survival on the monthly rations
distributed under the Oil-for-Food Program. With war anticipated,
however, since July 2002, the Government of Iraq has been
distributing two-month rations at a time. The food basket is
currently covered until January 2003 . The outbreak of war will
almost certainly severely disrupt the Oil-for-Food Program as Iraqi
officials are likely to abandon their posts and supply routes may
be blocked. Given that most of the Iraqi people are reliant on this
program for their daily rations, a comprehensive food distribution
plan cannot wait for the cessation of hostilities. A neutral and
effective food distribution program, possibly under United Nations
auspices, must be initiated as soon as supplies are exhausted
and/or distribution mechanisms disrupted.

Inadequate Capacity for Medical Response:

In the event of large scale armed conflict, medical infrastructure
in Iraq is grossly inadequate to effectively deal with the medical
emergencies. A Report on the Health Situation in Iraq, released
by the World Health Organization states that:

Many essential public health services such as blood transfusion
and water quality control services cannot function due to lack of
laboratory reagents and kits. Emergency and ambulance services for
the referral of patients cannot carry out their functions, due to
lack of or inadequate provisions of equipment and supplies. Most of
the health facilities are in poor physical state, lacking water and
often without power supply, making them unsafe and unsuitable for
good patient care. Significant quantities of medicine and medical
supplies and equipment have reached the country under Security
Council Resolution 986. Their utilization remains, however, not
optimal. The installation and transportation to locations where
they are needed has been and is still often prevented by logistic
or financial constraints.

In a move likely to degrade the supply of medicines still further,
the United States has recently proposed tightening sanctions
against Iraq so as to restrict pharmaceuticals such as ciproflaxin,
doxycycline, and gentamicin, all necessary to fight disease, but
that could also protect against a biological attack.

Reprisal attacks by Saddam Hussein's forces on the regime's
opponents including populations of Kurds in the North and Shiite
Muslims in the South are a distinct possibility in the event of
a US military attack. The use of biological or chemical agents by
Saddam Hussein against these groups cannot be ruled out. The
medical facilities in Iraq and the international relief
organizations working in the area are currently in no position
to deal with the effects of weapons of mass destruction on the
civilian population. A plan to provide emergency medical
assistance to the sick and wounded in Iraq in the midst of a
conflict urgently needs to be addressed before the US Government
wages war in Iraq.

Inadequate Presence of International Humanitarian Organizations
in Iraq:

The current state of humanitarian preparedness is cause for great
concern. Very few international agencies with large scale
emergency capacity are currently present in Iraq. Minimal planning
and preparation have been undertaken to mount a significant
humanitarian operation in Iraq. Planning has been further hampered
by the inability of any American relief organization to enter Iraq
since the imposition of sanctions. Through the last decade the US
Treasury's Office of Foreign Assets Control (OFAC) has not issued
licenses required for Americans to travel to Iraq. In addition
OFAC restrictions have prevented American groups from operating
in neighboring Iran. European groups, however have been able to
operate in Iran. Not having worked in Iraq for over a decade,
US based NGO's have relatively little knowledge of conditions
within the country.

Danger to Refugees and Internally Displaced Persons:

The protection and safety of Internally Displaced Persons (IDPs)
and refugees in Iraq and on its borders are at great risk.
Neighboring countries, particularly Turkey and Iran which took
in more than 3 million displaced Iraqis a decade ago have already
threatened to close their borders . This stance could endanger
Iraqis who may flee as a result of the anticipated war. The United
Nations High Commissioner for Refugees (UNHCR) has announced
its preparedness to facilitate services for 250,000 anticipated
refugees. But many humanitarian organizations urge that
preparations be made to accommodate far larger numbers, perhaps
as high as several million. Countries bordering Iraq must accept
refugees and the UNHCR must be provided adequate support to care
for those fleeing their homes within the country and pressing
on their borders.

The heavily mined Iraqi borders will further threaten internally
displaced and fleeing refugees and will also greatly hamper aid
reaching camps along the borders. Humanitarian demining of regions
likely to receive refugee outflows is critically important to
minimize deaths and maiming of both fleeing Iraqi civilians and
humanitarian workers in the region.

Treatment of Prisoners of War:

PHR insists that the US Government and its allies take full
responsibility to ensure that prisoners of war be treated
according to the Third Geneva Convention. In the event of a war
with Iraq, captured, surrendered, and wounded Iraqi military
forces are entitled to Prisoner of War status in accordance with
the Geneva Conventions. The US must also ensure that its local
allies and agents who may have authority over wounded or
surrendered combatants treat them in accordance with Geneva
standards. Failure to do so in the war in Afghanistan resulted
in US-backed Afghan forces reportedly allowing hundreds of
surrendered Taliban combatants to die under their watch.

Protection Steps In the Event of War

In the interest of protecting human life and health, PHR appeals
to the US Government to exert every effort to resolve the
conflict with Iraq without a resort to military force. We also
appeal to the Iraqi Government to comply fully with Security
Council Resolution 1441 calling for the elimination Iraq's
weapons of mass destruction. In the event that war occurs,
concerted steps should be taken to assure that human rights
and humanitarian law are respected. In addition to complying
with its obligations under the Geneva Conventions, which is its
duty at a minimum, PHR calls upon the US Government and its
allies to take measures to protect civilians which in some cases
exceed the strict requirements of international humanitarian law.

The President should issue a military mission statement, and
the Pentagon promulgate rules of engagement to carry it out,
that ensure strict adherence to humanitarian law by the United
States combatants and take responsibility for assuring compliance
by local allies, assets and agents.

Weapons should be deployed in such a way that civilian casualties
are avoided to the maximum extent possible. The US should seek to
avoid military operations in heavily populated areas, regardless
of the military legitimacy of the targets, if large numbers of
civilians could be harmed. The US and its allies should eschew
targets that are essential to civilian survival such as water
supply, electricity, food storage facilities, and hospitals, even
if some of this infrastructure has dual military-civilian use.

The US and allies must prepare for and develop a plan to prevent
or stop reprisals by Saddam Hussein against Iraqi citizens in the
midst of a conflict. This should include prevention of and
preparedness for the burning of Iraqi oil fields and other
elements of a scorched earth policy, as well as a chemical or
biological attack against Iraqi citizens, in addition to those
in neighboring countries.

The US should abjure the deployment antipersonnel landmines whose
inherent indiscriminateness will otherwise cost many civilian
casualties and should avoid use of cluster bombs in populated

The US and its allies should make the demining of the Iran-Iraq
border a priority if hostilities commence, in order to minimize
civilian losses as refugees flee into the area.

The United States Government and its allies should provide the
United Nations with the $37 million that has been requested to
address humanitarian exigencies pursuant to hostilities, and
assure adequate food, water, medical supplies and shelter for
Iraqis, both those in their homes and villages who are dependent
on the oil-for-food program, and those who flee their homes as
displaced people within Iraq or refugees in neighboring countries.
A similar plan should be instituted to ensure constant supply
and stock of essential medicines.

The US Government should provide adequate resources to United
Nations agencies and independent humanitarian organizations in
advance of hostilities to allow them to prepare for emergencies
both within Iraq and in neighboring countries.

The US Government should immediately suspend the requirement that
humanitarian groups and others must have OFAC licenses to operate
in Iraq and Iran so that American groups can hire local staff,
preposition supplies, and prepare for the massive numbers of people
fleeing hostilities that are expected. The US Government must
also facilitate the mobilization of international and American
assistance in Iraq at every point before, during and after the

Through diplomacy the US and UN must gain the assurance that Iraq's
neighbors will fulfill their obligation of nonrefoulement as stated
in the 1951 Refugee Convention and keep their borders open to those
fleeing the war. The US should also provide required resources to
UNHCR to address a large refugee influx on Iraq's borders.

The US and the UN must ensure that proper security arrangements are
in place to control post-war aggressors and facilitate the
establishment of a stable society operating under the rule of law
with respect for human rights of all inhabitants of a post war Iraq.

The US military should set in place a system for reporting and
investigating violations of the laws of war that are committed by
US personnel as well as their local allies, agents, and operatives
in Iraq, and establish means of accountability for such abuses.

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