High rates of malnutrition, lack of medical supplies, and diseases from lack of clean water were reported during the sanctions. In 2001, the chairman of the Iraqi Medical Association's scientific committee sent a plea to
The BMJ to help it raise awareness of the disastrous effects the sanctions were having on the Iraqi healthcare system. In January 1991, the U.S.
Defense Intelligence Agency (DIA) prepared a detailed study of Iraq's water treatment system. Titled "Iraq Water Treatment Vulnerabilities," the DIA study noted that Iraq's water treatment system was particularly vulnerable to sanctions, noting that "it probably will take at least six months (to June 1991) before the system is fully degraded," as supply levels of crucial water treatment chemicals such as
chlorine and
aluminium sulphate were "known to be critically low" and their "[i]mportation [have] been embargoed." The study thus predicted an increase in disease and even "epidemics of such diseases as
cholera,
hepatitis, and
typhoid" if the sanctions remained in place. The percentage of Iraqis with access to clean drinking water dropped from an estimated 90 per cent in 1990 to 41 per cent in 1999.
Denis Halliday, the UN
Humanitarian Coordinator in
Baghdad, Iraq, resigned in October 1998 resigned after a 34-year career with the UN in order to have the freedom to criticise the sanctions regime, saying "I don't want to administer a programme that satisfies the definition of
genocide." However, Sophie Boukhari, a
UNESCO Courier journalist, reports that "some legal experts are skeptical about or even against using such terminology" and quotes Mario Bettati for the view that "People who talk like that don't know anything about law. The embargo has certainly affected the Iraqi people badly, but that's not at all a
crime against humanity or genocide." Halliday's successor,
Hans von Sponeck, subsequently also resigned in protest, calling the effects of the sanctions a "true human tragedy". Jutta Burghardt, head of the
World Food Programme in Iraq, followed them.
Impact on agriculture Throughout the Ba'ath Party's rule over Iraq, the
agricultural sector had been under-performing. Those in the U.S. who supported sanctions believed that low agricultural production in Iraq (coupled with sanctions) would lead to "a hungry population", and "a hungry population was an unruly one". The Iraqi government, which understood the serious effects the sanctions could have on Iraq, was able to increase agricultural output by 24 percent from 1990 to 1991. During the sanction years, the agricultural sector witnessed "a boom of unprecedented proportions". Iraq's
Revolutionary Command Council (RCC) introduced several decrees during this period to increase agricultural performance. These decrees may be separated into three categories: • They introduced severe penalties on farmers (or landowners) unable to produce at full capacity on their land. • Government programs made it cheaper (and therefore more profitable for farmers and landowners) to produce. • Programs were initiated to increase the amount of
arable land. The RCC introduced Decree No. 367 in 1990, which stated that all lands which were not under production by their owners would be taken over by the state; if the owner could not use all of the land he owned, he would lose it. However, the RCC's policy was not "all stick and no carrot". The government made it easier for farmers and landowners to receive credit. On 30 September 1990, the
Ministry of Agriculture announced that it would increase loans to farmers by 100 percent, and would subsidize machinery and tools. In October 1990, the RCC stated it was planning to utilize and exploit "every inch of Iraqi arable land". While official statistics cannot be trusted entirely, they showed massive growth in arable land: from 16,446
donums in 1980 to 45,046 donums in 1990. In turn, irrigation projects were launched to meet the increased demand for water in Iraq's agricultural sector. The increase in agricultural output does not mean that hunger was not widespread; prices of foodstuffs increased dramatically during this period. However, overall the sanctions failed and (indirectly) led to an unprecedented improvement in agriculture, creating a constituency of farmers in central Iraq who had a vested interest in the sanctions remaining in effect. Data from 1990 is also consistent with the observation that destruction wrought by the 1991 Gulf War may be more responsible than the sanctions themselves for reducing Iraq's capacity to increase food production further. Joseph Sassoon commented on Iraq's successful use of food
rationing to mitigate the effects of sanctions and war, suggesting that Iraq's government was not wholly lacking in competence or efficiency despite being portrayed as such by critics.
Estimates of excess deaths due to sanctions During the 1990s and 2000s, many surveys and studies concluded that
excess deaths in Iraq—specifically among children under the age of 5—greatly increased during the sanctions at varying degrees. On the other hand, several later surveys conducted in cooperation with the post-Saddam government during the U.S.-led
occupation of Iraq "all put the U5MR in Iraq during 1995–2000 in the vicinity of 40 per 1000," suggesting that "there was no major rise in child mortality in Iraq after 1990 and during the period of the sanctions." However, when Sarah Zaidi—one of the study's coauthors—carried out follow-up surveys and reinterviews in 1996 and 1997: "65 deaths recorded in 1995 were not reported in 1996, and nine recorded in 1996 were not reported in 1995"; of 26 women interviewed in 1995 and 1997, "Nine child deaths that had been recorded in 1995 but not in 1996 were confirmed ... 13 were not confirmed, and four miscarriages and stillbirths were found to have been mistakenly recorded as deaths in 1995." Moreover, the results of the 1996 survey (38 deaths per 1000 births) was less than one-fifth that of the 1995 survey (206 deaths per 1000 births), leading Zaidi to conclude that "an accurate estimate of child mortality in Iraq probably lies between the two surveys." Zaidi later told Michael Spagat: "My guess is that 'some' Iraqi surveyors recorded deaths when they did not take place or the child had died outside the time frame but they specified the opposite." In 2000, Garfield, citing new data, recalculated his estimate to 350,000 excess deaths. Later on in 1999, the UN
International Children's Emergency Fund (UNICEF) published a study called the "Iraq Child and Maternal Mortality Survey" (ICMMS). Using survey data from nearly 40,000 households collated in cooperation with Iraqi government and autonomous
Kurdistan Region field workers, the ICMMS found that Iraq's under-5 child mortality rate increased from 56 deaths per 1000 births (during 1984–1989) to 131 deaths per 1000 births (during 1994–1999), which when extrapolated yields an estimate between 400,000 and 500,000 excess deaths among children under 5. The ICMMS reported that the autonomous Kurdistan Region experienced a lower child mortality rate (69 deaths per 1000 births) than the rest of Iraq. Several reasons have been cited for this: Kurdistan Region was subject to lesser sanctions; has borders with neighbouring countries that are more open than the rest of the country, making trade easier; and
Oil-for-Food Programme aid was delivered to Kurdistan faster and at a higher per capita rate compared to the rest of Iraq. In 2005, an Independent Inquiry Committee (IIC) set up by UN Secretary-General
Kofi Annan argued that, "for all [its] flaws," data found in Iraq's 1997 census "make the very sharp surge in mortality reported by [ICMMS] somewhat implausible," even commenting that the ICMMS data "may have been 'tampered with.'" However, in 2007, researchers John Blacker, Mohamed M. Ali, and Gareth Jones pointed out that the 1997 census relied on "data obtained in a format that had elsewhere been rejected as unreliable 30 years earlier," and that the results between the independent IST survey conducted in 1991 (128.5 per 1000 births) and the ICMMS (131 deaths per 1000 births) closely matched each other, indicating the latter's reliability. Although Iraqi government field workers conducted the interviews, they were supervised by UNICEF personnel; "any instructions to falsify the data would have had to be slipped in behind [UNICEF's] backs." The researchers also commented that for such tampering to occur, it "would have had to involve the insertion of fictitious births and deaths into the records," which "would have been almost impossible to effect without introducing serious distortions into the pattern of birth intervals" but there is no evidence that this occurred. They thus "maintain that the ICMMS is the most reliable, indeed the
only reasonably reliable source of information on mortality in Iraq in the 1990s." In 2017, researchers Tim Dyson and Valeria Cetorelli in
The BMJ described "the rigging of the 1999 Unicef survey" as "an especially masterful fraud," citing that three comprehensive surveys (using full birth histories) conducted with the
post-invasion Iraqi government—namely, the 2004 Iraq Living Conditions Survey (ILCS), which was initially discounted by the Volcker Committee for finding far fewer child deaths than expected, and the
Multiple Indicator Cluster Surveys (MICS) carried out by UNICEF and Iraq's
Ministry of Health (MOH) in 2006 and again in 2011—all found that the child mortality rate in the period 1995–2000 was approximately 40 per 1000, which means that "there was no major rise in child mortality in Iraq after 1990 and during the period of the sanctions," although a "slight increase" in child mortality did occur "between 1990 and 1991." As a corollary, "there was no major improvement in child mortality" as a result of the
2003 invasion of Iraq, contrary to claims made by some of its proponents. Per Dyson and Cetorelli, "the UN unobtrusively changed its own U5MR estimates in 2009." ==Controversies==