The Truth Behind Economic Sanctions:
A Report on the Embargo of
Food and Medicines to Iraq

by Eric Hoskins, MD

excerpted from the book

War Crimes

A report on United States War Crimes against Iraq

by Ramsey Clark and others

Report to the Commission of Inquiry for the International War Crimes Tribunal

Maisonneuve Press, 1992


Resolution 661, passed by the United Nations Security Council on August 6, 1990, states that the following items are exempt from the economic embargo of Iraq: supplies intended strictly for medical purposes, and, in humanitarian circumstances, foodstuffs.

Resolution 661 also calls for the establishment of a Sanctions Committee (called the Committee of the Security Council) to clarify and implement the terms of the Sanctions Resolution. One month later, on September 13, 1990, Resolution 666 was passed by the Security Council, further defining (and limiting) the conditions under which food and medicine would be permitted to enter Iraq. Since August 1990, the international community has been led to believe that economic sanctions did not include an embargo on food or medicine. Furthermore, the public was told that Iraqi civilians would continue to have access to these essential commodities. However, nothing could be further from the truth. The truth is that Iraqi civilians have been dying of starvation and disease in the thousands. They are dying because of lack of basic food and medicine-the same food and medicine that the United Nations claims the civilian population has always had access to.

It is likely that sanctions have resulted in more suffering and death of the civilian population of Iraq than even the war itself. The true and lasting war against the Iraqi people has been the war waged by economic sanctions. The continued imposition of punitive sanctions will, with certainty, lead to widespread epidemics (including cholera), hunger, and death. A blatant violation of fundamental human rights, sanctions have made their presence felt in a number of ways.

1. Medicines

It has been estimated by international experts that, since August 1990, less than one-thirtieth of Iraq's medicine requirements were being met. Historically, Iraq imports more than $500 million worth of medicines each year (one of the highest per capita rates in the Middle East). All medicines -including medicated milk for infants with diarrhea, vaccines, drugs for chronic diseases (diabetes, asthma, angina, tuberculosis), anesthetics for surgery, and antibiotics-have been found to be in short supply and this shortage is well-documented by independent international observers since late 1990.

Medical supplies-syringes, intravenous fluids, spare parts for incubators, X-ray equipment, surgical supplies-either ran out or are in short supply. Now, with the country's infrastructure destroyed, most health facilities have no electricity, no running water, no emergency transport, patients and staff are unable to find transport to reach health facilities, and food and medicine for patients is either unavailable or in short supply. Despite access to health care being a fundamental human right, the following methods were used to effectively prevent medicine from entering Iraq. A11 these methods are still being used against Iraq today.

a) It is illegal for the government of Iraq to purchase and import any medicines or medical equipment.

b) Many pharmaceutical companies refuse to sell or are being pressured not to sell medicines to Iraq following the August embargo

c) All medicines purchased or manufactured in the United States require a special license from the U.S. Treasury Department before export to Iraq. This is true for any humanitarian aid sent to Iraq and results in many delays and refusals.

d) More than fifty separate consignments of medicines and thousands of tons of infant formula and milk powder were purchased by the government of Iraq prior to August 1990. Governments of the countries where these consignments are being held still refuse to forward them to Iraq.

e) Only those items which the Security Council has deemed "supplies intended strictly for medical purposes" are allowed under the sanction's restrictions. All materials, spare parts, transport, and other para-medical items essential for the operation of a health care system are still prohibited-except on a time-consuming and unreliable case-by-case basis involving application to the Security Council.

Following two extensive health assessments carried out in Iraq by Gulf Peace Team health and relief experts during March and April 1991, it is clear that the health care system in Iraq is almost totally non-functioning.

The Simpler Truth

The Gulf Peace Team carried out an extensive health assessment in Iraq over a four-week period ending April 24, 1991. Health experts visited fourteen towns, including Basra, Nasiriyah, Najaf, Kerbala, Baghdad, Kirkuk, Sulaimaniyah, Erbil, Mosul, Dohuk and al Amadiyah.

The team's findings include:

1. In all parts of the country, critical shortages of clean drinking water have led to epidemic levels of gastroenteritis (infectious diarrhea). Thousands have died. Already at this early date over fifty cases of cholera have been confirmed by laboratory diagnosis. The true number could be one hundred times this figure since, in most parts of Iraq, hospital laboratories have been shut down due to lack of electricity and reagents-making diagnosis impossible. In Nasiriyah Pediatric Hospital, ninety eight percent of admissions are children with diarrhea. Infants as young as two months old are admitted badly malnourished and dying from diarrheal disease. A lack of infant formula and contaminated water are responsible. Now these babies, in hospital, are given only an intravenous drip of fluid since doctors have no drugs with which to treat the diarrhea, and no medicated milk (the drug of choice for diarrhea) with which to feed them.

2. Hospitals have been reduced to mere reservoirs of infection since most medicines are in short supply, laboratories cannot function, operating theaters have no supplies, and basic services (including food, water and electricity) are unavailable. In Kirkuk Hospital, an old man lay dying at the entrance to the emergency ward. Suffering from a potentially fatal exacerbation of his chronic high blood pressure, there were no medicines to give him. Inside, the 400-bed hospital's only physician explained how she had just completed an emergency cesarian section, "with flies swarming over the incision because operating room windows had been shattered during bomb blasts" and sanctions will not allow their replacement.

3. Food throughout the country is prohibitively expensive and generally in scarce supply. Agricultural production has been halted due to a lack of inputs (fertilizers, seeds, fuel and spare parts) all prohibited under the sanctions resolutions. Between August 1990 and January 1991, food prices had gone up by as much as 1,000%.

For the first time in history, a government has been prohibited from purchasing and importing food and medicine for its own people. Despite clear indications that a humanitarian emergency existed within Iraq, from August 6, 1990 to March 1991 no food whatsoever was allowed to enter Iraq (from any source) according to the provision of sanctions Resolutions 661 and 666. It is patently obvious that thousands of innocent Iraqi civilians (mostly children) are dying of disease and starvation. They are dying because the international community has withdrawn from them their fundamental human right to food and medical care. It is a dreadful lie when governments and individuals claim that food and medicine are getting through in adequate amounts to the Iraqi people. We must decide who the coalition forces fought this war against. We must also decide whether it is worth sacrificing the lives of thousands more innocent victims to achieve the removal of Saddam Hussein. And finally, we must show equal compassion to all innocent victims of this war regardless of their locality.

It is the opinion of the health assessment team that most of the current civilian ill-health and suffering (mostly of children) is a direct result of both the war and especially the continued imposition of punitive sanctions against Iraq. These sanctions violate not only of the Geneva Conventions and Protocols but also the Universal Declaration of Human Rights and every other United Nations resolution and convention concerned with human rights. The situation with regards to foodstuffs is even more worrisome.

2. Foodstuffs

The text of Resolution 661 referring to the importation of foodstuffs states that the embargo does not include, in humanitarian circumstances, foodstuffs.

Resolution 666 passed on September 13, 1990, issues a clarification that no food will be allowed into Iraq from any source until such time as a humanitarian emergency requiring the importation of food into Iraq is declared by the Security Council of the United Nations. Such a declaration requires a report issued from the Secretary-General's office and based on a United Nations mission to Iraq, recommending the declaration of a humanitarian emergency.

The Security Council must then go on to ask the Secretary-General to "seek urgently, and on a continuing basis, information . . . on the availability of food in Iraq." However, no such information was gathered until February 16, 1991, when the first United Nations mission (a UNICEF / WHO medical convoy from Teheran) entered Iraq to assess the humanitarian situation. Despite clear indications that a humanitarian emergency existed within Iraq, from August 6, 1990 to March 3, 1991, no food was allowed to enter Iraq (from any source) according to the provisions of sanctions Resolutions 661 and 666. In early March, after considerable pressure by humanitarian organizations and non-aligned governments, a humanitarian emergency was finally declared by the United Nations Security Council and food was allowed into Iraq subject to the following stringent conditions:

a) all foodstuffs should be provided through the United Nations in cooperation with the International Committee of the Red Cross or other appropriate humanitarian agencies,

b) Iraq would continue not to be allowed to purchase or distribute its own foodstuffs.

Up until this point in time, only two humanitarian agencies had been declared "appropriate" by the Sanctions Committee of the Security Council-the United Nations itself and the International Committee of the Red Cross. For all anticipated shipments of food, candidate humanitarian agencies would have to submit in advance to the Sanctions Committee a detailed application requesting approval to import and distribute specific food items. The truth is that this is a mechanism guaranteed to obstruct the movement of even small quantities of food, since many agencies either had no knowledge of the application procedure required, had no access to the Sanctions Committee in New York, were unable to draw up detailed lists weeks in advance of predicted convoys, or were unlikely to gain approval as "acceptable" to the security Council.

More to the point, Iraq historically imports more than seventy percent of its foodstuffs. As a result of war, agricultural production had ground to a halt (due to lack of seeds, fertilizers, spare parts and fuel for irrigation pumps, etc.). This meant that Iraq had become almost totally dependent on food obtained from abroad. With a population of 18 million persons, Iraq's daily food requirements (of grain only) amount to approximately 10,000 metric tons per day. From August 1990 to April 1991, the total amount of food provided by the international community was less than 10,000 metric tons-enough for only a single day's ration for the Iraqi people. Distribution of this token amount of food has been limited to hospitals and orphanages with no general ration distribution using these foodstuffs.

Not only is the international community entirely incapable of responding to Iraq's food requirements, it seems totally unwilling to try. Of the $178 million requested by the United Nations for humanitarian relief within Iraq, less than twenty percent has been forthcoming. Meanwhile, aid continues to pour in for Kurdish refugees in Turkey. While in urgent need of such aid, the 1-2 million Kurdish refugees share this need with over 17 million other Iraqis living in emergency conditions throughout the country. It is clear that until such time as the United Nations and the international community end the punitive sanctions against Iraq and allow them to import food and medicine for themselves, conditions within Iraq will continue to deteriorate. Starvation is already apparent in some parts of Ira* it is only a matter of time before widespread famine (as predicted by the United Nations itself) sets in.

3. Recommendations

Until the government of Iraq is able to begin purchasing and importing medicines, undoubtedly Iraqi civilians will continue to suffer. In light of this urgent situation, the following recommendations need to be implemented immediately:

a) End all punitive sanctions against Iraq. Conditions under which the sanctions resolutions were applied (that is, the Iraqi invasion of Kuwait) no longer exist. Furthermore, it has become clear in recent days, and publicly stated, that even if Iraq complies with all items of the cease-fire agreement, sanctions will not be loosened (let alone withdrawn) until such time as Saddam Hussein is removed from power. This blatant use of food, disease, and human lives as weapons for interfering with the internal politics of a country is both offensive and illegal.

b) Negotiate the release of Iraqi government assets currently frozen in overseas accounts to be used for the purchase of essential humanitarian commodities.

c) Allow Iraq to export commodities (including petroleum) for the purchase of food and medicine for the civilian population.

d) Release consignments of food and medicines currently being held in ports and along borders around the world.

e) Urgently implement the bilateral agreement signed between the United Nations and the Iraqi government regarding humanitarian assistance to affected groups.

f) Urgently implement a massive humanitarian relief effort to supply food and medicine to the civilian population of Iraq, both within Iraq and in neighboring countries.

In the concluding paragraph of his report, United Nations special representative Martti Ahtisaari states that "the Iraqi people may soon face a further imminent catastrophe, which could include epidemic and famine, if massive life-supporting needs are not rapidly met." Without an immediate and unqualified lifting of the punitive economic sanctions against Iraq and the Iraqi people, conditions will continue to deteriorate, thousands upon thousands of innocent civilians will perish, and the responsibility for the continuing despair of so many Iraqi women, men and children will rest on our shoulders and on our conscience.


Dr. Eric Hoskins was the Medical Coordinator for the Gulf Peace Team which was based in Amrnan and London. He is a specialist in public health and disaster relief.

War Crimes - report on United States War Crimes against Iraq

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