Rapid increase in cancer cases prolongs Gulf War punishment of Iraqi people

Fawzia Al-Bader's gesture would have been dramatic anywhere, but the 51-year-old Shia Muslim school teacher's brave baring of…

Fawzia Al-Bader's gesture would have been dramatic anywhere, but the 51-year-old Shia Muslim school teacher's brave baring of her scars was all the more surprising because she wore the Muslim head-scarf.

Despite the presence of western men and a Channel 4 television camera, Al-Bader pulled up her blouse to show us the vertical scar on the right side of her chest. 'I have breast cancer,' Al-Bader told us. It was as if her body's mutilation made traditional modesty unnecessary.

'Four years ago they removed my right breast,' she continued. 'I went to Baghdad; they gave me 12 injections, but it was useless. After four months my bosom became huge, so they cut it. That was my first operation, in 1993. Before that, my health was very good. Now I've had three recurrences.'

Taking care to keep her head covered by the scarf, Al-Bader then tugged at the neckline of her blouse to show a newly sutured incision, where doctors have just removed more tumours. 'I have pain here now,' she says, clasping a hand to her left breast. She knows she is going to die, but that is not her first concern.

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'From morning to night my head is busy. I am a mother and I have two boys. I am thinking all the time about what I can give them to eat. Please help us,' she pleads. 'All of us are human beings. We have a heart; we have families.'

Dr Jawad Kadhim Al-Ali is Al-Bader's physician and the main cancer specialist in the south-eastern Iraqi city of Basra, which had a pre-war population of 870,000. He says Al-Bader is one of several of his 765 cancer patients who has contracted rare double cancer. He is also seeing breast cancer in women below the age of 20 - something that never happened before Iraq's post-Gulf War cancer explosion.

'I have three patients from one family,' he says. 'The sister, Dijla, is still alive, but her brothers Hussein and Abbas Hawaz died of Hodgkin's lymphoma. They live near the power station. In another family, the husband has a brain tumour and the wife has breast cancer. They are both still alive, but the husband will die in the next few weeks.'

There is standing-room only in Dr Al-Ali's waiting room, which is packed with cancer sufferers. He points to a pretty young woman leaning on a crutch; she has a bone tumour in her thigh. Another young woman in a black chador, the garb worn by most Shia women, suffers from lung cancer, although she has never smoked.

'This one has breast cancer; this one uterine cancer. It's a tragedy for me, because I am losing friends every day. This young boy has Hodgkin's lymphoma,' he says, reaching towards a tall, good-looking young man in the crowd. 'Haji!' he shouts in greeting to a short middle-aged woman. 'She has lymphoma too.'

There are enough people in the waiting room to populate a small village. 'These people will live only two or three years,' Dr Al-Ali says with something approaching resignation. 'I lost three of my relatives - I certified their deaths. Two of my medical students have cancer. I will probably develop cancer too. If I had the right drugs, we could increase their life span by a year or two. As you know, the prognosis is very bad in cancer patients.'

Neither President Saddam Hussein's regime nor the international community have taken an interest in the apparently incredible effect of Gulf War weaponry on cancer. When Dr Al-Ali distributed a research paper at a European cancer conference in Hamburg last September, it went unnoticed. But a week of interviews and travel within Iraq corroborated his terrible conclusion that cancer has risen exponentially since the war.

Everywhere we went, people talked of friends or relatives stricken by it. In Baghdad, our interpreter's infant cousin, Noor, had an eye removed because it was cancerous; the doctor said the disease will move to her brain and kill her within six months. In Dour She'oun, a Basra slum chosen at random, I asked four women if they knew anyone who had cancer: the husband of one was suffering from the disease; another's aunt had just died of cancer and the other two had sisters diagnosed as having cancer.

On the cancer ward of Basra's Saddam Teaching Hospital, we saw first-hand what lies in store for Iraq's cancer victims. A few months ago, Matar Abbas, age 60, was a taxi-driver in the southern city of Nassiriyeh. 'He came to the hospital on January 16th, 1998, with swelling and an inability to talk or drink,' Dr Al-Ali says. 'The biopsy showed cancer of the nasal pharynx.' Today Abbas lies dying on a dirty, crumbling foam rubber mattress, without sheets or pillow cases, in a room reeking of urine and excrement. Basra's hospitals have no money to buy antiseptics or bed linen. There is little the doctors can do for Abbas, who has lost his right eye and cannot hear because of the tumour in his right ear. He no longer speaks or eats and his ribs stick out through his thin shirt. 'Later on the cancer will go to his brain and lungs,' Dr Al-Ali predicts. 'We rarely saw these types of tumours before.' Abbas' wife, Ghaniyeh, stands by his bedside, looking tenderly at her husband's horribly deformed face. 'During the war we stayed at home, between Amara and Misan, near Nassiriyeh,' she says. 'We only saw the flashes - nothing was bombed near us.'

Jawad Hassan (55) lies on the bed opposite Matar Abbas. 'He is from west Basra, near the television station, and was exposed to fumes and bombs, because they bombed the television station and the bridges,' Dr Al-Ali says. Outside the hospital room window, the broken remains of a bridge across the Shatt Al-Arab waterway jut aimlessly into the river.

Hassan, a driver for a petrochemical company, developed stomach cancer two years ago. 'We removed part of his stomach surgically and he is receiving chemotherapy,' Dr Al-Ali says. 'But the prognosis is very bad because he has advanced cancer. He is losing weight in spite of the treatment, and he was already malnourished.'

Dr Al-Ali says he often despairs. 'I am using my experience of 31 years as a doctor,' he says. 'I am using just my brain. We have no instruments. It is difficult to sustain patients - they need bone marrow transplants, transfusions. We don't have the means to do it. It is a great burden on me. I am losing patients every day, and I cannot sleep at night thinking about them.'

Ms Zubeida Ali's lymphoma, diagnosed two years ago, has infiltrated her lungs, and she has difficulty breathing. 'I feel a heat like a fire in my chest,' the 70-yearold mother of 10 tells Dr Al-Ali. 'It itches inside me.' She is from Zubayr, the site of an Iraqi air base that was heavily bombed on February 13th and 14th, 1991, and then continuously until the end of the Gulf War.

A row of charts and maps showing the incidence of breast, blood and lymph cancer in southern Iraq hang on the wall of Dr Al-Ali's cramped office. One map shows the highest concentration of cancer in central Basra, where Dr Al-Ali has recorded 380 cases. He believes radioactivity from depleted uranium tank shells fired in battles just south and west of Basra contaminated agricultural land, the food chain and the city's water supply.

To test Dr Al-Ali's theory, we drove south-west out of Basra, towards Safwan on the Kuwaiti border. There, as he had told us, were the green farmlands watered by canals and rivers. We stopped to talk to Iraqi peasants with leathery skin and bare feet as they picked tomatoes in the winter sunshine. Imad Ali Adwan (16) pointed towards the burnt-out Iraqi tanks from the battle he witnessed seven years ago, but advised us not to venture further. 'There are still mines everywhere, he said. 'This was the front line. Just a few months ago two children were blown up on mines.'

An old man in a flowing grey robe walked up, eager to know who were these visitors to Iraq's killing fields. Did he know anyone who had cancer? Hassan Gafah Salman (80) answered without hesitation: 'My daughter-in-law, Amal Hassan Saleh, died about 50 days ago from stomach cancer. She was 21. We have many cancer cases here; it started three or four years ago.'

The road back towards Basra was clogged with pick-up trucks loaded down with blood-red tomatoes, glistening white onions and bunches of garlic. Iraqi farmers have grown rich as UN sanctions drove up food prices. Is the farmers' innocuous-looking cargo now as lethal as the battle tanks that plied this road seven years ago? Is it radioactive contaminated death they are selling in the market stalls of Basra? And are Iraqis like Fawzia Al-Bader, Matar Abbas, Jawad Hassan and Zubeida Ali doomed to go on paying with their lives for the sins of Saddam Hussein?