May 18 - Responses to a detailed survey conducted by a United Nations agency and the Iraqi government indicate that everyday conditions for Iraqis in the aftermath of the 2003 US-led invasion have deteriorated at an alarming rate, with huge numbers of people lacking adequate access to basic services and resources such as clean water, food, health care, electricity, jobs and sanitation.

"This survey shows a rather tragic situation of the quality of life in Iraq," Barham Salih, Iraq's minister of planning, said in statement, adding: "If you compare this to the situation in the 1980s, you will see a major deterioration."

The United Nations Development Program (UNDP) conducted the far ranging survey, titled "Iraq Living Conditions Survey 2004," in cooperation with Iraq's Ministry of Planning.

Researchers determined that some 24,000 Iraqis died as a result of the US-led invasion in 2003 and the first year of occupation. Children below the age of 18 comprised 12 percent of those deaths, according to survey data.

The study also indicates that the invasion and its immediate aftermath forced more than 140,000 Iraqis to flee their homes.

The 370-page report evaluating the survey, which was in turn based on interviews conducted with more than 21,000 Iraqi households during the spring and summer of 2004, might not end the controversy over civilian casualty figures, but the study's authors drew a narrower range of estimated deaths. They report that the total number of war dead is between 18,000 and 29,000.

But they also acknowledge that their numbers are derived from a question -- posed to household members concerning dead and missing relatives -- that "underestimates deaths, because households in which all members were lost are omitted."

Other sources have reported widely varying figures for civilian deaths. Iraq Body Count, a website that tracks reported civilian deaths in Iraq, put the total number of civilians killed by military intervention at somewhere between 14,619 and 16,804 during the time covered by the UN survey.

A survey published last fall in The Lancet, a renowned British medical journal, extrapolated that 98,000 "excess civilian deaths" had occurred in Iraq during roughly the same period covered by the UN study, compared to the number of deaths to be expected in relative peace time. The authors of that study, who based their findings on interviews with fewer than 1,000 Iraqi households in various regions, were also careful to note that based on the same confidence level as the UN report, the possible range ran from 8,000 to 194,000 deaths.
Child Malnutrition Worsens

In addition to deaths attributed to warfare, Iraqi children have suffered from a lack of adequate nutrition since 2003, the survey reports.

Data from the survey indicates that 23 percent of children between six months and five years suffer from chronic malnutrition, while 12 percent suffer from general malnutrition, and 8 percent experience acute malnutrition.

The malnutrition figures are consistent with statistics from previous, smaller surveys cited earlier this year by Jean Ziegler, the UN's expert on malnutrition.

Ziegler drew harsh criticism from US officials in March when he told the UN Commission on Human Rights that child malnutrition rates in Iraq had nearly doubled since 2003. Ziegler said the rise was "a result of the war led by coalition forces."

In addition to war, the new UN report suggests that more than a decade of harsh economic sanctions against Iraq, enthusiastically supported by the US and British governments, has had a major impact on the health of Iraqi children.

"Most Iraqi children today have lived their whole lives under sanctions and war," the study says, noting that "the suffering of children due to war and conflict in Iraq is not limited to those directly wounded or killed by military activities."

The survey notes that children under the age of 15 make up 39 percent of the country's total population.
Health Care Facilities Dilapidated, Doctors Frustrated

Years of sanctions and war have also had a major negative impact on Iraq's health care system, once considered among the best in the Middle East, authors of the survey observe.

The list of "current major problems" includes "lack of health personnel, lack of medicines, non-functioning medical equipment and destroyed hospitals and health centers."

Iraqi health officials express a great deal of frustration at their limited capacity to provide services to those who are chronically ill and to the increasingly high number of people wounded in attacks by rebels, foreign occupation troops and Iraqi security forces.

In interviews with the Christian Science Monitor, doctors at Baghdad's Yarmouk Hospital, said the main problem at is funding for basic medical services. In fact, they say the money needed to run the facility, which has the biggest patient load in Baghdad, has run just out.

"The health ministry does not have money to spend until July," Tala Al-Awqati, a pediatrician at Yarmouk, told CSM. "A lot of things have stopped," she said, "People are not getting what they need from the health services. Money for disinfectant is not there anymore; sometimes we must buy it ourselves."

Iraq's Health Ministry had requested $2 billion for health care services in 2004 from US controlled funding sources, but reportedly received less than half that amount - only $950 million. Doctors told CSM that due to poor funding and the slow pace of the US-led reconstruction effort, projects to repair hospital water pipes and sewage systems are left undone.

In addition to poor facilities and the lack of medicine and personnel, Al-Awqati suggested that poor security is one reason the infant mortality rate in Iraq remains high under the US-led occupation. "Women can't reach the hospital at night," she said, referring to the lack of safety near her own facility.

The UN survey reports 32 deaths per 1,000 births during infants' first year. The report further indicates that "infant and child mortality rates appear to have been steadily increasing" during the last 15 years of war and sanctions. The number of mothers who die during labor was 93 for every 100,000 births, far worse than the rates of maternal mortality in Jordan and Saudi Arabia.

Iraqis Lack Safe Water, Sewage Treatment, Electricity

The condition of Iraq's health care infrastructure is mirrored by that of the country's larger civilian infrastructure, which the UN report says is marked by "degraded or disrupted electricity supply, sanitation, and communications."

In comparison with earlier statistics from Iraq on key measures of daily living conditions - such as reliability of electrical service, access to safe drinking water and sanitation systems and access to health care -- the report concludes that "an alarming deterioration in the indicators is apparent."

Of the households surveyed, 51 percent of those in urban areas of southern Iraq live in neighborhoods "where sewage could be seen in the streets." Nationwide, 40 percent of families in urban areas and 30 percent in rural areas reported living in neighborhoods where they can see sewage in the streets.

Iraqis are not fairing much better with respect to clean sources of water. The survey indicates that only 54 percent of households nationwide have access to a "safe and stable" supply of drinking water. An estimated 722,000 Iraqis, the report also notes, rely on sources that are both unreliable and unsafe.

Conditions are worse in rural areas, with 80 percent of families drinking unsafe water, the report says. According to researchers, "the situation is alarming" in the southern governorates of Basra, Dhi Qar, Qadisiya, Wasit, and Babil, located near the Tigris and Euphrates Rivers. A large percentage of the population in this region relies on water from polluted rivers and local streams, the report says.

Although 98 percent of Iraqi households are connected to the electrical grid, 78 percent of them report "severe instability" and low quality in the service, according to the survey. As a result, about one in three Iraqi families now relies on alternative sources of electricity such as generators, most of which are shared between households.
Literacy in Decline

The past two decades of war and sanctions have also taken a heavy toll on Iraq's education system, the report states.

The literacy rate among those between the ages of 15 and 24 is just 74 percent, the survey reveals - a rate researchers note is only "slightly higher than the literacy rate for the population at large." But this figure is lower than literacy rates for those 25-34, "indicating that the younger generation lags behind its predecessors on educational performance."

The survey also indicated that the literacy rate for women in Iraq has stagnated in the past two years. In some governorates, however, the level of female illiteracy is very high.

Overall, the gender gap in literacy is diminishing in Iraq, according to the report - but this appears due more to a drop in the literacy levels of men rather than gains made by women.

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