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Major Iraq Birth Defect Study Expected to Show Increase Linked to Conflict


May 3, 2013
International Coalition to Ban Nuclear Weapons

The BBC has reported that a much anticipated study by the WHO and Iraqi Ministry of Health will show that rates of birth defects in Iraq are higher in areas that were subject to heavy fighting in 2003. The publication of the final report, scheduled for early this year has been delayed, but the BBC's report offers a first glimpse at the results.

http://www.bandepleteduranium.org/en/bbc-iraq-birth-defect-study-to-show-increase

BBC: Major Iraq Birth Defect Study Expected to Show Increase Linked to Conflict
ICBUW

LONDON (March 22, 2013) -- The report, broadcast on BBC World and available online features an interview with researchers at the Iraqi Ministry of Health (MoH). The researchers indicate that the report, which has been produced jointly by the WHO and MoH, will find that rates of birth defects are higher in areas of Iraq that were subjected to heavy fighting in the 2003 war. The publication of the final report, scheduled for early this year has been delayed, but the BBC's report offers a first glimpse at the results.

"The BBC's report fits with our expectations from smaller localised studies and the reports of healthcare professionals in Iraq," said an ICBUW spokesperson. "Naturally we will await the publication of the full report but should the findings and methodology prove to be robust, the study could add considerably to the pressure for action to reduce the legacy of modern conflict on public health. However more research will be needed to establish the precise risk factors responsible."

The study was launched after concern was generated by reports from medical staff in cities such as Fallujah and Baghdad of spiralling rates of congenital birth defects. Fallujah, which lies in Anbar province, has become particularly notorious and medical staff and civil society organisations have argued that the increases are linked to environmental contamination from the US led attacks on the city in 2004.

Speaking at a workshop for the project in early 2012 Dr Hawrami Minister of Health of the Kurdistan Regional Government said: "There is a need for a comprehensive programme to learn more about birth defects in Iraq that could shed light on the incidence of various conditions, such as congenital heart defects and neurological defects, in different geographic areas over time in Iraq."

According to the WHO, the governorates in which the study has been conducted are Baghdad (Karkh and Rafafa), Diyala, Anbar (including the district of Fallujah), Suleimaniyah, Babel, Basrah, Mosul and Thi-Qar. Two districts were selected from each governorate (one as high risk and the other as a control).

The criteria for declaring a district as high risk is based on existing statistics showing a high number of congenital birth defect cases. A total of 10,800 households from 18 districts of the 8+1 governorates were selected as a sample size making it uniformly 600 households per district.

All mothers in these households who were married, between the ages of 15 and 49 years, and who had a child with any congenital birth anomaly were included as respondents. Two-stage sampling was undertaken for each child; one before the onset of the 2003 war and the other after the onset of 2003 war.

The WHO in Iraq prioritised measuring the magnitude and trend of congenital birth defects at selected district level, identifying possible risk factors of congenital birth defects and assessing the burden of these conditions and impact on the health status of care providers.

Notes:
BBC World: Doctors in Basra report rise in birth defects
http://www.bbc.co.uk/news/world-middle-east-21873892

WHO: Congenital birth defect study in Iraq: frequently asked questions
http://www.emro.who.int/irq/iraq-infocus/faq-congenital-birth-defect-study.html



Iraq Congenital Birth Defect Survey to Begin in April
ICBUW

(March 29, 2012) -- ICBUWA project to examine the rates of congenital birth defects such as heart and neurological problems is due to start next month, following a series of planning meetings held during 2011. The survey will cover six of Iraq's governorates including Baghdad, Anbar, Basrah, Thi Qar, Sulaymaniyah and Dialah.

Significant international concern has been generated over reports from medical staff in cities such as Fallujah and Baghdad of spiralling rates of congenital birth defects. Fallujah, which lies in Anbar province, has become particularly notorious and medical staff and civil society organisations have argued that the increases are linked to environmental contamination from the US led attacks on the city in 2004.

During a workshop on the project in February, Dr Hawrami Minister of Health of the Kurdistan Regional Government said: "There is a need for a comprehensive programme to learn more about birth defects in Iraq that could shed light on the incidence of various conditions, such as congenital heart defects and neurological defects, in different geographic areas over time in Iraq."

The WHO in Iraq has reported that priority will be given in the survey to measuring the magnitude and trend of congenital birth defects at selected district level, identifying possible risk factors of congenital birth defects and assessing the burden of these conditions and impact on the health status of care providers.

ICBUW welcomes this long overdue attention on these disturbing problems but emphasised that the process must be as transparent and wide ranging as possible to ensure that all environmental risk factors, including contamination from depleted uranium munitions and other toxic remnants of war are taken into account. Plans to analyse the health and social burden of these problems on communities are also welcome.

The project Pilot Assessment of Congenital Birth Defects (CBD) in Iraq has been split into two component parts, the first of which has been funded by the United Nations Development Group (UNDG) Iraq Trust Fund, which is administered by the United Nations Development Programme (UNDP) on behalf of itself and other United Nations Organisations. The first part of the project is expected to cost US$336,350 and will focus on:

Drawing initial baseline data from selected districts in 6 governorates and understanding the trends of birth defects in the selected governorates in Iraq;

Analyzing spatial and temporal trends and detect changes in the incidence of birth defects in Iraq

Capacity building of Ministry of Health national public health TORCH (Toxoplasmosis, Rubella, Cytomegalo and Herpes virus) laboratory and technicians


The second phase will aim at:

conducting observational and analytical epidemiological and laboratory investigations to understand underlying risk factors; strengthening the disease registry/surveillance for birth defects in Iraq and finally the proposed study will assist in assessing the burden of the problem on Iraqi health system, medical services and communities and formulating evidence-based recommendations to address the problem.

The initial research part of the project is expected to be complete by late summer but it is unclear when the first results will be made public.

Notes:
Training workshop for central and local supervisors on congenital birth defects survey, Iraq:
http://www.emro.who.int/iraq-press-releases/2012/training-workshop-for-central-and-local-supervisors-on-congenital-birth-defects-survey-iraq.html

Pilot Assessment of Congenital Birth Defects in Iraq in Six Governorates, project description (UNDP):
http://mdtf.undp.org/document/download/6499

Huge rise in birth defects in Falluja:
http://www.guardian.co.uk/world/2009/nov/13/falluja-cancer-children-birth-defects?intcmp=239

See also
Growing concern over humanitarian situation in Fallujah

The fifth anniversary of the second attack on Fallujah by US forces has seen an upsurge in interest in the lingering humanitarian problems resulting from the conflict. Both the US and UNEP have roles to play in clarifying exactly what happened and ICBUW calls on them to accept this responsibility.

19 November 2009 -- ICBUW

Posted in accordance with Title 17, Section 107, US Code, for noncommercial, educational purposes.

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