Medact Malpractice

by Howard Fienberg
November 18, 2002

Since 9/11 disabled the emotional support upon which many international activists rely, they have had to delve more often into research and data to prop up their causes. When America was busy deposing the Taliban in Afghanistan, Professor Marc Herold came up with a much-publicized faulty accounting of civilian casualties. As the U.S. prepared for war with Iraq, activists trotted out claims dating from the mid-90's that the UN sanctions killed millions of Iraqi children. Later, Professor William Nordhaus declared his somewhat dubious estimates of the economic costs of war (a condensed form of which was recently published in the New York Review of Books).


On November 12 came the latest rush to data, in the form of a report from Medact called "Collateral Damage." Medact, a nonprofit activist group composed of "health professionals who are concerned about major threats to health such as violent conflict, poverty and environmental degradation," tries to catalogue the effects of the first Gulf War and the subsequent sanctions, and then estimate the expected costs of a second war with Iraq. Australian General Pete Gration, who opposes war with Iraq, endorsed the Medact report as "no exaggerated tract by a bunch of zealots. It is a coldly factual report by health professionals." James Snyder, a spokesman for the anti-war activist group Physicians for Social Responsibility, told the Atlanta Journal-Constitution that "the estimates and ranges are based on sound science and previous experience."


Medact's data is largely unreliable, and focuses only on possible costs of war while ignoring any possible benefits. But dwelling on the data deficiencies only strengthens the organization's hand. The real problem lies not in the presented data, but in what is missing from them. Sanctions and war, hardship and heartache are all catalogued as if they were acts of nature or the effects of freakish chance. However, all of Medact's detailed situations, casualty figures, grisly war scenarios, and environmental and health impact estimates result from one cause, which does not get mentioned more than once or twice in the whole report.


·        A flow chart, adapted from a 2002 UNICEF report, outlines a "causal analysis of the fulfillment of children's rights to life and survival in Iraq." It starts with "basic causes" (like systems failures, crises, and sanctions), which lead to "underlying causes" (like poverty and the decline in infrastructure), which then lead to "immediate causes" (disease and malnutrition), and result in the "outcome" of high rates of infant mortality and under-five mortality, as well as underweight, stunted and emaciated growth. While the chart looks impressive and businesslike, it studiously ignores the impetus behind this chain of events.


·        Medact recounts the psychological impact of the first Gulf War, from combat exposure, bereavement, loss and chronic stress due to "further threats" and fears that "the experience of another war is likely to magnify psychological disturbances already present in adults and children." War is never pretty, this is true. But while the further threats Medact seems to be referring to are from the West, the Iraqi people are perhaps more disturbed by living in a totalitarian state where imprisonment, torture and murder are run of the mill occurrences. Might not liberation from this regime bring an improvement in psychological well-being? Medact fails to speculate.


·        Iraq's ignition of Kuwaiti oil wells during its retreat in the Gulf War was an environmental nightmare. Medact fears the same thing could happen if Iraq were invaded. The use of weapons of mass destruction is similarly feared. But every time these problems come up, they are discussed in the abstract, as they were simple byproducts of war.


Medact avoids apportioning blame. If Iraqis' ill health, poverty and environment are merely the results of "war" and "sanctions," then it becomes the United States' fault, since they imposed these twin boogeymen on Iraq. But what if the boogeymen were just resulting from the actions of one person (whose last name does not end in Bush). Well, that would be too simple, wouldn't it?


And yet, it is that simple. Sadaam Hussein invaded Kuwait and prompted the Gulf War. He set the oil wells of Kuwait ablaze. He invited sanctions by continuing to build weapons of mass destruction and foiling the efforts of weapons inspectors. He frittered away money on himself and his military, which could have been spent to rebuild and improve his country and his people. He paid cash rewards to suicide bombers who killed innocent Israelis.

Medact offers dozens of "mutually reinforcing and synergistic" actions to better the situation in Iraq and improve international security. But none of them targets the real problem. There hopefully will come a time for Medact's proposed actions, but only after the fall of the Sadaam Hussein. No dazzling array of "sound science" and data can alter that inescapable fact.

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