Kuwait City, April 27, 2003. The war may have lasted only a month, but the occupation and pacification of Iraq has only just begun. The transition to a peaceful and democratic Iraq is likely to be a long and frustrating process.
By the middle of April, organized Iraqi resistance to Coalition forces had ended and all major cities and towns were under either American or British control. The cheering crowds that greeted the advance units of Coalition troops in most cities symbolized for many the start of a new day for Iraq. Plans which had been drawn up months earlier in Washington were based upon expectations of a rapid change-over from the former Ba’athist regime to one under a transitional American-led administration. It was anticipated that humanitarian organizations from the U.S. Government, United Nations’ agencies and NGOs would quickly follow the troops and provide emergency assistance in medical care, food, water and shelter to people suffering the effects of the Saddam Hussein era and the consequences of the war. The post-conflict phase was expected to showcase the American resolve to help the Iraqis rebuild a prosperous and democratic society.
However, it isn’t quite working out as planned.
Security remains a troubling issue – one that has hampered relief efforts and prevented most of the humanitarian relief organizations from setting up operations in Iraq. Although organized military fighting has ended, it has been replaced by armed resistance by paramilitary elements and snipers and by revenge killings and criminal activity. The cities, in particular remain dangerous places, generally controlled by Coalition forces at public buildings and along major roads and key intersections, but often considered to be high risk in many neighborhood areas.
Perhaps if the Coalition had not insisted on destroying the Ba’athist Party and the government it controlled, there would have been some remnants of the previous regime to surrender and call upon its forces to lay down their arms. As it was, the Government of Iraq simply disappeared under the Coalition onslaught. Organized conflict ended, but pockets of resistance continue to this day, and no definable end to the war has yet to be seen.
The Coalition has responsibility for security in Iraq. Depending upon circumstances, it designates areas as permissive, meaning that humanitarian organizations are allowed to enter, or non-permissive, meaning that the areas are insecure and humanitarian organizations will be prevented from entering. Over the last few weeks, the permissive areas have been slowly expanding from the Kurdish areas in the north and from the Kuwaiti border in the south and progressively closing in on Baghdad in the center of the country. This process has been slower than anticipated, leaving many humanitarian organizations in Kuwait, Jordan and Turkey standing on the sidelines unable to provide the assistance for which they have been preparing.
Until recently, only a few reports of humanitarian needs filtered back from Iraq, but these were usually assessments carried out by civil affairs units within the Coalition military forces that followed immediately behind the combat troops. With few exceptions, civilian organizations were unable to provide humanitarian services in Iraq during the first half of April. Even when areas were finally declared permissive, most humanitarian organizations limited their activities to short assessment missions.
And so it was with the DART (Disaster Response Assistance Team), as we waited in our secure bases in Kuwait, Jordan and Turkey. By mid-April, several DART field teams had made a series of cautious assessments in Iraq, but no permanent base or office had been established there.
Finally, an opportunity to enter Iraq came my way. On April 17, the DART rec eived reports of an outbreak of severe diarrhea in the city of An Nasiriyah, 200 miles north of the Kuwait border. Fearing that it could be amebic dysentery, a six-man mission, composed of three physicians (two from DART, one from an NGO), myself (water supply and sanitation) and two security and communications staff, obtained the necessary clearances and immediately left for An Nasiriyah. Following mandatory security protocols, we traveled in two heavily armored vehicles capable of withstanding AK-47 gunfire, wore armored vests, and remained in frequent radio contact with our base in Kuwait.
Crossing into Iraq near the village of Safwan, we met our first Iraqis. They were standing along the roadsides selling Iraqi dinars bearing Saddam Hussein’s picture. Many people waved and cheered, while some begged for money, and a few threw stones at our cars. At one point, Iraqi children and some older boys and men crowded around our cars as we crept along a bumpy road in a long line of vehicles. Hands reached out to touch our cars. The side door of our first car was pulled open by the crowd, then quickly shut from the inside. I heard the rear door of our car open, but when I turned around I could see nothing because of boxes of medical supplies blocking my view. We quickly sped away from the crowd, but in that brief instant when the rear door was opened we lost a bag with $15,000 of communications equipment.
Arriving in An Nasiriyah, we passed one site where people had been reported to be digging in the ground in a frantic effort to find detainees entombed by the Iraqi Government in the closing days of the war. The local media carry many reports of Iraqis desperately searching for lost relatives who had been arrested by the previous regime. In Kuwait, there are influential groups still seeking information about Kuwaitis who disappeared during the Gulf War of 1990-1991.
The U.S. Marines controlled An Nasiriyah at the time of our visit. We found the senior medical officer, a Navy captain, at the heavily guarded command post in town. He briefed us on the diarrheal situation in the area and helped arrange an armed escort for our visits to the city hospitals and clinics. That night, we slept on cots in a former Iraqi military barracks now controlled by the U.S. Army. Our immediate neighbors were a Special Forces unit that was carrying out assessments of damaged public utilities.
The next morning we visited the main hospital (formerly Saddam Hussein Hospital) and several clinics where the DART physicians examined patients with severe diarrhea and collected stool samples to determine the nature of the illness. Although we had to remain together for security reasons, I spent my time collecting information on the city water supplies (the likely carrier of the pathogens) and the sewage system (the probable source of the pathogens). Our objectives were twofold: the doctors wanted to determine the appropriate treatment for the sick patients and I wanted prevent further cases by identifying measures to improve the unsafe water supplies and unsanitary sewage drains found in the city.
One clinic we visited was within a market area teeming with people. After about 30 minutes in the clinic, our chief security officer came inside and said that we had to leave immediately. The crowd around the vehicles had become unruly, despite the presence of an armed Marine Humvee, and he felt that it was prudent to leave before an incident occurred. We ended our work, climbed into the cars and edged our way through the crowds. For the remainder of our visit to An Nasiriyah, we were accompanied by a second Marine vehicle, this one carrying a TOW anti-tank rocket launcher on its roof.
Concerns for personal security – especially for Americans – is well founded. Violence can erupt at any time, and often it is addressed at Coalition forces or humanitarian workers who may be associated with the Coalition. Two weeks ago, two senior DART personnel were crossing Baghdad in an armored military vehicle escorted by two U.S. Army Humvees mounting 50-caliber machine guns. On three separate occasions, they were fired upon by unknown gunmen using automatic weapons. They escaped unharmed, but others have not been so lucky. Only today we learned that four U.S. Army civil affairs health personnel were shot and wounded when their car stopped at a busy Baghdad intersection.
On the drive back to Kuwait from An Nasiriyah, we passed long convoys of heavy trucks heading north towards Baghdad. Many trucks were hauling army tanks on flatbed trailers, while others pulled large, enclosed double trailers. I asked my colleagues why were heavy tanks being sent north if the war was essentially over. No one knew the reason. Security was the only answer we could find.