The following is an archived copy of a message sent to a Discussion List run by the Campaign Against Sanctions on Iraq.
Views expressed in this archived message are those of the author, not of the Campaign Against Sanctions on Iraq.
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I would like to make some comment about the effect of hospitals on health, which may put the health issue into context, particularly as it relates to sanctions and hospitals in Iraq. In one course in health economics which I studied a few years ago, the effect of hospitals on health was considered. I can't remember the exact figures, but if all hospitals throughout the world were closed down, the effect on overall life expectancy really would be minimal, in terms of months at most, it may have even been days or weeks, I remember feeling totally shocked when I first saw the figures. That doesn't mean that certain people get their life expectancy dramatically improved by a particular operation - for example, appendicectomy, heart surgery, but taken as a whole population it makes little difference. What improves life expectancy is education, particularly of women (this has the biggest effect of all in improving child survival, the more years education the mother has OF ANY SORT, the longer her children are likely to survive), good food, good hygiene, waste and sewage disposal, controlling environment (eg., temperature control, keeping out water and damp, controlling insects and other vectors of disease). The effect of good GP style treatment or good pharmacy advice would also be a factor in improving quality and quantity of life, far more than hospital care. Even immunisation programmes in poor countries have been shown to have nil effect on the number of children who survive to the age of 5, because if you are very poor, if you don't die from measles you will die from diarrhoea. Its a simple as that. So whilst we need to consider sanctions in some respect in terms of hospital care available, pre-the Gulf War and after, it makes very little difference to life expectancy of ordinary people. It seems to me that the major effects of the war and sanctions which adversely affect life expectancy in Iraq are: (1) Reproductive health, including fitness of mothers, child spacing practices, hygiene, breastfeeding, attendent at birth who has at least basic knowledge, all adversely affected in some way by sanctions. For example, if mothers can't work or if some of their children die, they are more likely to have more children who are then more at risk. Also repeated pregnancy puts them and their unborn child at risk. Another example, if there is a lack of training and health text books then some women may have a less safe birth situation. (2) Water issues, and the hygiene issues which arise. (3) Poverty in general, including the cost of food and availability of food. (4) Contamination causing illness, including cancers and birth deformities. (5) Restrictions on education. (6) Risk due to dangerous machinery which cannot be repaired effectively, including cars. (7) Psychological factors, including the will and motivation to live. By this I don't mean suicide risk, but a person with a lot to lose will fight harder when it comes to facing illness and will not succumb so easily. (These risks are not in order of importance) I hope this reduces the emphasis on the debate relating to the types of hospitals and care available for ordinary people in Iraq, as it really is only of very minor importance. Unfortunately, hospitals provide status for health workers and are visible symbols of health care, and in all societies, developed and developing, they are over-emphasised because of the collusion of medical staff and patients and misunderstanding of what health is - it is not merely the treatment of disease. Judith. _______________________________________________ Sent via the discussion list of the Campaign Against Sanctions on Iraq. To unsubscribe, visit http://lists.casi.org.uk/mailman/listinfo/casi-discuss To contact the list manager, email casi-discuss-admin@lists.casi.org.uk All postings are archived on CASI's website: http://www.casi.org.uk