Humanitarian consequences of war

About 1.8 million people became refugees in 1991

By Tarik Kafala BBC News Online

Many Iraqis will face starvation in the event of a US-led war in the country, a United Nations official has warned.

A widely-leaked UN report on the humanitarian consequences of a war has estimated that the conflict would create two million refugees.

In mid-January, the Turkish Red Crescent Society began preparations for the large number of refugees expected to cross into Turkey - a 24,000-tent refugee camp is planned.

UN estimates

16 million or 60% of Iraqis dependent on government rations

Two million refugees expected (half inside Iraq)

500,000 people will need medical treatment in early stages of war

Two million children and one million pregnant or lactating women will need immediate "therapeutic feeding"

These dire warnings reflect widespread concerns over the effects that any US-led war could have on the Iraqi people.

They are based on previous experience and on studies of the current state of health of Iraqis and how they are getting food.

Despite these warnings, the UN refugee agency, the UNHCR, has admitted to BBC News Online that its preparations are in the initial stages and "in terms of scope they are not really on a large scale".

During the 1991 Gulf War Turkey received 500,000 of the 1.8 million refugees went on the move. Nearly a million crossed into Iran.

The overall death toll among Iraqi civilians 12 years ago is hotly disputed. Estimates for civilian deaths as a direct result of the war range from 100,000 to 200,000.

In a sustained war this time around, the expectation among aid organisations and UN agencies is that the casualty and refugee figures will be higher because the aim of the war will be regime change.

All this assumes that non-conventional weapons or weapons of mass destruction are not used.

Food rations

The fear that large numbers of Iraqis will starve comes from the assessment that the system of government food rations on which many Iraqis depend will be severely disrupted.

The problem is we are trying to prepare for something in Iraq while we have real, existing crises on out plate in the Ivory Coast and Afghanistan. These real, rather than hypothetical, operations are themselves out of money

Chris Janovski, UNHCR

More than 60% of Iraqis, 16 million people, are dependent on government rations, the UN estimates.

Under the UN oil-for-food deal in place since 1996, Iraq has used oil sales to cover around 70% of its food needs.

Mike Rowson, the director for British health charity Medact, told BBC News Online that the Iraqi people as a whole are far less healthy than they were before the 1991 Gulf War.

This means they will be more vulnerable to the illness and distress caused by war and being forced on the move.

The main problems are likely to be:

• The immediate injuries and deaths from a bombing campaign
• Civilian deaths and illness from the damage done to essential infrastructure such as water and electricity supplies
• Health services in Iraq, already overstretched, can be expected to be overwhelmed.

These conditions are likely to create, Mr Rowson says, widespread epidemic disease and hunger.

Possible scenarios

In a report released in 2002, Medact tried to assess the most likely scenario for a war in Iraq and then estimated the likely casualties.

"War is unpredictable, but planning must try to use evidence gained from previous conflicts and comparable situations to make these kinds of estimates," Mr Rowson said.

It is astonishing to us how little the potential humanitarian effects of war are discussed either in parliament or in the media - there should be a full and open assessment of the likely costs followed by a public debate about the implications of this assessment

Mike Rowson, Medact

"We know that the Iraqi population is much weaker than a decade ago, so the death toll of up to 200,000 from the 1991 war could be higher; this pessimistic scenario should be coupled with the fact that war could be even more intense because its aim is regime change and Saddam Hussein may well fight on to the bitter end."

Depending on what kind of conflict it turns out to be and how long it lasts, Medact estimates civilian deaths as a direct result of fighting and bombing could range from 48,000 to over 260,000.

"It is astonishing to us how little the potential humanitarian effects of war are discussed either in parliament or in the media - there should be a full and open assessment of the likely costs followed by a public debate about the implications of this assessment," Mr Rowson told BBC News Online.

Preparations

When asked what preparations the UK Government was making for the humanitarian consequences of a war, the Department for International Development was able to say only that the government was "planning for all eventualities".

The UN's refugee agency, the UNHCR, told BBC News Online that its preparations were of a general nature and at an initial stage.

Existing refugees crises, like that in Afghanistan, are the UNHCR's focus

"The point is that we don't know what the humanitarian consequences will be. If there is some sort of military intervention, we have absolutely no idea what is going to happen. Nonetheless we have to be ready in broad terms," UNHCR spokesman Chris Janovski said.

Being ready means buying tents, sheeting, blankets, and non-perishable foods and medicines that are needed for any refugee crisis and stockpiling them in the countries neighbouring Iraq.

Mr Janovski said: "We are making preparations, but in terms of scope they are not really on a large scale. This is linked to the fact that we are out of money. We have spent close to $19m from various emergency funds for basic preparations and this is really it.

"The problem is that we are trying to prepare for something in Iraq while we have real, existing crises on out plate in Ivory Coast and Afghanistan.

"These real, rather than hypothetical, operations are themselves out of money."