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In: War and public health, edited by Barry S. Levy, Victor W. Sidel. Washington, D.C., American Public Health Association [APHA], 2000. 254-278.War has always been disastrous for civilians, and the Persian Gulf War was no exception. Yet the image that has been perpetuated in the West is that the Gulf War was somehow "clean" and fought with "surgical precision" in a manner that minimized civilian casualties. However, massive wartime damage to Iraq's civilian infrastructure led to a breakdown in virtually all sectors of society. Economic sanctions further paralyzed Iraq's economy and made any meaningful post-war reconstruction all but impossible. Furthermore, the invasion of Kuwait and the subsequent Gulf War unleashed internal political events that have been responsible for further suffering and countless human fights violations. The human impact of these events is incalculable. In 1996, more than five years after the end of the war, the vast majority of Iraqi civilians still subsist in a state of extreme hardship, in which health care, nutrition, education, water, sanitation, and other basic services are minimal. As many as 500,000 children are believed to have died since the beginning of the Persian Gulf War, largely due to malnutrition and a resurgence of diarrheal and vaccine- preventable diseases. Health services are barely functioning due to shortages of supplies and equipment. Medicines, including insulin, antibiotics, and anesthetics, are in short supply. The psychological impact of the war has had a damaging and lasting effect on many of Iraq's estimated eight million children. (excerpt)
National Program on the Control of Diarrheal Diseases. Report of the Joint MOH / WHO / UNICEF / USAID Comprehensive Program Review, 28 January to 11 February, 1985.
Manila, Philippines, Ministry of Health, 1985. v, 36 p.In early 1985, representatives of the Philippines Ministry of Health, WHO, UNICEF, and USAID visited health facilities (barangay health stations to hospitals) and used data from 9106 households (11,131 children under 5 years old) in the provinces of La Union, Bohol, and Bukidnon in the Philippines, to evaluate implementation and effect of the National Program on the Control of Diarrheal Diseases (CDD). 10.8% of the children had had diarrhea within the last 2 weeks. Mean diarrhea episode/child/year stood at 2.8. Mean infant mortality was 62.3/1000 live births (35.8 in La Union to 94 in Bukidnon). Diarrhea-related mortality for all children studied ranged from 3 in La Union to 18.3 in Bukidnon (mean = 8.6). Between 1978 and 1982, the diarrhea-related mortality rate for all of the Philippines fell from 2.1 to 1, presumably due to the CDD Program. Diarrhea was the leading cause of death in Bukidnon (21.3%), but in La Union and Bohol, it was the 5th leading cause of death (6.6% and 10.3%, respectively). 33% of children with diarrhea received oral rehydration solution (ORS), 12% did not receive any treatment, and 72% received herbs, antibiotics, or antidiarrheals. Many of the children receiving ORS also received other treatments. 86% of mothers were familiar with ORS and 73% of them had used it. 92% would use it again. 84% would buy it from stores, if sold. Government health facilities tended to use ORS and to prescribe it for diarrhea cases. Most facilities had successfully promoted breast feeding. The supply of ORS packets in most facilities was good. Almost all health personnel had received ORT training. Some recommendations included promotion of non-ORT strategies (e.g., hand-washing and food safety), conducting research (e.g., to identify suitable fluids and foods for home-based oral rehydration therapy, and regular monitoring and evaluation of the CDD Program.