Global Policy Forum

By Bob Herbert

We've heard from General Petraeus, from Ambassador Crocker, and on Thursday night from President Bush. What we haven't heard this week is anything about the tragic reality on the ground for the ordinary citizens of Iraq, which is in the throes of a catastrophic humanitarian crisis.

President Bush may not be aware of this. In his televised address to the nation he warned that a pullout of U.S. forces from Iraq could cause a "humanitarian nightmare." A trusted aide should take the president aside and quietly inform him that this nightmare arrived a good while ago.

When the U.S. launched its "shock and awe" invasion in March 2003, the population of Iraq was about 26 million. The flaming horror unleashed by the invasion has since forced 2.2 million of those Iraqis, nearly a tenth of the population, to flee the country. Many of those who left were professionals marked for death — doctors, lawyers, academics, the very people with the skills necessary to build a viable society.

The Iraq Ministry of Health reported that 102 doctors and 164 nurses were killed from April 2003 to May 2006. It is believed that nearly half of Iraq's doctors have fled. The exodus of health care professionals in a country hemorrhaging from the worst kinds of violence pretty much qualifies as nightmarish. While more than two million Iraqis have fled to other countries, another two million have been displaced internally. According to the Global Policy Forum, a group that monitors international developments: "Most of these internally displaced persons, or I.D.P.'s, have sought refuge with relatives, or in mosques, empty public buildings, or tent camps. ...I.D.P.'s live in very poor conditions. Public buildings are particularly unsanitary, often overcrowded, without access to clean water, proper sanitation and basic services, in conditions especially conducive to infectious diseases."

Iraqis are enduring most of their suffering out of the sight of the rest of the world. International relief organizations and most of the news media are largely kept at a distance by the insane levels of violence. Access to safe drinking water is a problem in much of the country. (The World Health Organization was asked to help with a recent outbreak of cholera in parts of Kurdistan that is believed to have been caused by polluted water.) Sanitation facilities are routinely crippled by violence and sabotage. The economy, like the country's infrastructure, is in shambles.

The worst aspect of the nightmare, of course, is the rain of death that has descended on Iraq since the U.S. invasion. Controversy has surrounded virtually all attempts to estimate the number of civilian casualties, but no one disputes that the toll is staggering. The U.S. government has behaved as though these dead Iraqis were not even worth counting. In December 2005, President Bush casually mentioned "30,000, more or less" as the number of Iraqis killed in the war. The White House later said there were no official estimates of Iraqi deaths. We shouldn't be so cavalier. Based on all available evidence, it seems unreasonable to believe that fewer than 100,000 Iraqi civilians have been killed thus far. Many very serious scholars believe the total is much higher.

As for the number of wounded and disabled Iraqis — men, women and children who have lost limbs, or been paralyzed or otherwise maimed in air, rocket and bomb attacks — no one has a real grasp of the size of the problem. "Just considering the number of the dead and the number of displaced, this is probably the biggest humanitarian crisis in the world," said James Paul, the executive director of Global Policy Forum, which recently compiled an extensive report on the war and occupation. "This is the biggest displacement of people in the Middle East in a very long time."

The effect on children of the carnage, the dislocations and the deteriorating quality of daily life has been profound. Conditions in Iraq were dire for children even before the war. One in eight died before the age of 5, many from the effects of malnutrition, polluted water and unsanitary conditions. Now, more than four years after the invasion, huge numbers of Iraqi children are finding themselves orphaned, homeless, malnourished, and worse. According to Unicef, the U.N.'s children's agency: "Many children are separated from their families or on the streets, where they are extremely vulnerable to abuse and exploitation. Most children have experienced trauma but few receive the care and support they need to help them cope with so much chaos, anxiety and loss."

These are just a few of the things you won't hear much about from the American officials in Washington who profess to care so deeply about the people of Iraq.