See Full Report

"..we will help you to build a new Iraq that is prosperous and free."
- US President Georges W. Bush *

The invasion of Iraq by the US Coalition in March 2003 caused many civilian casualties, but it did not create a major humanitarian crisis or set off mass migration. Soon, though, counter-insurgency operations, including massive attacks on cities like Falluja, Najaf and Tel Afar, led to substantially increased mortality and large displacement, affecting hundreds of thousands of people.[1] Unemployment and poverty rose sharply, too, as state institutions deteriorated or collapsed. Beginning in 2006, sectarian clashes worsened and inter-communal violence led to rising death and injury, as well as massive new displacement. The international relief system has not been able to respond to the growing humanitarian challenges. Humanitarian NGOs have long since withdrawn and donor governments have stayed away. International relief agencies have themselves faced serious problems in reaching Iraqis at risk and mobilizing funds for the deepening emergency.[2]

Displacement

Violence and increasing poverty have created an unparalleled movement of population in Iraq.[3] In April 2007, well over 4 million Iraqis had been displaced, about 14% of the total national population. Of that number, about 1.9 million Iraqis were internally displaced and over 2.2 million had migrated to other countries.[4] UNHCR, the UN refugee agency, has spoken of its "growing concerns over the rapidly deteriorating humanitarian situation facing hundreds of thousands of displaced Iraqis, both within and outside their country."[5] The refugee agency expects many vulnerable people who have still not fled to leave their homes in the near future as violence and inter-communal strife continue to rise.[6] Large numbers are in urgent need of aid, food and shelter. The scale of the problem and the difficulty of reaching the displaced people put very heavy pressure on the international relief system.

Coalition Operations

Since 2003, many Iraqis have been displaced by US Coalition military operations. These operations, which have included intense aerial and ground bombardment, have forced residents to leave in large numbers. More than 200,000 were displaced during the attacks on Falluja during 2004,[7] while hundreds of thousands more have been displaced in other city attacks. Many families have been unable to return, due to the ongoing insecurity, recurrent military offensives, lack of water, electricity and health services, and because their homes and places of business are ruined.[8] According to an estimate by the Falluja Reconstruction Project, about 65,000 people from that city were still displaced in early 2006.[9]

Sectarian Violence

In 2006, while military operations continue to force people from their homes, the main cause for displacement has shifted towards sectarian violence, particularly in Baghdad. The UNHCR estimates that some 730,000 people have been displaced due to sectarian violence since the attack on the Samarra Al-Askari shrine between February 2006 and March 2007.[10] Iraqis have been threatened because of their religious affiliation or professions. Sectarian militias and armed groups have attacked mosques, markets and villages of rivals. Mixed neighborhoods are increasingly polarized.

Minorities and Professionals

Minority communities are especially at risk. Reports suggest that religious persecution has led to the displacement of Christians, Turkmens, Assyrians and Saben-Mandeans, among others. The Sabean-Mandeans, a very old community, has dwindled from 13,500 in 2001 to roughly 4,000 in 2006.[11] Half of the 1.5 million Assyrians living in Iraq before 2003 have left the country and the remaining 750,000 are moving into "safe areas" in Zakho and North Ninevah.[12] Many Christians have been leaving for Syria and Jordan; a significant number has also sought refuge in Iraq's Kurdistan region.[13]

	Palestinians refugees on the Syrian border Photo credit: Christian Peacemaker Teams

Palestinian refugees in Iraq are facing very difficult living conditions, and are subject to repeated threats and attacks. Palestinian media sources report that there have been over 655 attacks against Palestinians, killing at least 186.[14] Palestinians in Baghdad are extremely fearful for their lives and have expressed their wish to leave as soon as possible.[15] But for many Palestinians leaving Iraq is not an option, as they are no longer in possession of valid travel documents.[16] UNHCR estimates that about 850 Palestinians from Iraq are trapped at the border with Syria.[17] A group of 365 has been living in a no man's land between the borders of Iraq and Syria, refusing to return to Iraq and having been refused entry by the Syrian government.[18] Neighboring countries like Jordan, Kuwait, Saudi Arabia, and Syria refuse to admit them[19] and going back to the Palestinian territories is not an option. Only about 15, 000 of an estimated 34,000 Palestinians formerly in Iraq remain in the country.[20]

Many professionals have been targeted because of their work. This includes academics, educators, professors, doctors, journalists, politicians, lawyers and judges.[21] Many have been arrested, kidnapped, killed or forced to flee to protect their lives and their families. According to the Iraqi Ministry of Health, 102 doctors and 164 nurses have been killed between April 2003 and May 2006, and some 250 Iraqi doctors have been kidnapped in the past two years.[22] According to the Brookings Institution's Iraq Index, 2000 Iraqi physicians have been killed and about 12,000 have left the country since 2003.[23] The negative effect of violence on professionals has substantially affected educational, judicial and health care systems in the country.

IDPs

An estimated 730,000 Iraqis fled their homes for other parts of Iraq since the Samarra bombings and UNHCR now estimates that the pace has increased to 50,000 per month.[24]

Most of these "internally displaced persons," or IDPs, have sought refuge with relatives, or in mosques, empty public buildings, or tent camps.[25] With limited access to food, health services, education and employment, IDPs live in very poor conditions.[26] Public buildings are particularly unsanitary, often overcrowded, without access to clean water, proper sanitation and basic services, in conditions especially conducive to infectious diseases.[27] In addition, occupants are constantly under threat of being evicted without being provided alternative accommodation. Those living in camps often have to choose between being located away from military operations or other targets, or being near education and health facilities.

Families and acquaintances have supported their displaced relatives and shared their limited supplies. But this has created a "rising tension between families over scarce resources" according to UNHCR. [28]

Humanitarian agencies are facing great difficulties in assisting IDPs. UN operations are mostly managed from Amman and Kuwait. The lack of security and military-imposed restrictions has prevented access to those in need of assistance and protection. Coalition forces have denied access of local aid groups to displaced communities.[29] Aid groups are also subject to intimidation from militias for helping displaced families of other religious backgrounds.[30]

Refugees in Neighboring Countries

In addition to the 1.9 million IDPs, over 2.2 millions Iraqis have sought refuge in other countries. At least 1.2 million Iraqis have fled to Syria, and an estimated 750,000 to Jordan. In addition, there are over 100,000 Iraqi refugees in Egypt, 54,000 in Iran, 40,000 in Lebanon, 10,000 in Turkey, about 200,000 in the Gulf States and around 200,000 have moved to Europe, Northern America and New Zealand.[31] A UNHCR report shows that asylum applications by Iraqis in industrialized countries rose by 77 percent in 2006, becoming the leading country of asylum seekers in 2006.[32]

In neighboring countries, tensions are rising as public services are overwhelmed by the rising number of refugees. Syria has become more restrictive. It now charges for health care and has reduced entry visas from six to three months, forcing refugees to exit the country for renewal.[33] Lebanon has closed its borders to Iraqi refugees and Lebanese authorities have increased arrests for illegal presence, forcing refugees to choose between prison and deportation.[34] Jordan, worried about risks of instability, has tightened its immigration rules, now requiring Iraqis to be in possession of a new type of passport.[35] The new measure has increased the feeling of insecurity experienced by many Iraqis in Jordan. Amman had already closed its borders to young men, obliging families to separate, [36] and made it difficult for Iraqi children to access public schools.[37] Refugees International reports that in certain cases border officials have issued transit visas that expire after a few days, leaving Iraqis subject to deportation.[38]

Long-Term Crisis and Broader Consequences

Hundreds of thousands of displaced Iraqis – both within and outside the country - are in dire need of assistance, for shelter, healthcare, education, legal aid, food and medicine. UNHCR predicts that Iraq's humanitarian crisis will last for years.[39] The UN agency is particularly concerned that displacement will persist over time, foreseeing that for most of the IDPs, "this is not a temporary" but a "permanent displacement."[40] This displacement has consequences beyond the country's borders, affecting Syria, Jordan, Egypt, Turkey, Iran and other countries outside the region.

In January 2007, UNHCR launched a $60 million appeal to fund its programs for the year,[41] a significant increase from the $29 million of 2006. Yet, "even US$60 million does not go very far,"[42] warned Andrew Harper, Senior Operations Manager for UNHCR's Iraq Operation Unit. Addressing Iraq's total humanitarian needs in the long-term would range in the "hundreds of millions, if not billions, of dollars," he added. "This is a [humanitarian] operation that is going to have to go on for years."[43]

Mortality

Iraq's death rate has substantially increased since the invasion. Demographic surveys, body counts using daily news reports, data from morgues and hospitals, and epidemiological studies – all show that Iraq's population has paid a steep price. Large numbers of people have been deprived of the right to life since March 2003.

Studies

The US and the UK governments have publicly insisted that they "don't do body counts," and thus have no reliable estimates of Iraqi civilian or military deaths.[44] Several studies have nonetheless sought to measure Iraq's mortality during the occupation:

Iraqi Ministry of Health figures for bodies brought to morgues and hospitals;[45]

UNAMI bi-monthly human rights reports, which provide figures based on "the number of casualties compiled by the Iraqi Ministry of Health from hospitals throughout the country and the Medico-Legal Institute in Baghdad";[46]

US Department of Defense quarterly reports to Congress, which provide rough counts of average numbers of Iraqis killed and wounded;[47]

Iraq Body Count, an independent and public database of civilian deaths reported in English-language news sources; [48]

Iraq Coalition Casualty Count, a website compiling mainly Coalition casualties, but also Iraqis death, based on a compilation of reports by news agencies;[49]

"Iraq Living Conditions Survey" (ILCS),[50] a study by the UN Development Programme measuring living conditions in Iraq between April 2002 and April 2004;

Two surveys carried out by Johns Hopkins University's Bloomberg School of Public Health published in The Lancet, Britain's most respected medical journal. The first study[51] appeared in 2004 and estimated excess deaths between March 2003 and September 2004. The most recent Hopkins study[52] was published in October 2006 and covered the much longer period from March 2003 to June 2006.