27 February 1997
Dr Hiroshi Nakajima, Director-General of the World Health Organization (WHO) accompanied by Dr Hussein Gezairy, Regional Director of the Eastern Mediterranean Office, paid a four-day visit to Iraq to observe the health situation in the country and examine the details of the implementation of UN Security Council Resolution (SCR) 986, which authorizes the sale of oil in return for the provision of food and medicines.
They visited Najaf, Kerbela, Babil and Baghdad governorates' health facilities, which suffer from a series of problems caused by lack of medicines and essential supplies as well as breakdowns in equipment and other logistical and managerial problems. Erratic electrical current is a major cause of breakdowns in the cold chain. This is a vital element in the expanded immunization programme and the eradication of polio under the WHO Mediterranean Caucasian and Central Asia (MECACAR) initiative.
Government drug warehouses and pharmacies have few stocks of medicines and medical supplies. In a large suburb of Baghdad, the Director-General saw queues of patients waiting to receive medicine. Stocks of medicines received for the month of February represented 30% of the normal needs of patients attending this facility. Moreover, eight essential medicines were not supplied as they were unavailable from "Kimedia", the State Company for Marketing Drugs and Medical Appliances. Basic medical materials, such as auto-destruct syringes, bandages or dressings are not available.
According to Dr Nakajima, "The consequences of this situation are causing a near breakdown of the health care system, which is reeling under the pressure of being deprived of medicine, other basic supplies and spare parts." He added that "its inability to cope with, and provide services which the Iraqi people used to receive is of grave concern." Diseases that were virtually under control are re-emerging. Malaria, and water-borne diseases such as typhoid have not reappeared but are now threatening large areas of the country that were never affected before.
The implementation of the Memorandum of Understanding (MOW) and the distribution plan of humanitarian commodities approved by the Secretary-General of the United Nations is being undertaken within the context of Security Council Resolution 986. During his visit, the Director-General was informed of the concerns of the Government of Iraq resulting from the delays encountered in receiving medicine and medical supplies.
In his discussions with the Iraqi authorities, Dr Nakajima offered the assistance of WHO in the overall implementation of SCR 986. He urged all parties concerned to "develop a spirit of closer cooperation in making this operation a success, keeping in mind the urgent need to improve the health conditions of the people of Iraq."
The Memorandum of Understanding envisages a dual role for WHO in operating humanitarian relief operations in Iraq:
The role of "observer" to ensure the equitable distribution of health commodities imported into Iraq, valued at US$210 million in the first six-month period.
The role of "implementor" for the health system in the northern governorates, to distribute US$28.8 million worth of medicines and medical supplies.
