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Opportunities Lost: Political Interference in the Systematic Collection of Population Health Data During and After the 2003 War in Iraq

Published online by Cambridge University Press:  09 March 2020

Frederick M. Burkle Jr*
Affiliation:
Harvard Humanitarian Initiative, Harvard University and Harvard TH Chan School of Public Health, Cambridge, MA Woodrow Wilson International Center for Scholars, Washington, DC
*
Correspondence and reprint requests to Frederick M. Burkle Jr, Harvard Humanitarian Initiative, Harvard University and Harvard TH Chan School of Public Health, 14 Story Street, 2nd Floor, Cambridge, MA02138 (e-mails: [email protected]; [email protected])

Abstract

The review of the article, “Developing a Public Health Monitoring System in a War-torn Region: A Field Report from Iraqi Kurdistan,” prompted the writing of this commentary. Decisions to implement health data systems within Iraq require exploration of many otherwise undisclosed or unknown historical facts that led to the politicization of and ultimate demise of the pre-2003 Iraq war systematic health data monitoring system designed to mitigate both direct and indirect mortality and morbidity. Absent from the field report’s otherwise accurate history leading up to and following the war is the politically led process by which the original surveillance system planned for the war and its aftermath was destroyed. The successful politicization of the otherwise extensively planned for public health monitoring in 2003 and its legacy harmed any future attempts to implement similar monitoring systems in succeeding wars and conflicts. Warring factions only collect military casualty data. The field report outlines current attempts to begin again in building a systematic health monitoring system emphasizing it is the “only way to manage the complex post-war events that continue to lead to disproportionate preventable mortality and morbidity.”

Type
Commentary
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

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References

REFERENCES

Clairmont, N. Those who do not learn history are doomed to repeat it – really? July 31, 2013, Big Think. https://bigthink.com/the-proverbial-skeptic/those-who-do-not-learn-history-doomed-to-repeat-it-really. Accessed July 18, 2019.Google Scholar
Guha-Sapir, D, Revel, JP, Lechat, MF. CISFAM: consolidated information system for famine management in Africa. Geneva: Centre for Research on the Epidemiology of Disasters and World Health Organization; 1987.Google Scholar
Guha-Sapir, D, Degomme, O, Phelan, M. Darfur: counting the deaths. Brussels, Belgium: University of Louvain, Center for Research on the Epidemiology of Disasters; 2005.Google Scholar
Murray, CJ, King, G, Lopez, AD, et al. Armed conflict as a public health problem. BMJ. 2002;324(7333):346-349.10.1136/bmj.324.7333.346CrossRefGoogle ScholarPubMed
Ghobarah, H, Huth, P, Russett, B. Civil wars kill and maim people – long after the shooting Stops. American Political Science Review. 2003;97(2):189-202. doi: 10.1017/S0003055403000613.CrossRefGoogle Scholar
Lacina, BA, Gledistch, NP. Monitoring trends in global combat: a new dataset of battle deaths. Eur J Popul Rev. 2005;21:145-166.CrossRefGoogle Scholar
Burkle, FM Jr, Garfield, R. Civilian mortality after the 2003 invasion of Iraq. Lancet. 2013;381(9870):877-879. doi: 10.1016/S0140-6736(12)62196-5.CrossRefGoogle ScholarPubMed
Burkle, FM Jr. Antisocial personality disorder and pathological narcissism in prolonged conflicts and wars of the 21st century. Disaster Med Public Health Prep. 2016;10(1):118-128.10.1017/dmp.2015.113CrossRefGoogle ScholarPubMed
The Future of Iraq Project. Public Health and Humanitarian Needs Working Group. US Department of State Case ID: 17 Jun 2005, 200304121. http://www.gwu.edu/http://www.gwu.edu/~nsarchiv/NSAEBB/NSAEBB198/FOI%20Public%20Health. Accessed July 20, 2019.Google Scholar
Shang-Ju, L, Flaxman, A, Lafta, R, et al. A novel method for verifying war mortality while estimating Iraqi direct war-related deaths for the Iran-Iraq war through Operation Desert Storm (1980–1993). PLoS One. 11(10):e0164709.Google Scholar
Mitchell, D, Massoud, TG. Anatomy of failure: Bush’s decision-making process and the Iraq war. Foreign Policy Anal. 2009;5:265-286.CrossRefGoogle Scholar
Galbraith, PW. The end of Iraq: how American incompetence created a war without end. New York: Simon and Shuster; 2006.Google Scholar
Burkle, FM Jr. Anatomy of an ambush: security risks facing international humanitarian assistance. Disasters. 2005;29(1):26-37.10.1111/j.0361-3666.2005.00272.xCrossRefGoogle ScholarPubMed
Woodward, B. State of denial. New York: Simon and Shuster; 2006.Google Scholar
Wright, DP, Reese, TR. Part II, transition to a new campaign. In: Contemporary Operations Study Team. Leading the new campaign: transitions in command and control in Operation Iraqi Freedom, On point 2: transition to the new campaign; The United States Army in Operation Iraqi Freedom. May 2003–Jan 2005. Washington, DC: United States Department of Defense; 2008.Google Scholar
Mason, P. Pharmaceutical chaos: e-mails from an academic pharmacist in Iraq. The Pharmaceutical Journal. January 29, 2005. https://www.pharmaceutical-journal.com/opinion/comment/pharmaceutical-chaos-e-mails-from-an-academic-pharmacist-in-iraq/10018290.article?firstPass=false. Accessed July 20, 2019.Google Scholar
Iraq family health survey study group violence-related mortality in Iraq from 2002–2006. N Engl J Med. 2008;358:484-493.CrossRefGoogle Scholar
Iraq Body Count Project 2003–12. Analysis and overview. January 2012. http://www.iraqbodycount.org/analysis/numbers/2011. Accessed November 20, 2012.Google Scholar
Henderson, SW, Olander, WE, Roberts, L. Reporting Iraqi civilian fatalities in time of war. Confl Health. 2009;3:9.10.1186/1752-1505-3-9CrossRefGoogle Scholar
Carpenter, D, Fuller, T, Roberts, L. WikiLeaks, and Iraq Body Count, the sum of parts may not add up to the whole – a comparison of two tallies of Iraqi civilian deaths. Prehosp Disaster Med. 2013; published online February 6. http://dx.doi.org/10.1017/S1049023X13000113. Accessed August 4, 2019.CrossRefGoogle Scholar
WikiLeaks. Iraq war logs. October 2010. http://wikileaks.org/irq. Accessed November 20, 2012.Google Scholar
Roberts, L, Lafta, R, Garfield, R, et al. Mortality before and after the 2003 invasion of Iraq: cluster sample survey. Lancet. 2004;364:1857-1864.10.1016/S0140-6736(04)17441-2CrossRefGoogle ScholarPubMed
Burnham, G, Lafta, R, Doocy, S, Roberts, L. Mortality after the 2003 invasion of Iraq: a cross-sectional cluster sample survey. Lancet. 2006;368:1421-1428.CrossRefGoogle ScholarPubMed
Political Videos. Transcript: Bush: Lancet study not credible. Videos and commentary from across the political spectrum. Political Videos. October 11, 2006. http://politicalvideos.blogspot.com/2006/10/bush-lancet-studynot-credible.html. Accessed January 23, 2013.Google Scholar
USIP. Iraq timeline: since the 2003 war. Tuesday, July 9, 2019, by Sarhang Hamasaeed and Garrett Nada. https://www.usip.org/publications/2019/07/iraq-timeline-2003-war. Accessed September 3, 2019.Google Scholar
UNICEF. Multiple Indicator Cluster Survey. UNICEF statistics and monitoring. https://www.unicef.org/statistics/index_24302.html. Accessed July 29, 2019.Google Scholar
Kerr, DL. Rebuilding Iraq’s healthcare system after 40 years of war. Medscape. March 6, 2019. https://www.medscape.com/viewarticle/909169. Accessed July 30, 2019.Google Scholar
Health Minister submitted resignation earlier but was rejected: Ministry. Baghdad Post, March 19, 2019. https://www.thebaghdadpost.com/en/Story/37456/Health-min-submitted-resignation-earlier-but-was-rejected-ministry. Accessed July 30, 2019.Google Scholar
USAID Iraq Health Update. Last updated: March 14, 2019. https://www.usaid.gov/iraq/health. Accessed July 23, 2019.Google Scholar
WHO Iraq. WHO Regional Director in Iraq to reinforce WHO support as country enters transition to development phase. July 15, 2019. https://reliefweb.int/report/iraq/who-regional-director-iraq-reinforce-who-support-country-enters-transition-development. Accessed July 23, 2019.Google Scholar
Tawfik-Shukor, A, Khoshnaw, H. The impact of health system governance and policy processes on health services in Iraqi Kurdistan. BMC Int Health Hum Rights. 2010;10:14.CrossRefGoogle ScholarPubMed
Al-Hamadani, AS, Jaff, D, Edwards, M. The factors impeding health system reform in Iraqi Kurdistan region. Med Confl Surviv. 2019;35:1, 80-102.10.1080/13623699.2018.1552239CrossRefGoogle ScholarPubMed
Moore, M, Anthony, CR, Lim, YW, et al. The future of health care in the Kurdistan Region – Iraq: toward an effective, high-quality system with an emphasis on primary care. Santa Monica, CA: Rand Health, Rand Corporation; 2014.CrossRefGoogle Scholar
Shukor, AR, Klazinga, NS, Kringos, DS. Primary care in an unstable security, humanitarian, economic and political context: the Kurdistan Region of Iraq. BMC Health Serv Res. 2017;17(1):592.10.1186/s12913-017-2501-zCrossRefGoogle Scholar
Anthony, CR, Moore, M, Hilborne, LH, et al. Health sector reform in the Kurdistan Region – Iraq: primary care management information system, physician dual practice finance reform, and quality of care training. Rand Health Qtr. 2018;8(2):1.Google ScholarPubMed
Burnham, G. Re: Advice: Message to FM Burkle, Tuesday, July 30, 2019, 6:39 AM via e-mail.Google Scholar
Kurdistan Region of Iraq, Part II. Humanitarian response plan. Humanitarian country team, Iraq. OCHA. February 26, 2019. http://www.humanitarianresponse.info/en/operations/iraq. Accessed July 23, 2019.Google Scholar
UN Office for the Coordination of Humanitarian Affairs (November 2018). Iraq: humanitarian needs overview 2019. December 16, 2018. Reliefweb. https://reliefweb.int/report/iraq/iraq-humanitarian-needs-overview-2019-november-2018. Accessed July 23, 2019.Google Scholar