View Related Topics

                              December 28, 1998, Monday, Late Edition - Final

 SECTION: Section A; Page 12; Column 1; Foreign Desk

 LENGTH: 976 words

 HEADLINE: Iraq a Pediatrician's Hell: No Way to Stop the Dying

 BYLINE:  By STEPHEN KINZER

 DATELINE: BAGHDAD, Iraq, Dec. 27

 BODY:
 The greatest misfortune that has been visited on three-year-old Isra Ahmed was not contracting leukemia. It was
 contracting leukemia in Iraq at a time when the country's medical system is all but paralyzed as a result of economic
 sanctions imposed by the United Nations eight years ago.

 Since Isra's illness was diagnosed earlier this year, she has spent most of her time in the Saddam Central Teaching
 Hospital for Pediatrics in Baghdad. She bleeds profusely from her nose, gums and rectum. Her mother has bought her
 earrings and a colorful clip to bind her thinning hair into a pony tail, but whatever diversion she has is likely to be only
 temporary.

 In developed countries, the cure rate for leukemia approaches 70 percent. In Iraq it is near zero.

 "It's still not too late to save this girl's life if we can give her a bone-marrow transplant," said Dr. Jasim Mazin, the
 hospital's chief resident. "But we don't have the equipment to perform that kind of operation. We're helpless."

 In his five years at Saddam Central, virtually all of his leukemia patients have died. Their deaths, coupled with those who
 die of gastrointestinal diseases, diarrhea, dehydration and other easily curable ailments, have clearly taken a toll on him.
 He often works 20 hours a day, and although he is just 28, he looks nearly twice that age.

 "Iraq used to be the best country in the Arab world in terms of science and medicine," Dr. Mazin said as he made his
 rounds on a recent morning. "Now we can't even read medical journals, because they are covered by the embargo."

 "I can't believe I use disposable syringes on one patient after another, or perform operations with worn-out instruments
 in operating theaters that are not even disinfected," he said. "It's very difficult to work very hard on a patient, try to care
 for him, and then lose him because you can't get some silly thing that you could pick up in a drug store in any other
 country.

 "And this is the best-supplied children's hospital in Iraq. If you go out into the provinces, you see that things are much
 worse."

 The coordinator of United Nations relief programs here, Hans von Sponeck, toured hospitals outside Baghdad last month
 and reported that much of the equipment he saw "was fit only for a museum."

 He said some of it is actually endangering the health of patients and staff, and cited X-ray machines that leak radiation
 and malfunctioning incinerators that leave residues of toxic medical waste.

 Although the effect of sanctions is evident in every aspect of Iraqi life, there are few places where it is more poignantly
 visible than at hospitals like Saddam Central. According to United Nations figures, Government spending on medicine and
 medical equipment has fallen by more than 90 percent since the sanctions were imposed after Iraq invaded Kuwait in
 1990 and the country began spiraling into economic collapse. Not a single new hospital has been built in that time,
 although the country's population has grown from 15 million to 22 million.

 Iraqi doctors say conditions have improved since 1996, when the United Nations began allowing the Government to sell
 limited amounts of oil and use some of the income it earns to buy food and medicine. About $450 million worth of drugs
 and medical supplies have entered the country since then, though the United Nations says distribution is inadequate
 owing to "transport and logistic difficulties."

 The Clinton Administration defends sanctions as an indispensable part of the Western campaign to bring down President
 Saddam Hussein, whom Western powers have accused of threatening the Middle East by building weapons of mass
 destruction. The Administration has, however, signaled its willingness to consider an expansion of the oil-for-food program
 that could allow Iraq to improve the abysmal conditions into which its heath care system has fallen.

 Any improvement would probably come too late for most of the children now lying listlessly in their hospital beds here.

 "Inside the hospitals is where you have to go if you want to see why so much antagonism and resentment is building up
 here," said Kathy Kelly, who runs a Chicago-based group called Voices in the Wilderness that is campaigning against the
 sanctions and who is making her ninth visit to Iraq since 1990. "I've seen doctors go from super-heroes to almost clinically
 depressed."

 At Saddam Central, Dr. Mazin said he maintains his equilibrium by concentrating his mind on the children he has been able
 to save. He said his worst period came last April, when he lost about 75 children during a two-week epidemic of chest
 infections and gastroenteritis. Every one of them, he believes, could have been saved with antibiotics that are commonly
 available in neighboring countries.

 Some patients at Saddam Central need more than medicine. Among them is 16-month-old Affaf Hussein, whose facial
 irregularities suggest congenital deformity. He suffers from recurrent pneumonia, and his mother spends several hours
 each day holding a respirator over his face so he can inhale moist oxygen.

 "This child is very sick," Dr. Mazin said. "I believe he has some kind of genetic disorder, but we don't have the tools to
 diagnose what it is. We can't do anything for him."

 One of the few bright spots at Saddam Central is a beaming 10-year-old named Marua Tariq, who comes in for a check-up
 every month wearing her favorite brightly-patterned sweater. She has leukemia, but was released from the hospital six
 months ago after her case stabilized, and has shown no symptoms since then. If she can stay healthy for another four
 and a half years, she will be considered cured, the first such case since the sanctions began.

 "I'm feeling good and I'm studying hard at school," Marua said with a broad smile. "When I grow up I want to be a doctor
 who treats children."
 

 GRAPHIC: Photo: Three-year-old Isra Ahmed, who has leukemia, with her mother in a children's hospital in Baghdad. The
 leukemia cure rate is near zero. (Murad Sezer for The New York Times)
 

 LOAD-DATE: December 28, 1998