Iraq: Inside Baghdad's 'ward of death'

DR ALI ISMAIL sat in his office, staring in front of him. "When Faisal Abbas died two days ago, I came here, closed the door, sat down and cried," he said. "I gave drugs to him from my own hands. He was like a brother to me. He was only 10 years old. He was diagnosed with leukaemia three years ago and we treated him with drugs; he received treatment, but it was only partial because we lack so many drugs."

He blamed the sanctions, of course, for blocking the medicines; and he blamed the 1991 war for turning his paediatric cancer ward into a way- station for dying children, for the infants who - given their first medicines - bleed to death in front of the doctors. There isn't a medical worker at the al-Mansur who doesn't believe that the West's arsenal in the 1991 Gulf war did not poison the land in which these children tried to grow up. "In three years, I have seen hundreds of children with leukaemia and last year there was a dramatic increase," Dr Ismail said. "This month, we diagnosed, 20 new cases, mostly from the south - from Basra, Nassariyeh, Kerbala and Najaf. It's mainly caused by radiation."

The doctors at the al-Mansur hospital in Baghdad have an odd way of expressing themselves, a scientific-emotional grammar. "We have palliative treatment but not curative treatment," the doctor explained to me, sighing all the while and still staring at the window.

When you walk into the child cancer ward across the hall, you understand why. Little Samar Khdair lies in what the doctors quite casually call the "ward of death". She is only five years old but looks much younger, lying shrivelled on her bed, her eyes squeezed shut with pain, her large, unwieldy father - massive in his grey gallibia robe amid such frailty and pain - gently placing a damp yellow compress on her face. She comes from al-Yusfia on the road to Babylon, the target of regular Allied raids in February 1991.

Samar's father, Jaber, looks poor because he is. He spent 15,000 dinars to buy cyto-toxins for his dying daughter - about pounds 6, but more than three months wages for Jaber. "I sold my car to buy the medicine for her," he told us quietly. And how would he pay for the next dose, we asked? "I will borrow the money." Dr Ismail, who is resident doctor in the cancer ward, listened in silence. Then he said to us, in English: "I've seen these patients' families so many times. They sell everything in their house, even their beds - and then their child dies anyway."

You cannot move through Baghdad's "ward of death" without two emotions - a deep sense of unease, even shame, that "our" 1991 military victory over the cruel Saddam may well have created this purgatory of the innocent by poisoning both the air they breathe and the land they try to grow up in; and a profound admiration for the dignity of the poor Iraqis who sometimes sell their own clothes in a vain effort to save the children who die in their arms.

Nor can one remain unaffected by the bravery of these tiny victims. Ali Hillal is eight years old but looks about four, a weird fringe of hair across the top of his forehead accentuating his baldness. "Yesterday, he had a very severe headache," Dr Ismail said, smiling at the child. "He was screaming. When I gave him an injection between his vertebrae, he told me he knew the pain of the needle, but that he would be very quiet because he knows I want what is best for him."

Ali Hillal was malnourished when he was brought here from the town of Diala, east of Baghdad, his home next to a broadcasting transmitter and several factories that were heavily and repeatedly bombed by Allied aircraft in February, 1991. He is the fifth child of a family that has no history of cancer. "First he had the mumps, then he had swelling in his chest and abdomen," Dr Ismail said. "Now the tumour has reached his brain. When the condition reaches this point, the prognosis is very poor."

Ali's mother Fatima remembers the bombing. "There was a strange smell, a burning, choking smell, something like insecticide," she said. And I wondered, listening to her, about those bombs. Was she smelling nitrite, which the doctors blame for some of the leukaemias? Or had "we" bombed one of Saddam's chemical warfare plants?

Latif Abdul Sattar was playing with a small car when I caught sight of him. His smile, beneath the dome of his baldness, suggested life. Diagnosed with non-Hodgkin's lymphoma three months ago, he has received two cycles of cyto-toxins. "But the third cycle is partial because he's getting only cyclophosphamide adriamycin as a substitute for vincristine," Dr Ismail said. What Latif needs is produced by a company in Germany called Astra Medica. "We received 20 vials of this 10 days ago - before that, the patients' families were buying it for 160,000 dinars [more than two years' salary for many Iraqis]. But still we can't get enough. Latif needs the treatment as long as his malignancy continues."

Dr Ismail continued his rounds. Youssef Abdul Raouf Mohamed from Kerbala - close to military bases bombed in 1991 - has gastro-intestinal bleeding. He still has his curly hair and can talk to his parents but has small blood spots in his cheeks, a sure sign of internal bleeding. And Dr Ismail is bothered by a memory. "Since the UN embargo, patients often die before they can receive induction treatment," he says. "They get thrombocytopenia, a severe reduction of blood platelets. They start bleeding everywhere. We had another child like Youssef. He was called Ahmed Fleah. And after we started the cyto-toxin treatment, he started bleeding from his mouth, eyes, ears, nose, and rectum. He bled to death in two weeks."