Last month, the World Health Organisation (WHO) published a long awaited document summarising the findings of an in-depth investigation into the prevalence of congenital birth defects (CBD) in Iraq, which many experts believe is linked to the use of depleted uranium (DU) munitions by Allied forces. According to the 'summary report':
"The rates for spontaneous abortion, stillbirths and congenital birth defects found in the study are consistent with or even lower than international estimates. The study provides no clear evidence to suggest an unusually high rate of congenital birth defects in Iraq."
Jaffar Hussain, WHO's Head of Mission in Iraq, said that the report is based on survey techniques that are "renowned worldwide" and that the study was peer reviewed "extensively" by international experts.
But the conclusions contrasted dramatically from previous statements about the research findings from Iraqi Ministry of Health (MOH) officials involved in the study. Earlier this year, BBC News spoke to MOH researchers who confirmed the joint report would furnish "damning evidence" that rates of birth defects are higher in areas experiencing heavy fighting in the 2003 war. In an early press release, WHO similarly acknowledged "existing MOH statistics showing high number of CBD cases" in the "high risk" areas selected for study.
The publication of this 'summary document' on the World Health Organisation's website has raised questions from independent experts and former United Nations and WHO officials, who question the validity of its findings and its anonymous authorship. They highlight the existence of abundant research demonstrating not only significant rates of congenital birth defects in many areas of Iraq, but also a plausible link to the impact of depleted uranium.
For years, medical doctors in Iraq have reported "a high level of birth defects." Other peer-reviewed studies have documented a dramatic increase in infant mortality, cancer and leukaemia in the aftermath of US military bombardment. In Fallujah, doctors are witnessing a "massive unprecedented number" of heart defects, and an increase in the number of nervous system defects. Analysis of pre-2003 data compared to now showed that "the rate of congenital heart defects was 95 per 1,000 births - 13 times the rate found in Europe."
The purpose of the WHO study was to probe the data further, but some say the project is deeply flawed.
Dr. Keith Bavistock of the Department of Environmental Science, University of Eastern Finland, is a retired 13-year WHO expert on radiation and health. He told me that the new 'summary document' was at best "disappointing." He condemned the decision from "the very outset to preclude the possibility of looking at the extent to which the increase of birth defects is linked to the use of depleted uranium", and further slammed the document's lack of scientific credibility.
"This document is not of scientific quality. It wouldn't pass peer review in one of the worst journals. One of the biggest methodological problems, among many, is that the document does not even attempt to look at existing medical records in Iraqi hospitals - these are proper clinical records which document the diagnoses of the relevant cases being actually discovered by Iraqi doctors. These medics collecting clinical records are reporting higher birth defects than the study acknowledges. Instead, the document focuses on interviews with mothers as a basis for diagnosis, many of whom are traumatised in this environment, their memories unreliable, and are not qualified to make diagnosis."
I asked Dr. Baverstock if, given the document's avoidance of analysing the key evidence - clinical records compiled by Iraqi medics - there was reason to believe the research findings were compromised under political pressure. He said:
"The way this document has been produced is extremely suspicious. There are question marks about the role of the US and UK, who have a conflict of interest in this sort of study due to compensation issues that might arise from findings determining a link between higher birth defects and DU. I can say that the US and UK have been very reluctant to disclose the locations of DU deployment, which might throw further light on this correlation."
If so, it would not be the first time the WHO had reportedly quashed research on DU potentially embarrassing for the Allies. In 2001, Baverstock was on the editorial board for a WHO research project clearing the US and UK of responsibility for environmental health hazards involved in DU deployment. His detailed editorial recommendations accounting for new research proving uranium's nature as as a genotoxin (capable of changing DNA) were ignored and overruled:
"My editorial changes were suppressed, even though some of the research was from Department of Defense studies looking at subjects who had ingested DU from friendly fire, clearly proving that DU was genutoxic."
Baverstock then co-authored his own scientific paper on the subject arguing for plausibility of the link between DU and high rates of birth defects in Iraq, but said that WHO blocked publication of the study "because they didn't like its conclusions."
"The extent to which scientific principles are being bent to fit politically convenient conclusions is alarming", said Baverstock.
Environmental contamination from the Iraq War
Other independent experts have also weighed in criticising the WHO study. The British medical journal, The Lancet, reports that despite the study's claims, a "scientific standard of peer review... may not have been fully achieved."
One scientist named as a peer-reviewer for the project, Simon Cousens, professor of epidemiology and statistics at London School of Hygiene and Tropical Medicine (LSHTM), told The Lancet that he "attended a relatively brief meeting of around one and a half hours, so just gave some comments on an early presentation of the results. I wouldn't classify that as thorough peer review."
Just how distant the new WHO-sponsored study is from the last decade's scientific literature is clear from a new report released earlier this year by a Tokyo-based NGO, Human Rights Now (HRN), which conducted a review of the existing literature as well as a fact-finding mission to Fallujah.
The HRN report investigated recorded birth defects at a major hospital in Fallujah for the year 2012, confirmed first hand birth defect incidences over a one-month period in 2013, and interviewed doctors and parents of children born with birth defects. The report concluded there was:
"... an extraordinary situation of congenital birth defects in both nature and quantity. The investigation demonstrated a significant rise of these health consequences in the period following the war... An overview of scientific literature relating to the effects of uranium and heavy metals associated with munitions used in the 2003 Iraq War and occupation, together with potential exposure pathways, strongly suggest that environmental contamination resulting from combat during the Iraq War may be playing a significant role in the observed rate of birth defects."
The report criticised both the UN and the WHO for approaches that are "insufficient to meet the needs of the issues within their mandate."
According to Hans von Sponeck, former UN assistant secretary general and UN humanitarian coordinator for Iraq, the gap between previous claims made by MOH researchers about the study, and the new 'summary document', justified public scepticism.
"The brevity of this report is unacceptable", he told me:
"Everybody was expecting a proper, professional scientific paper, with properly scrutinised and checkable empirical data. Although I would be guarded about jumping to conclusions, WHO cannot be surprised if people ask questions about whether the body is giving into bilateral political pressures."
Von Sponeck said that US political pressure on WHO had scuppered previous investigations into the impact of DU on Iraq:
"I served in Baghdad and was confronted with the reality of the environmental impact of DU. In 2001, I saw in Geneva how a WHO mission to conduct on-spot assessments in Basra and southern Iraq, where depleted uranium had led to devastating environmental health problems, was aborted under US political pressure."
I asked him if such political pressure on the UN body could explain the unscientific nature of the latest report. "It would not be surprising if such US pressure has continued", he said:
"There is definitive evidence of an alarming rise in birth defects, leukaemia, cancer and other carcinogenic diseases in Iraq after the war. Looking at the stark difference between previous descriptions of the WHO study's findings and this new report, it seems that someone, somewhere clumsily decided that they would not release these damning findings, but instead obscure them."
The International Coalition to Ban Depleted Uranium (ICBUW) has called for WHO to release the project's data-set so that it can be subjected to independent, transparent analysis. The UN body continues to ignore these calls and defend the integrity of the research.