On 24 July, the Independent reported the results of a questionnaire survey conducted in Fallujah in January and February. These included a twelve-fold increase in the risk of cancer for under-14s (compared to rates in the Middle East Cancer Registry), and an anomalous birth sex-ratio (the ratio of girls to boys) in children under five (Patrick Cockburn, “Toxic legacy of US assault on Fallujah ‘worse than Hiroshima’”).
The Iraqi city has been the site of some of the worst atrocities of the US occupation – including two major massacres, involving massive bombardment of the city in April and November 2004. This July, Reuters reported that the city still had no functioning sewage system. Iraqi doctors have reported a dramatic rise in birth defects since the 2004 offensives, as well as increased cancer rates, and depleted uranium weapons – which are not known to have been used in Fallujah – have been raised as a possible factor.
“Poor scientifically”
So how well does the new evidence stand up? The source for the new cancer claims is a paper by Chris Busby, Malak Hamdan and Entesar Ariabi, “Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005–2009”, published in the peer-reviewed International Journal of Environmental Research and Public Health (IJERP).
A similar survey conducted by Dr Busby, concerning increased cancer mortality risks near Hinkley Point nuclear power station (“Cancer in Burnham on Sea North – Results of the PCAH Questionnaire, 2002”) was strongly criticised by the UK government’s expert advisory Committee on Medical Aspects of Radiation in the Environment (COMARE).
Indeed, COMARE – which claims never to have drawn any members from either the nuclear or electrical power supply industries – concluded that the Burnham survey “provide[d] no reliable information whatsoever about cancer in Burnham on Sea” and was “so poor scientifically that it would not be acceptable for publication in any reputable professional journal”.
Suggestive but nothing more
Aware of these criticisms, PN asked Dr Richard Garfield, professor of Clinical International Nursing at Columbia University, an expert in assessment of mortality in humanitarian crises and co-author of the well-known 2004 Lancet-published survey on post-invasion mortality in Iraq, for comment. “The paper overall look[s] reasonable,” he told PN. “I think they went to good efforts to be transparent with the information they had. It does seem that there is an excess cancer rate but it is somewhat difficult to interpret such information as verbal autopsy (which is what this is called) is notoriously unreliable, so again we have suggestive information but nothing more.
“This can be seen in their data on child deaths; it is virtually impossible that there were no deaths in 2004 or 2005, and then 10 in the last year – this is highly biased recall.”
All of which suggests that those wishing to help the long-suffering people of Fallujah should demand an unimpeachable and properly resourced study.