BAGHDAD – The guns are gradually falling silent in Iraq as a fragile stability takes hold, turning the spotlight on a stealthier killer likely to stalk Iraqis for years to come.
Incidences of cancer, deformed babies and other health problems have risen sharply, Iraqi officials say, and many suspect contamination from weapons used in years of war and accompanying unchecked pollution as a cause.
"We have seen new kinds of cancer that were not recorded in Iraq before war in 2003, types of fibrous (soft tissue) cancer and bone cancer. These refer clearly to radiation as a cause," said Jawad al-Ali, an oncologist in Iraq's second city of Basra.
In the city of Falluja in western Iraq, scene of two of the fiercest battles between U.S. troops and insurgents after the 2003 U.S. invasion, a spike in the number of births of stillborn, deformed and paralyzed babies has alarmed doctors.
The use of depleted uranium in U.S. and coalition weaponry in the 1991 war to liberate Kuwait and the 2003 Iraq invasion is well documented, but establishing a link between the radioactive metal and health problems among Iraqis is hard, officials say.
Iraqi medical facilities are limited, and keeping accurate health statistics during years of sectarian slaughter unleashed by the invasion was impossible.
In Basra in particular, pummeled by years of war and swamped with industrial and agricultural pollution, it is difficult for doctors to isolate specific causes for cancer.
Its people have for years lived among mounds of scrap metal that include war debris, the brown rust flaking off into the wind and carried into peoples homes, food, and lungs.
"Our information indicates there are more than 200 square kilometers of land south of Basra containing war debris, some of which is contaminated with depleted uranium," said Bushra Ali, of the Environment Ministry's radiation prevention department.
A 2007 Basra University medical journal report found "no major rise" in cancer death rates, but that the proportion of children dying of cancer in Basra had jumped 65 percent in 1997 and 60 percent in 2005, compared to 1989.
CHILDREN SUFFERING MOST?
Depleted uranium, a dense metal, is used in weaponry to pierce heavy armor such as on tanks. Linking it to ill health is controversial — the British Ministry of Defense says there is "no reliable scientific or medical" evidence.
Large quantities of depleted uranium were used in the first Gulf War, some of it near Basra.
It is not clear how much, if any, was used in Falluja by U.S. troops fighting mostly house-to-house battles in two assaults on the city in 2004.
The U.S. military did, however, use white phosphorous, which can cause serious burns if it comes in contact with skin, to mark targets or to flush enemy gunmen out of their hideouts.
Five years later, doctors in Falluja are recording an unusual number of babies with congenital heart disease and neural tube defects, the latter involving abnormal spinal cord or brain development, which can cause paralysis and death.
"The marked increase of congenital malformations of newborns in this hospital pushed the hospital's board of directors to form a special committee to investigate and record these cases," said Abdulsatar Kadim, manager of Falluja's main hospital.
Doctors say they have not been able to isolate a specific cause. Several factors can trigger the condition, including a lack of folic acid during pregnancy.
A neural pediatric specialist, who declined to be named, said he was seeing on average three or four newborns with neural tube defects a week in Falluja and its surrounding areas, a region with a population of about 675,000 people.
In Britain, the incidence of the condition is less than 1 birth in every 1,000. Most births in and around Falluja are at its main hospital, where up to 30 are recorded daily, roughly equating to a neural tube defect rate of 14 in every 1,000.
"Some families decide to end the matter from the beginning. They choose to end the life of child, by refusing surgery for them — 90 percent of the children whom we don't treat die in the first year," said a Falluja doctor who declined to be named.