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Interview: Dr. Michael Van Rooyen Discusses The Potential Disruption Of Food And Medical Services In Iraq In The Event Of War

All Things Considered: February 16, 2003

Humanitarian Groups Prepare for Possible U.S. War on Iraq


In the wake of any war in Iraq, the United Nations is planning for the possibility of feeding up to 10 million civilians, and as in any war, someone may end up having to care for millions of potential refugees. Humanitarian agencies met this weekend in Geneva to discuss what to do. Twenty-nine countries sent representatives to the meeting called by the Swiss government. The United States chose not to attend, though the US military says it is already stockpiling food in the Persian Gulf region.

Dr. Michael van Rooyen just finished a trip to that region. He directs the Johns Hopkins Center for International Emergency and Refugee Services(ph), and he recently spent 10 days inside Iraq.

Dr. van Rooyen, welcome.

Dr. MICHAEL VAN ROOYEN (Johns Hopkins Center for International Emergency and Refugee Services): Thank you.

INSKEEP: What are your biggest worries for civilians in the event of a war?

Dr. VAN ROOYEN: The largest two worries are the food distribution system, which really delivers this massive amount of food aid to 16 million Iraqis. Then the second major problem is just the tenuous nature of water and sanitation. And, again, things that most of the people in urban Iraq, the major cities, have access to clean water and about half of them in rural areas. But if the system is disrupted, it leads to this massive increase in diarrheal illnesses, and this increase can be a huge catastrophe.

INSKEEP: This is a country that's got something of a hospital system. It's a country that has certainly dealt with a lot of war casualties in the past, had an incredibly bloody war during the 1980s against Iran. But is this system ready to handle a lot of war casualties, civilian casualties, if a war were to turn out that way?

Dr. VAN ROOYEN: Well, Steve, I was actually particularly interested in that because I'm an emergency physician. And, really, I thought that their level of preparedness to handle war casualties was pretty poor. You know, their blood banking facilities are tenuous. The access to surgeons is limited. Their emergency care facilities are fragile and poorly stocked. And while there's some excellent providers and a number of, you know, professionals that have had some experience in this, their ability to care for a large number of trauma patients and injured patients and even the follow-up patients that get communicable diseases is, really, very limited, I thought.

INSKEEP: Did you get a chance to talk to many civilians in Iraq?

Dr. VAN ROOYEN: We did, actually. We got to talk to patients in hospitals, to people on the street. We had actually pretty good access.

INSKEEP: What kind of preparations did individuals seem to be making?

Dr. VAN ROOYEN: Most of the individuals and health providers and even hospital leaders were, really, less concerned with the impending war and the potential for conflict and more concerned with sanctions. So they wanted to talk more about the problems they were having with sanctions and with constraints. But when it came to planning for war, people were aware of the, you know, potential, but they had not done that much to prepare and didn't plan to do very much to prepare.

INSKEEP: I'm trying to figure that one out. I assume somebody's told them that war might be imminent.

Dr. VAN ROOYEN: Well, yeah. I mean, you know, even in the Iraqi press, you know, while there's certainly a spin, there's a lot of talk about the buildup and the potential for this. So, you know, people are fairly well-educated to this. I think it was with an air of resignation that, you know, there's not much--they don't have much anyway, so what are they going to prepare for?

INSKEEP: Dr. Michael van Rooyen just finished a trip to Iraq. He is the director of the Johns Hopkins Center for International Emergency and Refugee Services in Baltimore. Dr. van Rooyen, thanks very much.

Dr. VAN ROOYEN: My pleasure.

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