UCSF Teach-in Focuses on Health Effects of Iraq War

About 500 people experienced a sobering and uncensored assessment of the catastrophic health effects of the Iraq war on combatants and civilians at a symposium at UCSF on May 9.

UCSF faculty joined experts from across the country and Iraq to deliver a critical review of the war and its impact on Iraqis and Americans. Some speakers issued powerful and passionate calls to action supporting veterans and speaking out about the war. Audience members also were able to sign a petition calling on Congress to put an end to the carnage.

Organized by the campus Iraq Action Group, the symposium was UCSF's first-ever public forum focusing on the casualties and consequences of the four-year-old conflict. The Iraq Action Group is an alliance of students, faculty and staff united to educate each other, the campus community and the public about the health effects of the Iraq war on American and Iraqi citizens and soldiers.

So far, the war has killed 3,400 US soldiers and wounded about 34,000. The economic impact on the United States is estimated at $2 trillion, according to news reports. In his opening remarks delivered via video, Haile Debas, MD, executive director of UCSF Global Health Sciences and former UCSF chancellor and dean of the UCSF School of Medicine, said he hopes the UCSF teach-in will spark similar events at other universities. "We have a moral obligation to examine the health effects of the war," Debas said. "We have been silent too long."

"This is a truly a historic moment in the UCSF community, which has taken the time and energy to engage in a discourse" about the war, said Jess Ghannam, PhD, a clinical professor of psychiatry who is part of Global Health Sciences at UCSF.

While Iraq once had universal health care, today most hospitals are ill equipped and understaffed, Ghannam said. He urged colleagues "not to hide behind the cover of an academic health care institution" and rally against the war. Often asked if he is afraid of taking an anti-war stand, Ghannam said simply: "What keeps me up at night is not speaking out."

Iraqi-American physician Dahlia Wasfi, MD, vehemently blasted the war, personalizing the conflict by showing photos of her friends and family and explaining that lives of Iraqi citizens have been forever changed. She read an email from a friend living in Baghdad who fears for her life while walking to work. Her friend's father was kidnapped and, although her family paid the ransom money, they have not heard a word in more than a month.

Many women, once productive members of the Iraqi workforce, are prisoners in their own homes today, Wasfi pointed out. Wasfi noted that 68 percent of Iraqis are without clean water and 81 percent are without working sewers. One in eight children dies by age 5, Wasfi said. She also showed shocking images of people who she alleged were exposed to white phosphorus - a weapon that can cause burning of the flesh — reportedly used in the offensive on the Iraqi city of Fallujah.

"This is not a war on terror; this is a war of terror," said Wasfi, who received a standing ovation after her speech.

Getting an accurate death toll of Iraqi citizens is challenging, with Iraqi Ministry of Health and morgues not properly keeping track, according to Richard Garfield, DrPH, a professor in the School of Nursing at Columbia University. He estimates that about 650,000 Iraqi civilians have died, based on a population-based household survey he worked on, which was reported in the Lancet.

Garfield said it's the responsibility of the world community to work for a more comprehensive accounting to "memorialize their deaths."

'Shameful Period'

Describing the times as a "shameful period for media," nationally syndicated San Francisco Chronicle columnist Robert Scheer criticized the mainstream press and pundits for their filtered and faulty accounts of the run-up to the war and the many failures during its execution. A Los Angeles Times columnist for 30 years, Scheer was one of the first, lone voices to question the rationale of the war well before it was launched in March 2003, when post-9/11 outrage was being misdirected toward Iraq.

In his keynote address, Scheer also pointed out the apathy and inaction across the nation's universities, where few demonstrations have been staged. Most of the criticisms by Scheer and other speakers at the teach-in were directed toward the Bush administration for its discredited claims about Iraq's weapons of mass destruction and involvement in the Sept. 11, 2001, attacks, as well as the overall mismanagement of the war.

Since the election last November, opinion polls continue to show that the war is unpopular with the American people. "The public has come to recognize that it's largely a disaster," said Scheer.

Even those closely involved with the Bush administration's decision to go to war, the latest being George Tenet, former director of the Central Intelligence Agency, and some of those who voted in Congress to authorize it, including Republicans, are distancing themselves from the war and the White House. "Imperial ventures," as Scheer described the war, usually serve powerful, corporate interests, like Halliburton, rather than most people, who have seen gas prices soar and federal budgets for domestic programs like health care, research and education decrease. Civil liberties also have been compromised, he said, from torturing Iraqis to warrantless wiretapping of US citizens.

Among other highlights of the teach-in:

• About 1,700 US soldiers have suffered severe traumatic brain injuries in combat so far, which is likely to cost the United States $20 billion over the next 20 years, according to William Schecter, MD, chief of surgery at San Francisco General Hospital.
• Post-traumatic stress disorder (PTSD) has lasting effects on soldiers and their spouses and children, transcending a generation and lasting 30 years or more, according to Charles Marmar, MD, chief of mental health services at San Francisco Veterans Affairs Medical Center (VAMC), who recounted lessons learned from Vietnam. Unlike in Vietnam, where women served as nurses rather than combatants, 13 percent of soldiers in Iraq and Afghanistan are women, many in combat situations.
• Of 103,788 US veterans from Iraq and Afghanistan seeking treatment at VAMC clinics throughout the nation, 25 percent received one or more mental health diagnoses, with most involving complex, multiple diagnoses that require more time and treatment, according to Karen Seal, MD, MPH, a physician in general internal medicine at SFVAMC. Despite such diagnoses, veterans have a huge "no-show rate" for appointments, with stigma of mental health being the biggest barrier, she noted. SFVAMC is offering telephone and Internet-based intervention programs to bridge the gap.