Weapons of mass reconstruction

While companies slaver over the multimillion dollar building
contracts that seem to be the most immediate spoils of the war in
Iraq, there are quieter, more seemly, preparations being made that
will have just as much impact on the country’s long-term
reconstruction. Child protection schemes and home visiting for
older people might not be making the headlines, but it is projects
like these that will ultimately help repair the social fabric of a
country whose welfare system was once the envy of the Arab world,
but has now been torn apart by the recent hostilities and years of
conflict, sanctions and deprivation.

For the local social care professionals, volunteers and expatriate
aid workers who are struggling to help Iraq’s most vulnerable
people, the challenge is immense. Security is still uncertain, much
of the country’s infrastructure has been destroyed and many social
care projects have stalled through lack of staff, loss of equipment
and a displaced clientele. Others have managed to continue
throughout the conflict. And with parts of the country previously
controlled by the government of Iraq soon expected to open up to
aid agencies, many are planning to expand their activities.

In the northern Iraqi region of Dohuk, Christine Smith has been
back at her desk for just two days. Pulled out of Iraq just before
the war on advice from the Foreign Office, she has returned to
continue her work as a project manager for an innovative home
visiting programme funded by HelpAge International.

The scheme, which has been running since 1997, aims to provide
psychosocial support, health care and other forms of practical help
to the region’s most vulnerable older people and their
families.

“As in any region affected by war, the elderly here are
particularly vulnerable,” says Smith. “They may become isolated,
lose access to essential health care and, due to frailty, be unable
to displace themselves to safer areas. Many have lost family
members in previous conflicts and are now caring for their orphaned
grandchildren. About 20 per cent of older people here are
responsible for children.”

Older people in northern Iraq have also been particularly affected
by the years of economic sanctions imposed since the last Gulf war
ended in 1991. Economic collapse has led to high unemployment and a
severe reduction in pension provision. Many older people have lost
their property and livelihoods at least once in their lives and the
United Nations’ Oil for Food programme has reduced agricultural
activities on which many older Kurds depended. Two-thirds of the
population of northern Iraq now survive on the monthly food ration.
Although social services do exist they are limited and are usually
targeted at children and families.

To help address these issues the HelpAge International programme
uses community-based staff and organisations to visit older people
in their homes and assess their needs for social support and access
to health care. The programme can then offer practical assistance,
for instance by supplying a wheelchair, delivering medicines or
helping renovate a dilapidated property. The programme has also
conducted a three-year project to raise the profile of older people
and ensure that they are actively included in the social and
economic life of their community.

Smith is one of two international managers of the programme which
also employs 88 national staff and 660 volunteers in the Kurdish
regions of Dohuk and New Kirkuk. The international staff were moved
from the areas during the war, but the national staff and
volunteers remained and tried to keep the programme running.

“Dohuk wasn’t really affected by the war so, other than having to
deal with a lot of extra people who moved into the area to get away
from the fighting, our volunteers were able to continue the home
visiting programme without too many problems,” says Smith. “On the
eastern side, however, most people left the area during the early
stages of the war so the programme was suspended. Most of the
volunteers and clients are back now so things should be returning
to normal.”

Indeed, war and displacement have become such a way of life for
people in this troubled region that many of those returning home
have been able to take the disruption in their stride.

“Many of these older people have experienced a number of conflicts
in their lives so this is more of what they have lived through many
times,” says Smith.

Now that the war is over it is possible that HelpAge International
may extend its activities into previously inaccessible areas,
although Smith emphasises that it is still too early to make any
firm commitments. “At the moment the situation is unclear and the
HelpAge future programme is being reassessed,” she says. “We are
planning to conduct a security assessment of the situation in Mosul
and to assess the needs of elderly people there. But it is too
early to say what happens next. I’m just pleased to be back and I
would say I’m fairly hopeful for the future.”

Like HelpAge International, most aid agencies have been prevented
by the unstable security situation and uncertainty over the
establishment of an interim government of Iraq from making plans
beyond the immediate need for emergency relief. Denied access to
government-controlled areas of the country, most of the pre-war
programmes were based in Kurdish controlled northern Iraq. As the
rest of the country opens up, however, many will be seeking to
address the huge need for social care projects throughout Iraq (see
panel, overleaf).

Save the Children is keen to extend the child protection work it
has been carrying out with sections of the de facto Kurdish
government, focusing on children in institutions and the juvenile
justice system. The charity’s own research has identified a
significant problem of institutionalised abuse in Iraqi children’s
homes and it is offering training in child protection to government
staff, non-government organisations, the UN and the military. Other
projects include a scheme to train teachers in supporting children
who have been traumatised by the war.

Care International is also planning to develop social care
programmes. Middle East project officer Mara El Ansary says: “We
expect the emergency situation to last at least another two months
and our main priorities at the moment are water and sanitation. But
once things have improved we will be looking towards more long-term
sustainable projects with a focus on education and measures to
strengthen civil society.”

In particular the charity intends to develop programmes to improve
the education of girls, long neglected under the previous Iraqi
regime.

There is unlikely to be much of a role for British social care
professionals in the reconstruction of Iraq. Most aid agencies are
keen to stress that, although there may be a limited need for
trainers and project administrators, the front-line work will be
carried out by Iraqi nationals. This tallies with a Community Care
website poll in which more than 60 per cent of respondents said
they did not think it was feasible for British social workers to
make a significant contribution to the reconstruction of Iraq
(news, page 8, 17 April).

Dr Sultan Barakat, director of the post-war reconstruction and
development unit at York University, says the last thing Iraq needs
is for Western “experts” to start imposing new systems and
structures on the country.

“Lessons learned from all over the world in the past 20 years show
that running reconstruction activities like a military campaign –
from the top down – is expensive, unsustainable and ineffective,”
he says.

Instead Barakat believes that all reconstruction activities,
including re-establishing social support structures, must draw on
the “expertise and enthusiasm of the Iraqi people”.

“The idea that Iraq was a completely dysfunctional society is
totally wrong,” he says. “After the last Gulf war they virtually
rebuilt the country in much less time than it has taken the
international community to reconstruct places like Somalia.”

Indeed, Barakat believes that one of the major challenges ahead for
Iraq will be the transition from a highly centralised, socialist
system to the kind of free-market economy likely to be encouraged
by the US authorities and the World Bank.

The challenge is to try to marry free-market economics with the
social support that Iraqis enjoyed in the early 1980s – a tricky
task indeed. What is certain is that there’s a long way to go
before Iraq can reclaim its place as the Arab world’s beacon of
social care.

How social support vanished 

Iraq once offered its people some of the most progressive social
support in the Middle East. During the 1980s it had an extensive
and sophisticated public health care system, free access to
education and a national welfare system to protect poor people. Its
1980 social welfare law made Iraq the first Arab country to
recognise the medical, educational and economic rights of disabled
people. Until 1991 at least 3 per cent of every employer’s staff
had to be disabled.  

Today, however, much of this social support has disappeared.
Even before the recent conflict, the combined effect of two major
wars and 13 years of sanctions had taken their toll on Iraq’s most
vulnerable people.   The national welfare system that guaranteed
destitute people a monthly cash allowance of about £100
virtually collapsed in the mid-1990s and by 1994 the ministry of
labour and social affairs had officially stopped registering new
cases.  

By 1999 facilities to educate and train disabled children had
been reduced to 30 per cent of their 1990 level and the number of
street children referred to rehabilitation centres had increased at
least five-fold since the early 1990s. 

Meanwhile, the effects of war and deprivation were exerting a
telling toll on the nation’s mental health. From 1990 to 1998 the
number of mental health patients attending health facilities rose
by 157 per cent.   But it was older people who were most severely
affected by the collapse of the Iraqi economy with its attendant
inflation and currency devaluation. First, the value of their life
savings was eroded and many resorted to selling off their
properties and household goods. 

Many also lost their sons either in the Iraq-Iran war or in the
1991 Gulf war. With no funds and no one to take care of them, many
older people succumbed to hunger and disease. Little of the social
support that remained in Iraq was directed towards older people and
by 1999 there were only three older people’s care homes left in the
entire country.