For other versions of this document, see http://wikileaks.org/wiki/CRS-RL31814 ------------------------------------------------------------------------------ Order Code RL31814 Report for Congress Received through the CRS Web Potential Humanitarian Issues in Post-War Iraq: An Overview for Congress March 18, 2003 Rhoda Margesson Foreign Affairs Analyst Foreign Affairs, Defense, and Trade Johanna Bockman Research Associate Foreign Affairs, Defense, and Trade Congressional Research Service ~ The Library of Congress Potential Humanitarian Issues in Post-War Iraq: An Overview for Congress Summary Since 1996, the Oil For Food Program (OFFP) has alleviated some of the worst effects of the 1991 Gulf-War international sanctions regime, but the humanitarian situation in Iraq (defined as an urgent need for food, shelter and basic health care) remains serious. While some improvements have been seen in nutrition, health services, water supply and sanitation, there is greater dependence on government services, and observers of the Iraq situation have identified disturbing health and nutrition problems affecting the civilian population. These have been tied to the consequences of war, sanctions, shortcomings of assistance, and the deliberate policies of the Iraqi regime. There seems to be a consensus that the current poor humanitarian situation inside Iraq could worsen during a conflict, though this would likely depend on the nature and duration of the conflict and the extent and quality of humanitarian assistance. Problems could arise from the following: malnutrition and disruption of food supplies, inadequate sanitation and clean water, and reduced health and medical care. The consequences of war in Iraq could also include a potential humanitarian emergency with population movements across borders or within Iraq itself. Given the challenge of current conditions in Iraq, U.N. agencies indicate that a conflict in Iraq would disrupt critical infrastructure, delivery of basic services, and food distribution with the potential of severe humanitarian consequences. Relief agencies are having to plan for humanitarian needs amid great uncertainty about conditions in the aftermath of conflict. In recent months many have continued to reiterate that contingency planning does not mean they assumed war was inevitable. The Department of Defense (DOD) has set up an Office of Reconstruction and Humanitarian Assistance as a central point for those involved in humanitarian and reconstruction efforts. The group has developed an operational concept for the delivery of aid, relief coordination, and a transitional distribution system. This office is coordinating efforts with other U.S. agencies, including USAID and the State Department. U.S. forces are pre-positioning food and relief aid near Iraq and making plans to deal with a possible humanitarian crisis. Several issues are of critical interest to Congress, including food security, implementation and coordination of assistance, humanitarian relief activities during war, the impact of population movements, and humanitarian and reconstruction efforts after war. The information in this report reflects the situation prior to the start of the war in Iraq and is current as of March 18, 2003. This report will not be updated. For further information, please see CRS Report RL31833, Iraq: Recent Developments in Humanitarian and Reconstruction Assistance. Contents Current Humanitarian Situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Latest Developments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Malnutrition and Lack of Food Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Inadequate Sanitation and Clean Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Basic Health and Medical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Potential War-Related Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Food Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Sanitation and Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Other Humanitarian Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Contingency Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Aid Agency Preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Initial DOD Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 USAID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 International Organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 NGO Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Concerns of Relief Agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Preparation for Refugees and IDPs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Considerations for Congress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Food Security and the OFFP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Implementation and Coordination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Humanitarian Relief Activities During War . . . . . . . . . . . . . . . . . . . . . . . . 11 Impact of Population Movements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Humanitarian and Reconstruction Efforts After War . . . . . . . . . . . . . . . . . 12 List of Tables Comparative Population Statistics: Iraq, Afghanistan, and Saudi Arabia . . . . . . . 4 Potential Humanitarian Issues in Post-War Iraq: An Overview for Congress Current Humanitarian Situation Latest Developments With the Administration's announcement on March 17, 2003 giving Iraq a final 48 hour ultimatum and bringing a close to U.S. diplomatic efforts, the humanitarian situation appears to have shifted into a new phase. There are reports of Kurdish civilians either leaving cities located in possible combat zones or safeguarding their homes with sheets of plastic in the event of a chemical attack by Hussein. In Baghdad, civilians bought water and canned food, converted currency, and filled gas tanks in preparation for war. On March 18, 2003, the U.N. Secretary-General Kofi Annan authorized an immediate withdrawal of United Nations (U.N.) personnel from Iraq and suspended the Oil-for-Food Program (OFFP).1 Background During 1991-1996, surveys and studies suggest a precipitous continuing decline in the health and nutrition status of the Iraqi civilian population, especially among children and the elderly. However, because much of the information available on the conditions within Iraq is considered unreliable, it is difficult to determine how much of the suffering is due to the sanctions imposed on Iraq and how much is due to other factors, such as government policies.2 In general, there seems to be a consensus that the humanitarian situation remains precarious, and to some observers, a humanitarian crisis could arise from war.3 Iraq's population is estimated at between 24 and 27 million, which includes approximately 3.5 million children.4 According to the U.S. Committee for Refugees, there are more than 300,000 Iraqis living with refugee status in other countries; there 1 Iraq appears to still be allowed to export oil via Turkey as U.N. staff were evacuated only from inside Iraq. 2 Some groups question the accuracy of statistics published by the government, but have no independent sources of information. All estimates of the number of deaths due to lack of food or medical care vary widely based on the source. 3 "U.N. Official Warns of Iraqi Food Crisis," Washington Post, February 28, 2003. 4 Total population numbers for Iraq vary by source. UNICEF Humanitarian Action: Iraq Donor Update January 14, 2003. See [http://www.reliefweb.int]. CRS-2 are similar numbers of other Iraqis living elsewhere who have not been granted refugee status. Within Iraq, there are also possibly 700,000 internally displaced persons (IDPs).5 In addition, Iraq hosts refugees from other countries. The United Nations High Commissioner for Refugees (UNHCR) has four offices inside Iraq, and works primarily with 100,000 Palestinian, 23,000 Iranian and 13,000 Turkish refugees.6 Imposition of U.N. sanctions in 1991 followed a nearly decade-long war between Iraq and Iran, during which spending on the social welfare system declined. Decades of conflict, including the Iran-Iraq war and the bombing during Desert Storm, damaged or destroyed much of the Iraqi public infrastructure such as water and sewage plants and many public buildings. In response to these concerns, the United Nations and other humanitarian agencies have been providing aid to Iraq through the Oil-for-Food Program (OFFP), which uses revenue from Iraqi oil sales to buy food and medicines for the civilian population.7 Both bilateral and multilateral aid have continued to flow into the country since the end of the war, although it is difficult to assess the total amount provided by all donors outside the OFFP. Since 1996, the OFFP has alleviated some of the worst effects of the sanctions, but the humanitarian crisis (defined as an urgent need for food, shelter and basic health care) remains serious. While some improvements have been seen in nutrition, health services, water supply and sanitation, there is greater dependence on government services. Observers of the Iraq situation have identified disturbing health and nutrition problems affecting the civilian population. These have been tied to the consequences of war, sanctions, shortcomings of assistance, and the deliberate policies of the Iraqi regime. Some argue that supplies of water, food, medicine, and electricity are now a matter of urgent concern.8 Malnutrition and Lack of Food Security In part as a response to the devastation of the 1991 Persian Gulf War, the Iraqi government expanded its food distribution system to work in conjunction with the OFFP. Nearly 60 percent of the Iraqi population has been receiving monthly food distributions at a total cost of $290 million per month under the OFFP.9 As a result, 5 "Overview of Numbers and Conditions of Iraqi Refugees in the Middle East and Internally Displaced Persons in Iraq," U.S. Committee for Refugees, January 27, 3003. 6 "U.N. seeks $37.4 million Humanitarian Supplies in Case of Iraq War." Dow Jones International News, December 23, 2002. 7 For more information about the Oil-for-Food Program (OFFP) see CRS Report RL30472, Iraq: Oil-for-Food Program, International Sanctions, and Illicit Trade, by Kenneth Katzman. 8 "Agencies Fear Consequences But Plan for War in Iraq; Iraq stocks up food ahead of possible US War." Turkish Daily News, December 27, 2002. 9 "U.N. Sees Huge Aid Need in Case of War on Iraq," Reuters, December 23, 2002; "War could cut Iraqis' food lifeline - AID agencies mobilizing," Atlanta Journal and Constitution, (continued...) CRS-3 the minimum nutritional requirement per person/per day set by the U.N. Secretary General is nearly being reached. While this program has improved the situation, malnutrition remains a serious problem throughout the country, especially for children and other vulnerable groups. The rates of malnutrition in Iraqi children have reportedly increased from 18.7 percent in 1991 to 30 percent a decade later.10 Observers indicate that families cannot make their rations last the full month or need to sell part of them for other necessities. This leaves many people without any food stored in reserve and makes them vulnerable to food distribution disruptions, now more likely with the March 18 suspension of the OFFP.11 Furthermore, most of the warehouses that store food in OFFP are thought by some to be empty, which means there are few reserves within Iraq.12 Inadequate Sanitation and Clean Water A major cause of unnatural deaths noted by the United Nations High Commissioner for Refugees (UNHCR) and the World Health Organization (WHO), especially among children, is intestinal disease due not only to lack of common medicines and medical equipment shortages, but also to unsafe drinking water and inadequate sanitation. The United Nations Children's Fund (UNICEF) reports that approximately 5 million people are at risk from these factors alone. Health experts and Iraqi doctors say malnutrition and increased early childhood deaths are no longer primarily the result of lack of food, as they were before the Oil-for-Food program.13 Intestinal disease can dehydrate children and leave them far more vulnerable. This problem is especially severe in rural areas where people are poor and have little knowledge of prevention. Part of the problem arises from the fact that many of the electrical generators that run water and sewage treatment plants do not work either due to war damage or lack of spare parts. Decaying electric generators are available for only 70% of the urban water treatment plants and 10% of the rural units. As a result, sewage may be dumped directly into rivers, which may also supply drinking water, leading to a lack of clean water, inadequate sanitation, and possible public health crises. Basic Health and Medical Care In general, there is great concern about the health status of Iraqis and the available medical care in Iraq. For the South/Center regions of Iraq, the mortality rate for children under five is 136 per 1,000 live births (2.5 times worse than in 1990); in the northern regions it has shown some improvement from 80 to 72 per 9 (...continued) December 20, 2002. 10 "War could cut Iraqis' food lifeline - AID agencies mobilizing," Atlanta Journal and Constitution, December 20, 2002. 11 UNICEF Humanitarian Action: Iraq Donor Update January 14, 2003. 12 "U.N. Official Warns of Iraq's Food Crisis," Washington Post, February 28, 2003. 13 Struck, Doug. "Iraqi Ingenuity Aids Survival." Washington Post, May 3, 1988, A22. CRS-4 1,000 live births.14 UNICEF reports that maternal mortality rates have more than double at 294 per 100,000 births in the South/Center and 120 in the North. The Agency indicates that approximately one third of deaths among women aged 15 to 49 years can be attributed to childbirth.15 More than 50 percent of pregnant women are anemic; 30 percent of babies born weigh less than 5.5 pounds.16 The key sources of mortality are malnutrition and disease­both diarrheal and respiratory. Measles outbreaks in older children are attributed to a lack of immunization coverage (vaccination rates are at about 80%). Shortages in medical supplies, drugs and vaccines have also been reported.17 Current stocks are predicted to last 4 months at current consumption rates. A comparison of basic health statistics for the populations of Iraq, Afghanistan, and Saudi Arabia, chosen for their similar size and location, provides a general contextual framework for Iraq's problems.18 Interestingly, although this data shows that Iraq is much better off than Afghanistan, it is about on par with Saudi Arabia for these criteria. Comparative Population Statistics: Iraq, Afghanistan, and Saudi Arabia Iraq Afghanistan Saudi Arabia Population 24,001,816 27,755,775 23,513,330 Population growth rate 2.82% 3.43% 3.27% Birth rate 34.2 births/ 41.03 births/ 37.25 births/ 1,000 population 1,000 population 1,000 population Death rate 6.02 deaths/ 17.43 deaths/ 5.86 deaths/ 1,000 population 1,000 population 1,000 population Infant mortality rate 57.61 deaths/ 144.76 deaths/ 49.59 deaths/ l,000 live births 1,000 live births 1,000 live births Life expectancy at birth 67.38 46.6 68.4 (total population (total population) (total population) Fertility rate 4.63 children 5.72 children 6.21 children born/woman born/woman born/woman Source: CIA, The World Fact Book 2002­Iraq; CIA, The World Fact Book 2002­Afghanistan; The World Fact Book 2002­Saudi Arabia. [http://www.cia.gov] 14 UNICEF Humanitarian Action: Iraq Donor Update January 14, 2003. UNICEF reportedly says that under the sanctions regime, mortality rates in young children have increased by 500,000. 15 UNICEF Humanitarian Action: Iraq Donor Update January 14, 2003 16 "Wartime Iraq Aid Calamity feared." San Francisco Chronicle, January 5, 2003. 17 "Supplies Amassed Along Front Line of Iraq's `Other' war; As U.S. Military Prepares for Fighting, Relief Groups Mobilize to Save Lives," Washington Post, January 5, 2003. 18 These statistics reflect the average for the entire country; numbers in specific regions may vary. CRS-5 Potential War-Related Concerns Overview It is widely believed that the current humanitarian situation inside Iraq could worsen during a conflict, though this would likely depend on the nature and duration of the conflict and the extent and quality of humanitarian assistance.19 Problems could arise from malnutrition and disruption of food supplies, inadequate sanitation and clean water, and reduced health and medical care. The impact of war in Iraq could also include a potential humanitarian emergency with population movements across borders or within Iraq itself. The United Nations and others have explored the likely humanitarian situation in Iraq in the event of a war.20 Although any predictions are highly speculative without a sense of the extent and duration of a war, the United Nations reportedly expects that 600,000 to 1.45 million refugees and asylum seekers might flee Iraq, 2 million could become internally displaced, and 4.5 to 10 million inside Iraq (nearly 40% of the Iraqi population) could require food assistance within weeks after the onset of hostilities.21 Leaked U.N. documents reportedly show that the organization is expecting 100,000 immediate casualties in Iraq and increased risk to children due to malnutrition.22 However, some analysts believe that if the war is a brief one, casualties could be considerably fewer. Food Security During a conflict, food security would remain a critical concern because of the dependence of the population on the food distribution network. With more than two thirds of the country receiving food assistance and many suffering from malnutrition and other health problems, this situation could get worse if parts of Iraq became isolated and humanitarian agencies could not gain access to these areas. Military destruction of roads or railways could also destroy the food distribution systems within Iraq and disrupt the assistance plans of the international community. Furthermore, in addition to functioning roads, fuel would be essential for humanitarian food distribution. 19 For additional information on a post-war Iraq, see RS 21454, Iraq: Potential Post-War Foreign Aid Issues by Curt Tarnoff. See also RL31766, Iraq: United Nations and Humanitarian Aid Organizations by Tom Coipuram. 20 Strictly confidential U.N. document "Likely Humanitarian Scenarios," Dec. 10, 2002, [http://www.cam.ac.uk/societies/casi/pr/pr030107undoc.html]. 21 Over time sources have referred to approximate numbers (with a degree of variation) of Iraqis requiring assistance. "Supplies Amassed Along Front Line of Iraq's `Other' war; As U.S. Military Prepares for Fighting, Relief Groups Mobilize to Save Lives," Washington Post, January 5, 2003."Shortfall Imperils U.N.'s Iraq Aid; Funds Sought for Humanitarian Work," Washington Post, February 14, 2003. U.N. Official Warns of Iraqi Food Crisis," Washington Post, February 28, 2003. 22 "`Grim Picture' Seen for Iraqis," Los Angeles Times, February 14, 2003. CRS-6 Sanitation and Health If power stations were hit, the already damaged water and sanitation systems could be further damaged, which might lead to epidemics, such as cholera and hepatitis. According to the United Nations, "the outbreak of diseases in epidemic if not pandemic proportions is very likely."23 Water and sanitation are of greatest concern.24 Other Humanitarian Concerns A particular area of concern is the possibility of large-scale population movements. An increase in displaced populations could quickly multiply the rates of disease and infection to epidemic proportions. There are already displaced persons, refugees, and other vulnerable groups within Iraq who currently require humanitarian assistance and for whom lack of food, poor health, and other problems would only be intensified. Some observers have suggested that in the confusion of war or in the context of a power vacuum, Iraqis may initiate revenge killings and seek to resolve grievances through violence or some form of revolt. In 1991, some Shiites executed Baath party officials. A breakdown of the social order could have serious humanitarian impacts, bringing increased mortality and serious human rights abuses. Women could be particularly vulnerable.25 Depending on the type of warfare, many Iraqis could suffer the unintended consequences of military action or the effects of chemical and biological weapons if used by their government. If units of the Iraqi army undertook a scorched earth policy, as they did with the Kuwaiti oil wells in the Gulf War, there could be serious environmental and health consequences. Contingency Planning Aid Agency Preparations Given the challenge of current conditions in Iraq, relief agencies indicate that a conflict there would disrupt critical infrastructure, delivery of basic services, and food distribution. They are planning for humanitarian needs amid great uncertainty about conditions in the aftermath of conflict. Although the humanitarian issues in Iraq have in recent weeks been getting much more attention in the United States and abroad, the state of preparedness for humanitarian contingencies, degree of transparency over planning, and possible lack of funding have many concerned about 23 Ibid. 24 "Supplies Amassed Along Front Line of Iraq's `Other' war; As U.S. Military Prepares for Fighting, Relief Groups Mobilize to Save Lives," Washington Post, January 5, 2003. 25 "Statement on War with Iraq," Women's Commission for Refugee Women and Children, International Rescue Committee, [http://www.womenscommission.org]. CRS-7 the impact of war and capacity of the international community to meet the humanitarian needs on the ground. A U.N. official has said that preparations so far by the U.S. military and the World Food Program (WFP) are "grossly inadequate."26 Initial DOD Lead. On January 20, 2003, a presidential directive established the Office of Reconstruction and Humanitarian Assistance in the Pentagon to prepare for war and post-war aid needs. The Office, headed by retired Army Lt. Gen. Jay M. Garner, is set up under the Department of Defense (DOD) but staffed by officials from agencies throughout the U.S. government, including the United States Agency for International Development (USAID) and the State Department. Civilian coordinators in charge of three substantive areas ­ humanitarian relief, reconstruction, and civil administration ­ and a fourth coordinator, responsible for communications, logistics, and budgetary support, are expected to work on the planning and implementation of assistance programs.27 According to Pentagon planners, U.S. armed forces would initially take the lead in relief and reconstruction, later turning to Iraqi ministries, nongovernmental organizations (NGOs), and international organizations to assume some of the burden.28 The group has developed an operational concept for the delivery of aid, relief coordination, and a transitional distribution system. U.S. forces are pre- positioning food and relief aid near Iraq and making plans to deal with a possible humanitarian crisis. How long the civil affairs teams (a special section within each of the armed services) will be leading the relief efforts remains to be seen. DOD is taking an inter-agency approach to the potential need for humanitarian assistance. On February 11, in congressional testimony, Marc Grossman, Under Secretary of State for Political Affairs, stated that USAID and the Department of State were working with NGOs and international organizations, which would be "important partners in addressing Iraq's humanitarian needs," adding "civilian and military officials regularly consult and coordinate plans." With funding from USAID, U.S.-based NGOs have formed a consortium, the Joint NGO Emergency Preparedness Initiative, for better coordination. Grossman noted that the United States had allocated $15 million for planning, and $35 million was being made available from other accounts.29 USAID. Since October 2002, USAID has been putting a Disaster Assistance Response Team (DART) together and is making preparations to deal with the basic needs of one million people. There will be a core office in Kuwait City and three mobile field offices. Planning has included assembling and training the response team; stockpiling emergency supplies and commodities; and communicating with U.S. and international organizations. According to USAID, so far it has spent $26 26 U.N. Official Warns of Iraqi Food Crisis," Washington Post, February 28, 2003. 27 General Garner arrived in Kuwait on March 18 to oversee the potential postwar Iraq effort. 28 "U.S. Military Lays Out Postwar Iraq Plan," Washington Post, February 12, 2003. 29 Senate Foreign Relations Committee Hearing, February 11, 2003. Transcript provided by Federal Document Clearing House. CRS-8 million from contingency planning funds. Another $56 million will be drawn from existing funding sources within USAID. Whether or not adequate preparations are being made by the U.S. government to meet the needs of enough people is difficult to predict. Still, the total amounts being spent by the United States on contingency planning for humanitarian assistance and the projected funds required are not yet clear. The Administration's request for an FY03 supplemental appropriation including additional aid for Iraq is expected shortly. International Organizations. Until quite recently, U.N. agencies continued to reiterate that contingency planning did not mean they assumed war was inevitable. Some international organizations, such as the International Committee for the Red Cross, stockpiled supplies in and around Iraq, but others have been concerned that such action would send a message that they believed conflict to be unavoidable.30 U.N. humanitarian agencies have met with key donors to develop possible humanitarian scenarios and contingency plans. UNHCR has been putting together a contingency plan to address the potential for large-scale population movements with an initial working figure of 600,000 refugees. Emergency stocks are being prepositioned around the region. The United Nations Department of Peacekeeping is reportedly planning to establish an office that could help with the coordination and distribution of humanitarian aid.31 Other agencies such as the World Health Organization (WHO) and WFP are also developing plans for emergency relief. The United Nations is appealing for $123 million to provide humanitarian assistance and food, increase staffing for relief operations, develop joint services for the aid community, and prepare for post-war Iraqi relief. So far, it has received pledges of about $30 million. In addition to the United States, other international donors are also responding to the U.N. request for support. NGO Challenges. Unlike the extensive NGO and international organization (IO) networks working in and around Afghanistan before Operation Enduring Freedom, only a handful of NGOs have a presence in Iraq. The Iraqi regime restricts the territories in which NGOs can operate­for example, NGOs that work in the North cannot have offices in the South. In addition, U.S.-based organizations are required by the U.S. government to have a license to operate in Iraq.32 NGOs complain that the U.S. government has delayed approval of licenses required for U.S. agencies in Iraq, Iran, and Syria because of U.S. sanctions and licenses required for organizations not already present in Iraq to set up operations.33 However, as of March 13, new 30 "This Time Around, War Would Hit Iraq Harder," The Washington Post, Oct. 29, 2002. 31 "Iraq War Could Put 10 Million in Need of Aid," The Washington Post, January 7, 2003. 32 "U.S. Plans Humanitarian Assistance for Iraqi People in Case of War," January 16, 2003, [http://usinfo.state.gov/regional/nea/iraq]. "Uncertainty Dogs Relief Groups' Plans to Care for Iraq Refugees," Financial Times, January 6, 2003. 33 "Aid agencies accuse US of hindering war relief preparations in Iraq," Agence France- (continued...) CRS-9 interim regulations on humanitarian aid to Iraq have been established that are more relaxed. U.N. sanctions still require licenses for certain "dual-use" medical items, such as chlorine bleach. The absence of international organizations and NGOs operating in and around Iraq means there are few networks in place and there is little experience in the area.34 Concerns of Relief Agencies. Among relief organizations there remains a concern that U.S. and other military leaders underestimate the potential humanitarian crisis in Iraq35 and the large-scale humanitarian operation required in the case of conflict. Questioning whether adequate plans for dealing with that crisis have been developed, some complain that, despite U.S. statements to the contrary, they are not being adequately consulted on relief plans and at present lack the resources to send into Iraq behind advancing U.S. forces, as projected by military planners.36 Preparation for Refugees and IDPs There are also concerns about the absorptive capacity of neighboring countries, whether they can provide adequately for these populations, and the impact of refugee flows on stability in the region. Iran, Turkey, Jordan, Syria, and Kuwait have publicly stated that they will prevent refugees from entering their countries.37 Iranian leaders, already dealing with a large refugee population, have stated that refugees will not be allowed over Iranian borders, but refugees would be provided assistance in Iraq, which is a similar strategy used by Iran in Afghanistan.38 However, Iran is also setting up 19 camps within its borders just in case. Turkey has said that it would prefer not to allow refugees over its borders and is planning to build 13 camps in northern Iraq. However, Turkey is also planning five more camps within its borders and has started preparations to build one camp of 24,000 tents. The Red Crescent team in Iraq is making preparations to accommodate up to 100,000 people and treat 33 (...continued) Presse, Jan. 17, 2003. 34 Interaction, U.S. Relief and Development Organizations Concerned Over Potential H u manitarian Consequen c e s o f Wa r i n I r a q , N o ve mb e r 2 0 0 2 , [http://www.interaction.org/media/Hot_Iraq.html]. Within Iraq, relief agencies are stockpiling supplies of food, water, hygiene packets and medical supplies for approximately 250,000 people. 35 AlertNet, "Agencies Should Resist Being Taken for Granted," January 17, 2003, [http://www.reliefweb.org]. 36 "AID Groups Say U.S. Shut Them Out of Post-Invasion Plan," Boston Globe, February 18, 2003. 37 "Aid groups cagey on contingency plans for Iraq war," Reuters, Jan. 15, 2003. 38 Iranian police chief Mohammad Baqer Qalibaf recently said, "No refugees will be allowed into our territory if America attacks Iraq." "Tehran sends mixed signals on Iraqi refugees," RFE/RL, Jan. 16, 2003; "Iran prepares for possible Iraqi refugee influx," Reuters, Jan. 16, 2003. CRS-10 up to 7,000 injured by bombs and fighting.39 It is also prepared to provide assistance to up to one million refugees crossing into neighboring countries. Kuwait's government has said it will not let refugees enter the country from Iraq but that displaced people could be cared for on the Iraqi side of the demilitarized border zone between the two countries.40 The government is also preparing to establish a camp for refugees.41 According to relief agency officials, although Jordan is also reluctant to accept Iraqi refugees, it is preparing one site 60 kms from the Iraqi border and establishing a possible transit area at a border crossing point. A camp is also being constructed in Syria 100 kms from the Iraqi border. Saudi Arabia has not publicly discussed the need for preparation for refugees, but there have been reports that the government is making some plans.42 With regard to the U.S. position on Iraqi refugees, according to the U.S. Committee for Refugees, the U.S. Immigration and Naturalization Service (INS) has stated that there was a `temporary interruption' on the admission of Iraqi refugees into the United States in mid-January. This was apparently due to the implementation of new security procedures introduced after September 11, 2001. The suspension has since been lifted. The Administration has authorized the admission of a total of 70,000 refugees in FY2003. Considerations for Congress Several humanitarian issues could receive near-term attention from Congress. Except for the funding provided in the foreign operations bill, few of these issues appear to be directly addressed by pending legislation. Food Security and the OFFP It is unclear what assumptions are being made about estimates of food aid and the cost per Iraqi citizen­how much will be required for how many people over what period of time? There is concern about whether food delivery will be dependent on keeping the OFFP distribution network in place. The United Nations has an extensive infrastructure in Iraq to oversee the OFFP,43 but expatriate staff, some of whom have been leaving voluntarily in recent weeks, are now being evacuated. Those who leave would not be available to administer assistance while the fighting 39 "Turkey to set up 24,000 tents at Iraq border for possible refugee influx," Agence France- Presse, Jan. 15, 2003; "Supplies Amassed Along Front Line of Iraq's `Other' war; As U.S. Military Prepares for Fighting, Relief Groups Mobilize to Save Lives," Washington Post, January 5, 2003. 40 "Aid groups Cagey on contingency Plans for Iraq war," Reuters, Jan. 15, 2003. 41 "Hoping for Peace but Preparing for War," The Washington Post, Jan. 12, 2003. 42 "Hoping for Peace but Preparing for War," The Washington Post, Jan. 12, 2003. 43 The United Nations High Commissioner for Refugees (UNHCR) has four offices inside Iraq, and works primarily with 100,000 Palestinians, 23,000 Iranians, and 13,000 Turks­all of whom are refugees. "U.N. Seeks $37.4 Million Humanitarian Supplies in Case of Iraq War." Dow Jones International News, December 23, 2002. CRS-11 lasts.44 It is unknown to what extent contingency plans are being coordinated and implemented with the OFFP. Reportedly, Administration officials have indicated that once the military gains control, the OFFP will be restarted.45 Future control over the OFFP remains a question. In the event of war, and to ease emergency relief, it would appear that some sort of new U.N. action could be required to transfer control over Iraq's oil revenue and purchase of food and supplies. The OFFP, set up as a temporary measure until Iraq fulfills its obligations under specific Security Council resolutions, might be amended or replaced. A new resolution could form the basis of post-invasion assistance and reconstruction. The current phase of the OFFP expires in June 2003, when another resolution for the current program is required. The June rollover could be the time for the Security Council to change the terms of the OFFP in response to a U.S. occupation. Implementation and Coordination How the war is fought and for how long ­ whether it will be a protracted, urban war with heavy civilian casualties or a shorter war with less impact on the Iraqi people ­ will in part determine the scale of the humanitarian problems. How assistance is to be implemented ­ through U.S. occupation, U.N. administration, or donor assistance ­ could affect the response to humanitarian problems. Within this context, the type of humanitarian assistance provided can also determine the scale of the problems. DOD has clearly stated that it is not the lead agency for humanitarian relief beyond "creating humanitarian space," but it is not known how assistance will be implemented in a postwar Iraq, the role of the U.S. government, U.N. agencies, and NGOs, and what agencies will coordinate this effort for the United States and the international community.46 Humanitarian Relief Activities During War The Pentagon has stated that humanitarian agencies may not have access to Iraq immediately. In the absence of relief agencies, the military would have to be prepared to handle the humanitarian issues that may arise. Further, for more effective planning, policymakers may need to consider whether humanitarian agencies will have access to all of Iraq, even those areas experiencing continued fighting. Other NGOs have questioned whether military operational security will impair the communication necessary to evaluate the humanitarian situation and provide assistance. Humanitarian assistance is usually based on non-partisan need- based criteria, which can come into conflict with military goals. Ensuring civilian security and establishing coordination of programs with the military are key issues that must be addressed. 44 "Hundreds of U.N. Workers Leave Iraq Voluntarily,"Washington Post, February 22, 2003. 45 "U.S. Business Will Get Role in Rebuilding Occupied Iraq," New York Times, March 18, 2003. 46 "Pentagon News Briefing on Humanitarian Assistance for Iraq," February 25, 2003. CRS-12 Impact of Population Movements Many organizations have predicted that a conflict would initiate large-scale population movements across borders or within Iraq itself. Considering the scope of the conflict, in recent weeks questions have been raised about the level of preparedness on the part of the United States and the international community for the humanitarian consequences likely to result. In Iran, there are already large refugee populations. There are also concerns about the absorptive capacity of neighboring countries, whether they can provide adequately for these populations, and the impact of refugee flows on stability in the region. Humanitarian and Reconstruction Efforts After War Congress has been concerned about burden sharing, about how much the United States should pay in relation to other donors, the aid priorities, and the possible use of oil revenues to offset humanitarian and reconstruction costs. Still to be determined is the role of the international donor community and neighboring countries in contributing to immediate post-war efforts. Another area of concern is the time required to transition from humanitarian assistance to reconstruction. Frustration with slow progress on the ground and growing disinterest on the part of the international community are risks in any conflict, but particularly in Iraq where there is broad international opposition to intervention in the first place.47 47 For example, the European Union has stated it might be unwilling to fund the reconstruction of Iraq if war is declared on Iraq without U.N. authority. "EU Might not Fund Iraq Aid if War Illegal," Reuters, March 12, 2003. ------------------------------------------------------------------------------ For other versions of this document, see http://wikileaks.org/wiki/CRS-RL31814