The children of Iraq are caught up in war for the third time in 20 years. Although a clear picture of the impact of the fighting on civilians has yet to emerge, World Vision is deeply concerned by the deteriorating conditions facing children in the country.

One in four children aged under five is chronically malnourished. One in eight die before their fifth birthday

Almost half of Iraq's total population is aged under 18. Even before the conflict began, many children were highly vulnerable to disease and malnutrition. *One in four children aged under five is chronically malnourished. One in eight die before their fifth birthday.
Iraq's situation is unique in many ways. An eight-year war with Iran in the 1980s and the Gulf War in 1991 greatly damaged Iraq's infrastructure. The country was under comprehensive United Nations sanctions for 12 years. However, the Oil for Food Programme (OFFP), passed by the Security Council in late 1996, did help to reduce the impact of sanctions on the population by allowing the Iraqi government to sell oil and use the revenue to purchase humanitarian supplies.
These efforts stopped the humanitarian situation from deteriorating, but did not greatly improve conditions for most Iraqis. This is partly because revenue has not been sufficient to comprehensively rehabilitate the country's infrastructure.

Population:		24.5 million Half of Iraq's population is under 18
GNP per capita:		$700
Under five mortality rate:		1 in 8 children die before the age of five
Under five mortality rate ranking:		33 Eritrea, Sudan and Haiti have lower under-five mortality rates than Iraq
Maternal mortality rate:		294 deaths for every 100,000 births
Child malnutrition:		One in four children aged under five are chronically malnourished
Birth weight:		24.7% of all children are born underweight 70% of child deaths are due to diarrhoea and respiratory disease The incidence of preventable disease has increased more than 100% since 1990 5 million people lack access to safe water
Not attending primary school:		Girls 31% Boys 17.5%
Not attending secondary school:		Girls 60% Boys 50% 70% of all schools need repairs Teachers earn $5-$8 per month
GNP per capita:		$700

Children make up almost half of Iraq's population, which is now close to 25 million. Securing the rights of children not only guarantees the well-being of the present generation, but also that of future generations. However, many of their rights are denied, as illustrated by the following facts and figures:

• Nearly one in four children aged between six and twelve do not attend school- 31.2 per cent of girls and 17.5 per cent of boys.
  
• Girls and women are facing a major learning gap. There has been a sharp decline in adult female literacy and nearly twice as many girls as boys are out of school.
  
• The rate of acute malnutrition among children has dropped from a high of 11 per cent in 1996 to 4 per cent this year. However, close to 1 million children under the age of five suffer from chronic malnutrition.
  
• Infant mortality today (107 deaths per 1,000 live births) is more than double what it was at the end of the 1980s. The under-five mortality rate (131 deaths per 1,000 live births) is two-and-a-half times what it was in 1989.
  
• Preventable illnesses such as diarrhoea and respiratory infections account for 70 per cent of child deaths.
• The water supply system was heavily compromized during the 1990s. Restoration work is underway, but children and women are still exposed to water-related health hazards on a daily basis. Safe drinking water is a nation-wide problem and cases of diarrhoea have increased from an average of 3.8 episodes per child/year in 1990 to nearly 15 episodes per by 1996. During the same period, typhoid fever increased from 2,240 to over 27,000 cases.
  
• There is an increase in the number of children at work, as well as in the number of orphans needing state assistance which existing institutions are unable to provide.
  
• There has been a sharp increase in maternal mortality because women are not getting emergency obstetric care for complications during pregnancy and childbirth.
  

It is important to distinguish the different causes for this situation. There are immediate, underlying and basic causes.

• Immediate causes directly relate to life, survival and development rights, and include disease and malnutrition, with preventable illnesses such as diarrhoea and respiratory infections accounting for 70 per cent of child mortality.
  
• Underlying causes affect the well-being and development of children. These causes include the lack of resources to rehabilitate service sectors, including health, water and sanitation, and education, as well as Iraq's electricity "deficit."
  
• Basic causes are systems-related, as well as crises and sanctions-related. This includes the effects of two major wars, civil strife, over a decade of sanctions, inadequate resource distribution, poor institutional capacity and inadequate human resources.
  

World Vision has worked for 29 years in the Middle East with offices in Beirut and Jerusalem (West Bank, Gaza). We conducted relief projects in Turkey after the 1999 earthquake, and we continue to run small offices in Iran and the United Arab Emirates to assist our Afghanistan programme. During the 1991 Gulf War, World Vision distributed food parcels in Baghdad. We also provided emergency supplies to the people of Iraq inside and outside the country via local partners. World Vision responded to the December 2003 earthquake, which struck Bam, Iran. Now shifting from relief to rehabilitation, World Vision is focusing its efforts on child protection, health services, education, agriculture and housing, directly benefiting more than 50,000 individuals (10,000 families) and many others indirectly.

Introduction
World Vision prepared to assist refugees fleeing to neighbouring countries in the early stages of its relief response for Iraq. The humanitarian community expected hundreds of thousands of people to flee Iraq into the surrounding countries of Iran, Jordan, Syria and Turkey. World Vision mobilised staff and resources, pre-positioned goods and services, and developed partnerships with other non-government humanitarian organisations.

World Vision's programmes in Iraq assisted approximately 482,000 people. At least 204,000 of these were children.

The large number of people expected did not eventuate and World Vision adjusted its relief response accordingly. World Vision worked in conjunction with the Jordan Red Crescent and JECRaD (a consortium of Jordanian NGOs), supporting a small refugee camp in northern Jordan, close to the border with Iraq.
When military hostilities ceased in Iraq in May 2003, we were able to access communities to conduct needs assessments. These assessments allowed World Vision to clarify what was needed in communities and find out if water and sanitation systems were functioning and if children had access to appropriate health care.
World Vision's main programme focus in Iraq became school rehabilitation, water and sanitation projects, provision of medical supplies and registration of Internally Displaced Persons and then provision of relief items to IDPs.
From May 2003 until March 2004, World Vision's programmes in Iraq assisted approximately 482,000 people. At least 204,000 of these were children.

Water & sanitation

Ali Khuder, an eighth grade student disliked being at school. Only three of the seven toilets at his school worked. Having to share these toilets with 500 other students was horrible.

"I was very annoyed. It wasn't just me but all the students and my friends at the school. Here in Iraq it is too hot in the summer. At school we could hardly get water. If we did have water it was hot. We used to bring bottles of cold water from our houses to solve the problem," said Ali.

World Vision has rehabilitated the water and sanitation systems of 205 schools in Iraq, which accommodate around 153,000 school children.

"I am very glad about coming to school now. I have many plans for the future. I want to join a sports college because I love sports in general. I like football in particular and I would like to represent my country, " said Ali.

Village teenager, Imad (16) said, "When we drink water we see some moss and worms which are longer than 6 centimetres. We have no choice but to drink this contaminated water."

Children such as Imad can now drink clean water after World Vision helped to rehabilitate 20 Compact Water Pumping units in northern Iraq, which will give some 150,000 people access to safe drinking water.

Education

World Vision's focus on education has involved the rehabilitation of 205 primary and secondary schools in northern and western Iraq, with some 10,000 school children. The schools were also equipped with furniture that had either been damaged or stolen during conflict or in some cases needed to be equipped for the first time.

Thank you for caring about our children. They feel as if people are concerned about them now with their new clothes and shoes

"The children were happy when they returned to school. Some were afraid it wasn't their school! On the first day back at school, when the children were lining up to go into class, I explained that World Vision had rehabilitated the school and they must protect the school from damage and keep it clean", said one school principal in western Iraq.

World Vision also:

• Rehabilitated a kindergarten in western Iraq for around 300 young children
• Rehabilitated the Education Directorate in western Iraq for approximately 6,000 students
• Created a Computer Training Centre in western Iraq for approximately 6,000 school age children
• Provided clean drinking water for 8,000 students sitting August exams in northern Iraq

A principal in a western Iraq school says "Thank you for caring about our children. They feel as if people are concerned about them now with their new clothes and shoes".

Primary Health Care

World Vision has made life a little easier for 10-year-old Salim Khaleef Ayash and his mother, thanks to a wheelchair donated by an Australian Rotary Club.

Now having this wheelchair, it will make is so much easier for me to take Salim to different places

Salim has cerebral palsy. His mother Khalfa Haso has to attend to his every need. She has to carry him everywhere.

"Now having this wheelchair, it will make is so much easier for me to take Salim to different places, and his three brothers can take turns wheeling him around," said Khalfa.

Over the past year World Vision has implemented a number of health projects that are benefiting around 36,000 people in northern and western Iraq.

These projects include:

• Renovation of a primary health care centre in western Iraq
• Provision of home care equipment to 33 families with children with disabilities in western Iraq
• Distribution of items to 'winterise' 6 care centres for people with disabilities in northern Iraq, as well as provision of aids (crutches, stump socks, hearing aids, wheelchairs)
• Distribution of emergency drugs, medical equipment and supplies to hospitals and clinics to serve around 10,000 people.

Internally Displaced Persons (and Urban Poor) in northern Iraq

World Vision provided non-food items and winterisation materials, including jackets, winter shoes, blankets and household cooking sets to approximately 3,100 families and provided the same kits to 6,000 urban poor families.

Over 25,000 people in northern and western Iraq received gift-in-kind non-food items, such as warm jackets, blankets and shoes.