Health Crisis: With the United Nations concerned about the effects of "anarchy and chaos" - which has resulted in the looting of hospitals and health facilities in central and southern Iraq - the first priority is to re-establish security on the streets. Dr Muris Houston reports.
Albeit eroded by 12 years of sanctions, Iraq is fortunate to have a relatively well-developed health infrastructure; without basic law and order, however, it will not be in a position to function.
According to the World Health Organisation, four medical facilities have been destroyed in the conflict. Only two doctors are on duty in the main hospital in Basra, where staff are reportedly having difficulty getting to work.
Hospitals in Baghdad have been flooded with casualties, draining stocks of antibiotics and anaesthetics and tiring medical and nursing staff who are working non-stop to deal with the injured. "Health workers are overwhelmed by the injured and routine hospital work is disrupted", a WHO spokeswoman has said.
The health challenge is inextricably linked to humanitarian needs. Food reserves are expected to last a number of weeks. If the population slips into malnutrition, then diseases normally coped with by a healthy body will overcome its weakened defences. This could lead to infectious disease spreading rapidly.
As summer approaches, rising temperatures add to the likelihood of epidemics. A lack of power supplies means that air conditioning and refrigeration systems are not available to help contain this threat. And perhaps most important of all, clean water supplies are dependent on the maintenance and repair of water treatment facilities in Iraq.
Latest reports suggest that 60 per cent of the water treatment plants are out of action. All Iraq's sewage plants are non-operational, with the result that 500,000 tonnes of raw sewage are pouring into rivers and lakes each day. With no running water in their homes, people are bathing and drinking water from heavily contaminated sources.
"There must now be a threat of disease as tens of thousands of people in homes, hospitals and care institutions attempt to find what water they can from rivers and other source," UNICEF spokesman Mr Geoffrey Keele said.
He warned that children were most at risk. "There is the real possibility of child death from the effects of diarrhoea and dehydration. We estimate that at least 100,000 children under the age of 5 are at risk," he said.
Even before the conflict there was a high burden of communicable disease among children. This was mainly due to respiratory infection, diarrhoea and measles. The number of new tuberculosis cases almost tripled from 46 per 100,000 people in 1989 to an estimated 131 per 100,000 in 2000.
The incidence of whooping cough is reported to be on the increase. Cases of diphtheria have begun to appear. These findings suggest the health system is already under strain.
About one in eight children in Iraq die before the age of five. A quarter do not have access to safe water supplies. One third of Iraqi children are malnourished, due to a combination of a lack of food and a rise in gastric infections linked to poor-quality water.
As well as meeting the ongoing health needs of the population, Iraqi doctors will need assistance in dealing with the psychological aftermath of war.
With fields full of landmines, the demand for artificial limbs is likely to rise.
"Iraq is not East Timor and Iraq is not Kosovo," UN Secretary General Kofi Annan said in reference to the availability of trained personnel from the previous regime.
But the war-torn nation will still need plenty of care from the international community if its citizens' health is not to deteriorate further in the months ahead.