As the coalition forces dropped the first bombs in the war in Iraq, aid agencies and United Nations teams were working around the clock in bordering countries to prepare for a predicted influx of refugees.

Although estimates of the size of the likely population movements vary widely, the UN Office for the Coordination of Humanitarian Activities (UNOCHA) estimates that as the war escalates between 600000 and 1.1 million people may flee the country to neighbouring Iran, Turkey, Jordan, Syria, Saudi Arabia, and Kuwait.

As the BMJ went to press, the United Nations also warned of a potential humanitarian crisis in Iraq's second city, Basra. Secretary general Kofi Annan called for urgent measures to help the 1.5 million residents of Basra who were facing the threat of disease from a lack of clean water.

Fighting had continued in Basra for four days and 100000 children were now at risk. A UN official in Amman, Jordan, said many people were now taking water from the Shatt-al-Arab river where sewage was dumped, with the result that diarrhoea was likely and children were seriously at risk.

But …