WHO should undertake full inquiry into Gulf war illnessBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7195.1422a (Published 22 May 1999) Cite this as: BMJ 1999;318:1422
EDITOR—Coker et al found a high prevalence of various illnesses among British Gulf war veterans, confirming other recent reports from the United Kingdom and the United States.1 They say that they found no evidence for the existence of a unitary “Gulf war syndrome” and think that several possible causes are responsible for the symptoms reported. There have also been numerous reports of increasing ill health among Iraqi civilians, over and above deaths ascribed to malnutrition and lack of adequate medical care. These are widely blamed on the sanctions.2 Sikora describes both a breakdown in cancer services and a rising incidence of some cancers,3 and there are disturbing, if anecdotal, reports of an increase in major congenital malformations.4 Some possible causes (toxic chemicals from oil fires, chemical warfare agents, depleted uranium) could be common to both troops and Iraqis, but others (insecticides, multiple immunisations) could not; it is hard to blame cancer and congenital deformities on stress.
As Sikora notes,3 the World Health Organisation has already worked in Iraq, but to a limited extent. We propose that the WHO should be authorised—and supported—to undertake a full inquiry into both effects and causes of illness following the Gulf war, not least as we are told that this could be a foretaste of future high-intensity wars. In your accompanying editorial,5 Murphy writes that proactive prevention must be developed to reduce the burden of postwar illnesses. A comprehensive study such as we propose might go further and say that war as a way of settling disputes must be avoided until diplomacy as an alternative really has been ruled out. This was clearly not the case in 1990-1, nor, we believe, in the December 1998 bombing, in which hospitals seem to have been “collateral damage.”