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Iraqis have been exposed to the effects of burn pits for more than 10 years

LEILA FADEL, HOST:

If you've heard American veterans celebrating one thing about the PACT Act, which President Biden will sign into law this week, it probably has to do with burn pits. These were massive piles of uniforms, equipment, computers and other things the U.S. military incinerated to prevent them from falling into the hands of the wrong people. American veterans, including those who served in Iraq and Afghanistan, will be able to access VA support for a variety of medical problems they likely suffered because of their exposure to burn pits. But soldiers are not the only people still struggling with their damaging effects. Kali Rubaii studies the toxic legacies of the U.S. war in Iraq. She's an assistant professor of anthropology at Purdue University.

KALI RUBAII: Veterans saw acute short-term exposure, and they were at peak health. Iraqi people were in all stages of their life course when they were exposed to burn pits, and they were exposed for over 10 years. Even those who live at a distance and downwind face a lot of health effects, and they're varied. Farmers who live downwind noticed a lot of birth defects and fertility issues with their crops and their livestock. And then children report symptoms of, you know, dizziness, balance problems. There have been many cases of brain cancer near and around burn pits. The issue that I'm most focused on is intergenerational damage. And the incidence of birth defects in Iraq may be linked to burn pits and other detritus of war.

FADEL: So you've been documenting intergenerational impacts on people in Iraq. What are you finding? Fallujah's a place that's seen several U.S. offensives. I used to speak to families who didn't lose their house once but twice, maybe three times - lost family members. So...

RUBAII: Yeah. So in one way, burn pits are the least of the violence done to Iraqi people. For example, in 2004, 74% of Fallujah was leveled. I mean, what does that actually mean? That means no water, no electricity, no hospital - massive injury and death, lots of pollution released into the air. So in Fallujah today, the long-standing effects of that level of bombardment are there is still only a few hours of electricity. My tap water, living there, is brown. It's undrinkable. The hospitals still lack essential equipment.

So it's in the wake of all of this destruction that doctors like Dr. Samira Alani, who's a pediatrician at Fallujah Hospital, started noticing, around 2004, all of these babies that were born with birth defects. And they started cataloging it because it just was anecdotally noteworthy that there were more and more. And the tragedy here is that it's unclear what the cause is, but it definitely indicates there's an environmental factor. And people notice that the timeline indicates something about U.S. occupation.

FADEL: You know, I think so often when the damage of war is discussed, we think of it in immediate killings, right? But that long-term impact, the environmental impact, is something that isn't as much discussed. If you could just talk about the way your research looks at the damage of war when it comes to environment.

RUBAII: I think that it's very clear, of course, American soldiers were exposed to way more than just burn pits, right? Every time there was a sandstorm, all of that heavy metal material from the 1990s was picked up into the wind, and everyone was breathing that. One of the common problems that people face is that during sandstorms, the air quality is very poor, and every single microparticle that can be picked up into the wind is entering people's lungs, lining your teeth, and it's everywhere. And this is a climate change issue, of course. We have more and more sandstorms and dust storms in Iraq. And the more war detritus that is lying around, the more people are inhaling war. They're inhaling the past of war.

FADEL: Wow.

RUBAII: And similarly, Iraq has two major rivers - the Tigris and Euphrates. And everything that's farmed inside of Iraq is irrigated from those rivers. But those rivers are also the place where waste is dumped. But then, of course, that water is getting irrigated into farmland, and people are eating whatever the plants take up.

FADEL: Yeah.

RUBAII: And so the detritus of war isn't just lying on the ground and aerosolized, it's also entering people's bodies and the ecosystem.

FADEL: You've been in and out of Fallujah for your research. Can you speak about specific families that you've met and the impact that war has had on their lives?

RUBAII: I had to watch a child die a few months ago. She was just this dynamic, inquisitive baby who was born in Fallujah with multiple congenital anomalies. Some of her organs were outside of her body. She had a gap in her heart. She lived for about a week. She made really deep eye contact with everyone, and she was really fighting for her life. The cause of her birth defects were likely environmental and linked with burn pits. But the cause of her death was the destroyed hospital infrastructure. Had she been in a place where the hospital hadn't been bombed several times, it's possible that she would have survived her birth defects. And I think maybe one of the toughest legacies in Iraq is that environmental damage to people's bodies doesn't have to be fatal if there is also infrastructure to contend with it.

A woman I met had lived right next to a burn pit near the Balad Air Base. And she had a child in 2017 with anencephaly, and it died immediately. And then she had another child who had spina bifida and hydrocephaly, and it was born dead. So she kept conceiving children. So the doctor said, look, you've been living near a burn pit. You can't have more children. But she was really determined to have another baby. She had three more miscarriages and two more stillbirths.

FADEL: Oh, my God.

RUBAII: And she is still trying to have a child. But her determination to make a new generation of life in the wake of all of the destruction she had witnessed in the decades before - it's an indicator of this incredible will to survive and recover and why I feel that now that the PACT Act has been passed, it would be up to U.S. health justice organizers to reach out to Iraqi people who are managing incredible burdens and who would be very keen to engage in a joint struggle for extending the kind of imperative care that's available to veterans now to the Iraqi people who've been living in the wake of these burn pits.

FADEL: Kali Rubaii is an assistant professor of anthropology at Purdue University. Her work focuses on the toxic legacy of war in Iraq. Thank you so much.

RUBAII: Thank you.

(SOUNDBITE OF AIR'S "LOST MESSAGE") Transcript provided by NPR, Copyright NPR.