Joost Hiltermann, an editor of this magazine, traveled through Iraq from March 23 to April 10, 1991, as Middle East field coordinator of the Boston-based organization Physicians for Human Rights. The delegation, whose mission was to study the impact of the Gulf war and civil conflict on the health of Iraq’s civilian population, went to Baghdad, Basra, al-Zubayr, Karbala’, Najaf, Kirkuk, Suleimaniya and Erbil.

The roads in the north between Kirkuk and Suleimaniya and Kirkuk and Erbil and then especially on the stretch from Erbil up to Salah al-Din, were littered with overturned, destroyed and disabled civilian vehicles. They might have run out of gas or something else, but then they had been entirely stripped of tires and parts, and people’s clothes were strewn out over the roads. I think that once the army retook Kirkuk, they started clearing the roads with helicopter gunships as they moved on to the next town, mowing down everything in their way. We saw several corpses lying to the side of the road.

In Suleimaniya I talked to a young Kurd who said that everybody had fled on April 3 when the Iraqi army arrived and started bombing with helicopters. People were afraid that what had happened in Kirkuk might be repeated here. The peshmerga [Kurdish fighters] left as well, so there was not really much of a battle. After a day or two, a few people started returning, but just a trickle. (The large masses of people were rumored to be along the border, but we couldn’t get there on the road north from Erbil because the army was in the process of retaking Salah al-Din.)

On the road from Kirkuk to Suleimaniya, we saw large trucks carrying tanks returning to Kirkuk. There were lots of soldiers sitting on top of the tank carriers, but many refugees were getting rides, too. There were also refugees stranded along the road, bearing their belongings on their backs and in their hands, and individual soldiers were trying to catch rides. There didn’t seem to be any particular animosity between the groups. The refugees must have been exhausted. The soldiers raised their flags and cheered as they entered Kirkuk.

The regime will have a very difficult task regaining a modicum of legitimacy because of the diseases and hunger that are starting to spread. People have very little food. In Basra, there were cases of malnutrition. Basic staples are lacking or are available at amazing prices. There’s no milk of any sort. In Basra, in the pediatrics ward of the main hospital, we saw tiny kids suffering from severe diarrhea and dehydration, and the only thing they were getting to drink in the hospital was, once again, polluted water.

In the north, in Erbil, I walked around the open-air market, which was crowded with people, although nearby shops were still closed. They were selling only dates, potatoes, raisins and leaf vegetables like lettuce. People said there was no wheat or rice. Like everywhere else outside Baghdad, there was no electricity or potable water. And everything was very expensive.

All the hospitals in Baghdad have been under emergency procedures since September, which means they can only take life-threatening cases. There is no elective surgery. People with diabetes cannot go to the hospital, and there is no insulin anyway because of the embargo. So most of these hospitals are at less than 50 percent occupancy, but not because there are no people needing care.

In Saddam Children’s Hospital, I saw emaciated children with malnutrition, diarrhea and terrible burns due to kerosene fires, which are also war-related in a way. Most of the war casualties have already gone home, or died of infections that could not be healed because there are no antibiotics due to the embargo. I did see a large number of civilian casualties in the Yarmouk Hospital in Baghdad on March 25, all from the southern towns of Karbala’, Najaf, Kufa and Hilla. They had just arrived there, with shrapnel and shell wounds to their abdomens, legs and arms from the civil war. There was a whole ward full of them. These were just the people who had managed to reach Baghdad. There’s very little transportation. So what you see in the hospitals is only the tip of the iceberg.

I have no way of knowing whether the government’s police and informer networks were wiped out. In the al-Husayn mosque in Karbala’, the army showed us a room which was completely blackened, where they said that four people had been “necklaced” [killed by setting fire to a car tire placed around their necks]. They said that the rebels had done this to four people: the head of internal intelligence of Karbala governorate and three Baathist party bosses. In the al-‘Abbas mosque, they took us to a large gallery normally used for prayer, where five or six nooses were hanging from the electrical fixtures in the ceiling. The soldiers told us that the rebels had hanged people there. I have no way of verifying that. People don’t talk about these things, since we were always accompanied by a semi-official Iraqi guide. There were also rumors of the army executing rebels, especially in Najaf, where we were denied access to the main mosque on April 6.

Clearly the civil war caused more direct civilian casualties than the American war, and there was more damage in the civil war. Even though the Americans had bigger bombs, they hit only a few civilian sites, while the damage done during the civil war is spread throughout and affects whole city neighborhoods. The army officer who was taking us around al-Husayn mosque in Karbala’ said that the rebels had caused most of the damage, but then I asked him how the rebels could have damaged the outside of the mosque by rocket fire when they were inside. He thought about it, and then admitted that the army had used RPGs and tanks to drive the rebels out.

It’s clear that the Iraqi army took revenge against civilian population groups, and not only against the rebels. They would not have done this if the people had not given at least tacit support to the rebels. In Basra, I saw a huge neighborhood with tanks positioned every hundred yards or so. And the house that happened to be standing in front of each tank had a whole chunk of wall knocked out. Collective punishment. This was not trying to weed out rebels.

It’s hard to get figures on civilian casualties. First, the Iraqis probably have no interest in releasing such figures. Secondly, they have no such figures. The government is in complete disarray, by its own admission. There are no telephones. The only way to communicate is to actually go to a place, and there’s very little fuel, so how do you go? In the governorates, the government buildings were burned down by the rebels, so files are gone, and people are trying to get the offices working again. The last thing they’re thinking about is trying to compile casualty statistics. I think nobody really gives a damn how many people died during the war.