Dr Elham Naji, 27, is making house calls. Her job as President of the regional branch of the Iraqi Red Crescent doesn’t require it, but here in the poorest part of the country this woman keeps a personal eye on things.

The aftermath of the Gulf war has brought disaster to embargoed Iraq: a lack of food and widespread malnutrition, a shortage of drugs and unchecked disease, hyperinflation and destitution.

Elham Naji pushes open the door of a crowded house in a Nasiriyah alley. A cry of recognition emanates from the dingy, ground-floor room as she enters. A bedridden woman beams up at her.

Fatma, 32, is a mother of five, paralysed and confined to bed for the past four years by a partial spinal obstruction. She has no income, her husband has deserted her, and somehow she must find 5,000 dinars (just over 9 US dollars) a month to buy the cotton, gauze and ointment for her bed sores. In a country where a nurse’s monthly salary is 1,000 dinars, it isn’t easy.

In the good times, when Iraq swelled its coffers with revenues from the second biggest oil reserves in the world, an operation might have helped her. Today, surgery is limited to emergencies, due in part to an insufficient amount of anaesthetics.

Elham Naji has witnessed many such nightmares. No region has been harder hit by the Gulf war than her native The’kar province. Besides hunger there is thirst, due to a shortage of clean water. In the deep south, a litre of water costs five times more than a litre of Iraqi petrol.

She’s a charismatic figure in this depressed environment. Until 1991, the Red Crescent had no branch in Nasiriyah. She was its founding President, a veterinary surgeon turned humanitarian, the first and still the only woman to hold a top regional position.

Her sex is irrelevant, she says. Yet she’ll talk willingly of other Iraqi women — of their vulnerability in the present crisis, of widows, of single mothers, of their concern for their families, of their strength. She speaks also of her income-generation schemes for displaced marsh Arab women and of her mother-and-child health
programme.

In Nasiriyah, she calls on the elderly widow of a fisherman, a frail little lady who barely survives on drastically diminished government food rations and a monthly Red Crescent food distribution. As for the fish her husband once caught, she can no longer afford it. Her monthly income is less than one US dollar. A good fish costs two.

“Resistance to disease diminishes as a result of little food,” says Dr Naji. Gastro-enteritis is rampant due to unclean water, typhoid fever is increasing and respiratory diseases are taking a heavy toll. Few medicines are available to treat these illnesses.

The The’kar region has a population of almost one and a quarter million, and of these, says Naji, a million are destitute. Monthly she distributes 18 kilos of rice, six kilos of lentils and three of oil to 1,000 families.

“We simply cannot help everyone,” she says. “People cannot understand our limitations. For us it is heart-breaking. We see these people getting more and more desperate. They are most worried about their children.”

“The marshes,” says Dr Naji, “are in tremendous need, and water-borne disease is causing high infant mortality. For every 10 children who survive in the city, only one survives in the
marshes. Almost 25,000 marsh children under the age of five were treated for diarrhoea in the first five months of 1994.”

The war damaged water and sewage treatment plants, and drought following land reclamation has deprived some parts of The’kar of all drinkable water. What they get must be brought in by tanker. One-third of the province’s tankers are off the road for lack of spare parts, so the Red Crescent has stepped in with a fleet of 37 tankers.

Dr Naji stands by a noxious roadside ditch which at one time supplied villagers with water. She’s not thinking of the scene surrounding her; she’s thinking of ways to provide necessities. Food and clean water, she reflects, are powerful preventive medicines. “With another 25 tankers, I could reach 50,000 more people.”