Oil fields and war remnants raise cancer rates in Basra

Dawai Naji (45 years old) from Basra, southern Iraq, lives in a whirlwind of anxiety about his mother, who is suffering from leukemia and has been hospitalized for weeks at Al-Sadr Teaching Hospital. He fears she might join his younger sister and nephew, who both died of cancer in 2014. He believes that emissions from oil fields are the cause: “A gas flare from an oil extraction facility is only 1000 meters away from our home in the paper factory area in the Dhi Qar region north of Basra, and because of it, the residents are vulnerable to various types of diseases, including cancer.”

He then points out the lack of many essential and supportive cancer medications at the oncology center in the province. His concern about the inadequacy of supplies and treatments, along with his doubts that the delay in administering chemotherapy ten years ago to his sister and nephew hastened their deaths, led him to take his mother to Iran for treatment in January 2023.

There, she underwent five chemotherapy sessions in three phases and a series of treatments that required spending an amount of 15,000 US dollars, “but her condition did not improve,” he says.

He took her back to Iraq to continue her treatment at the Oncology Center in Al-Sadr Teaching Hospital in Basra, where she has since undergone 11 sessions of chemotherapy. Dawai travels 45 km weekly with his mother from their home to the Oncology Center to obtain her chemotherapy dose, and due to the crowding there, they are forced to wait between 8 to 10 hours each time. He says, “The lack of treatments at the center forces me to buy them from external pharmacies for fifty thousand dinars ($30), and I also have to buy immune injections for thirty-five thousand each and conduct PET scans in the Breha area for seven hundred thousand dinars ($450) because there is only one machine in the Oncology Center, which receives only 10 cases daily, and many times it stops working.” Dawai’s mother’s story is one among hundreds of similar stories in Basra, where the number of cancer patients between 2004 and 2022 reached tens of thousands. Medical, environmental, and parliamentary sources link their illnesses to the effects of radioactive waste, war remnants, and pollutants from dozens of oil extraction facilities that do not adhere to environmental requirements.

Chronic shortage of treatments and medications

Abu Ahmed Al-Shughani, an employee at the Basra Electricity Department, lost three family members due to cancer-related injuries. He accuses both the local government in Basra and the central government in Baghdad of negligence for failing to provide essential treatments at cancer centers, and neglecting the families of the patients, “forcing many of them to sell their homes and everything they own to cover their patients’ treatment costs.” 

The scarcity of effective cancer medications and their exploitation by corrupt individuals in the cancer drug trade is confirmed by Alya Nassif, a member of the Parliamentary Integrity Committee, who states that part of the capital belonging to prominent politicians “was invested through private companies to open two factories for producing cancer medications in the country, which rely on importing treatments from India and Iran and then packaging them as Iraqi-made.” She described the two factories as “projects to kill patients,” indicating doubts about the quality of the medications. 

Majid Shankali, the head of the Parliamentary Health Committee, points to the country’s need for advanced diagnostic equipment and the necessity to cover the severe shortage of radiation therapy in many medical centers due to the rising number of patients. He also confirms a significant shortage of treatments for cancer and biological diseases and the high costs associated with them. 

Shankali continues, saying: “In the 2023 budget, the government allocated 200 million dollars for purchasing cancer medications, as well as approximately 250 million dollars to cover some requirements through governing expenses. These amounts are insufficient and do not match the suffering of the people and their needs in light of the increasing number of cases.”

he is noted that local pharmaceutical companies only meet 15% of the need for cancer medications, due to “the losses incurred by those companies, such as Samarra Pharmaceutical Company, which lost a total of 31 billion dinars during the first 10 months of 2022.”

The Ministry of Health provides its services at four centers for treating childhood cancer, one of which is in Basra, five centers for radiation therapy, and twenty-three centers for chemotherapy throughout Iraq, which doctors and specialists consider insufficient.

Environmental Violations 

In 2018, the German Organization for Human Rights, based in Basra Governorate, conducted a field visit to areas in the Al-Midaina district north of Basra to assess the “notable increase” in cancer rates and pollution levels in those areas. 

According to the organization’s president, environmental expert Dr. Saad Al-Jubouri, the organization recorded 1,200 cancer cases in northern Basra within just three months, which was the duration of a field study conducted in 2018. He links the rise in cancer rates among the residents to the worsening air pollutants emitted from oil fields in those areas. 

Dr. Saad confirms that specialists in the organization have recorded an increase in the levels of hydrocarbons released from oil flares “at very high concentrations compared to environmental standards, with significant impacts on human health,” indicating that this issue persists. 

He continues: “We noticed that oil companies do not keep their extraction facilities at least 15 km away from residential areas, as is practiced in other countries; on the contrary, some companies are located 4 km or less from residential clusters that contain between 750 to a million residents. Therefore, an increase in cancer rates is not unlikely with the rising concentrations of oil pollutants in the air and soil.”

Conflicting Statistics

The Basra Governorate recorded high cancer rates from 2004 to 2022, according to former Member of Parliament Haidar Al-Mansouri, with 27,397 cases reported to the Ministry of Health. He stated that there are nearly 40,000 unrecorded cases in the governorate, as most patients sought treatment in hospitals outside Basra. 

Meanwhile, Member of Parliament Ahmed Al-Rubaie claims that cancer cases reached 31,392 from 2004 to 2022, with notable cases including colon, bladder, lymphatic, and breast cancers. Al-Rubaie warns that the average monthly death toll at the Oncology Center in Al-Sadr Teaching Hospital due to cancer reaches 60 cases, some of which are linked to “a shortage of medications for treating this disease.” 

In Iraq, some believe that the numbers are much higher than those reported by the Ministry of Health. Among them is Mahdi Al-Tamimi, director of the High Commission for Human Rights in Basra, who mentioned in a press statement published in March 2024 that between 9,000 to 10,000 new cancer cases are recorded annually in the governorate. 

The investigation team attempted to contact officials in the Ministry of Health more than five times, but they refused to answer some questions, including those related to disclosing cancer incidence numbers in Basra, citing higher instructions that prevent revealing these figures.

High concentrations of pollutants

A research study by Dr. Suad Al-Azawi, a professor of environmental engineering at the University of Baghdad, published in the Arab Journal of Scientific Research in Qatar in 2020 under the title “Assessment of the Risks of Using Depleted Uranium Weapons in Iraq,” revealed that the residents of Basra were exposed to high radiation doses.

The study indicated that these doses were about 200 times higher than the annual radiation dose received by any person in a natural setting worldwide, which does not exceed 2.4 millisieverts (Sv, a unit for measuring equivalent radiation dose).

According to the study, the total effective dose that residents in the Zubair district and western Basra received was approximately 268.6 millisieverts, and around 167 millisieverts in the city of Safwan adjacent to Kuwait, due to the depleted uranium used by American and British forces during the Gulf War in 1991. Populated areas such as Zubair, the international road, West Qurna fields, and Mount Sanam were subjected to bombardment with radioactive shells.

According to farmer Khudair Hanoon from the Mount Sanam area southwest of Zubair in Basra Governorate, “hundreds of destroyed vehicles from the bombardment were indeed left near villages and informal areas, and due to people’s ignorance of their dangers, they were dismantled and parts were stolen and sold in scrap markets, in addition to children playing with them in nearby areas, which directly exposed them to the risk of cancer.”

Adding that one of his ten-year-old sons “developed a tumor in his head that later turned out to be cancerous, and he is still receiving treatment doses.” Dr. Saleh Al-Bakri, a specialist in internal medicine and hematology, links those pollutants to the risk of cancer, explaining that equipment exposed to shelling with depleted uranium munitions “produces emissions that spread in the air containing radioactive uranium oxides, which can travel long distances. When these oxides are inhaled by humans, their tiny particles (nano) penetrate the alveolar membrane, reaching the bloodstream and entering the cells of internal organs.” He adds: “Depleted uranium ions exchange ions in the human body with magnesium in the cells of the organs, leading to the destruction of the body’s ability to repair and compensate for damaged cells. As a result, the body suffers from chronic diseases and cancerous tumors. Additionally, free radicals present in the cells interfere with the process of manufacturing and folding the proteins specific to the formation of DNA, which may lead to hereditary genetic disorders in the affected individuals.”

Factors and Other Causes

According to a knowledgeable source in Basra, there are 26 contaminated sites in the areas of (Al-Dharhamiya, Al-Hawair, Al-Rameela, Abu Al-Khaseeb, Al-Burjasiya, Al-Qurna, Jabal Sinan, and Al-Faw) and other areas of Basra.

According to the Basra Human Rights Commission, U.S. forces used more than 900 tons of uranium-tipped missiles during the Second Gulf War in 2003, with Basra alone receiving about 200 tons of those missiles, and their devastating environmental effects are still evident.

Dr. Kamal Hussein Al-Rubaie, head of the Iraqi Commission for Control of Radioactive Sources (a body affiliated with the Council of Ministers), states that the commission has recorded several types of cancer resulting from radioactive waste among the residents of Basra.

He explains: “Such as lung cancer caused by inhaling air contaminated with radioactive materials, and kidney and intestinal cancer that occurs when uranium enters the body through the consumption of certain foods and vegetables grown in contaminated areas, in addition to other types resulting from the vapors of oil extraction, such as mercury and magnesium vapors, and deadly metal and sulfur vapors, along with contaminated dust extracted from wells.”

Government Acknowledgment of Danger

On August 21, 2023, the Federal Board of Supreme Audit accused foreign companies responsible for oil extraction of causing an increase in cancer cases in Basra and other cities, due to rising concentrations of non-methane hydrocarbons closely related to cancer diseases at all monitoring points in the Basra fields, exceeding permissible limits.

The report stated that “oil extraction operations release environmental pollutants into the air resulting from the flaring of associated gas from extracted fossil fuels, as the Basra Oil Company and the foreign companies operating in the fields in the governorate flared (54, 52, 53) percent of the associated gas in the years (2019, 2020, 2021).”

It warns that this has led to the release of hazardous chemical compounds into the air at high concentrations, causing cancer cases among the population, particularly in the center of the governorate, which has the highest incidence rate of 76.3 people per 100,000 in 2020.

The report reveals that the most polluted areas are Al-Zubair followed by Al-Qurna, according to a research study published in 2021 by Maysan University on “The Impact of Air Pollutants from Hydrocarbons Excluding Methane on the Increase in Cancer Cases, Particularly Lung and Bladder Cancer.”

Complaints Against Oil Companies

In August 2021, the German Human Rights Organization in Basra Governorate adopted legal action against foreign oil companies operating in northern Basra, including the Russian company Lukoil. They filed 54 lawsuits, but the case was quickly closed in the Federal Basra Appeals Court due to armed threats faced by the legal team, according to the organization’s president, Saad Al-Jubouri.

The investigator obtained a warning document issued by the notary public in the association’s area of Basra, dated April 6, 2021, to the Russian company Lukoil, submitted by six individuals suffering from cancer, through lawyer Salah Abdul Hassan Al-Amara, demanding the company pay a compensation amount of 1.5 billion Iraqi dinars for each of them.

The warning directed to the company held it responsible for causing several residents of Basra to suffer from cancer-related diseases and for the death of some due to environmental pollution resulting from oil burning due to exploratory operations and drilling in the West Qurna/1 and West Qurna/2 fields without taking necessary measures and precautions, which contradicts the Environmental Protection and Improvement Law No. 27 of 2009.

The areas of Al-Madina and Al-Qurna are exposed to pollutants limited to three foreign oil companies: the Russian company Lukoil and the American company ExxonMobil, while the British company BP operates in the fields of Zubair, Rumaila, and Shuaiba west of Basra.

In this regard, legal expert Karar Saleh confirms the state’s responsibility “to remove pollution in accordance with the applicable laws and constitutional provisions,” noting that “Article 33 of the Iraqi Constitution emphasizes the state’s responsibility to provide a healthy and suitable environment for living and to protect citizens from various diseases resulting from environmental pollution.”

The legal expert believes that the governor of Basra has the right to file a lawsuit in the Federal Court or the Administrative Court to sue the federal government and compel it to compensate the injured and the owners of expropriated lands, whether for oil purposes or those designated as cemeteries or centers for gathering destroyed military vehicles.

Communications to Reduce Pollution

A document issued on December 16, 2018, by the Studies, Planning, and Follow-up Department of the Ministry of Oil, requests the Basra Oil Company to instruct the West Qurna/2 Field Operating Authority to take necessary measures to mitigate the impacts resulting from oil activities in the field “and to adopt modern methods in all stages of crude oil production and waste treatment, and to commit to reducing polluting emissions resulting from oil activities.” 

Another document issued by the Ministry of Environment in August 2019 links gas pollutants to the rising cancer rates in Basra. 

It confirms the impact of pollutants (Total Hydrocarbons THC, and Non-Methane Hydrocarbons NMHC) on the lungs and respiratory tracts, indicating that they can be very toxic and may cause cancer when exposed for long periods. 

On February 23, 2019, a member of the parliament from Basra, Faleh Al-Khazali, sent a letter from the Ministry of Health and Environment to the Basra Health Directorate, titled (Report on Environmental Factors for Cancer Patients), which mentioned the deaths of several citizens in the Al-Hawair area, north of Basra, due to cancer-related illnesses. 

In the letter directed to the Government Coordination Department for Citizen Affairs in the General Secretariat of the Council of Ministers, the deputy refers to the responsibility of the oil companies operating in Basra for those deaths.

On January 29, 2024, a Member of Parliament from Basra, Alaa Al-Haidari, reported to the Public Prosecution about the oncology centers at Al-Sadr Teaching Hospital and Basra Specialized Children’s Hospital discharging cancer drug waste directly to the biological treatment station without proper processing according to health requirements. He warned that this waste poses a danger as it can cause genetic mutations, congenital malformations, and cancers in living cells if not treated correctly.

In the midst of these official documents linking oil pollutants to the increase in cancer cases, “Hussein Jaloud,” a 55-year-old father of a young man named “Ali,” who died of leukemia at the age of 21 in April 2023, initiated legal proceedings against British Petroleum, as the main contractor for the Rumaila oil fields west of Basra, accusing it of polluting the area where he lives with his family with toxic gases.

Jaloud, a government employee, says that his son Ali was admitted to the cancer hospital in Basra on July 17, 2017, to receive chemotherapy. However, due to the high costs of treatments not available at the center, he was forced to sell his house and his wife’s jewelry and take out a loan from one of the Iraqi banks. He adds with a tone of pain: “The costs of his treatment exceeded 170 million dinars (129,000 dollars).” He recalls that the head of the Basra Oil Company granted him a financial amount of four million dinars (more than 3,000 dollars) and that British Petroleum promised him financial compensation “but their promises went up in smoke, which pushed me to take legal action,” he says in a sharp voice. Ali was not the only victim of emissions from the Rumaila oil fields, his father says: “I am aware of 15 others suffering from cancer, ten of whom have died, and there are cases of congenital deformities in newborns, as well as other respiratory and skin diseases.” He pauses for a moment before clenching his fists and adds: “My pursuit of the lawsuit is on behalf of everyone, so that no more people die like my son Ali, and to help the affected receive proper treatment… It is unfair to leave them suffering and drowning in the search for treatment.”