After 13 months distributing food and medicine inside Iraq, Douglas Broderick has returned to Baltimore at odds with his government.
Entering its second summer since the Persian Gulf war, Iraq faces a serious danger of cholera and typhoid epidemics as its population struggles with bad water systems and an acute shortage of medicine, he says.
Lack of spare parts for water filtration means water supplies continue to be drawn from sewage-tainted rivers.
And lack of medical supplies increases the chance of cross infection in hospitals, he says. The cholera and typhoid that hit some Iraqi cities at epidemic levels last summer, in the early months following Desert Storm, already have returned.
His warning conflicts with the assessment of U.S. government analysts, who believe the threat of serious epidemics is "somewhat diminished."
Mr. Broderick, 37, entered Baghdad with a laptop computer and a few aides to begin providing food and medicine to Iraqi mothers and children, the elderly and widows.
He calls himself a specialist in emergencies, someone able to land in a devastated area and scramble for contacts and information on malnutrition and diseases where the need is worst. One of his rules is not to respond at all until he has the necessary information.
It is a line of work he fell into after he once successfully procured a relief plane on short notice while in Cairo. The job, which has also taken him to the Israeli-occupied West Bank, Gaza and Thailand, and will soon land him in Ethiopia, offers the chance to see "real benefits in the field" from his work with a minimum of bureaucracy.
Until last Sunday he was the longest-serving international aid agency veteran in Baghdad since the Gulf War ended.
During his Iraq tour, CRS built up a distribution system serving 220,000. His experience gave him a rather world-weary view of Desert Storm as one of many wars that are going to continue occurring in that part of the world, but a keen sympathy for the plight of ordinary Iraqis.
Sanctions need to be relaxed, he says, to allow Iraq's government to use some of its assets frozen abroad to make food and medicine more readily available.
"According to every human rights document in the world, everybody should have adequate access to food, water and medicine," he said.
By keeping the economy crippled, he says, sanctions serve to deprive Iraqis of money to buy food. It forces Iraqis to devote their entire budgets, supplemented by extra jobs, to feed their families.
Mr. Broderick says some malnutrition has occurred, particularly in the slums of Basra, in Iraq's most backward and hardest hit southern region.
The population also faces a severe shortage of medicines for chronic diseases, the usually costly long-term prescription drugs needed for life-threatening cancers and heart, kidney and liver diseases.
U.S. officials believe some of the medicine is being hoarded by Saddam Hussein's regime and kept out of the distribution system. Mr. Broderick said, however, that he had not seen evidence of diversion on a big scale.
Mr. Broderick says he has seen some signs of recovery in Iraq.
Locally brewed beer and locally baked bread are starting to become available.
"People are coping with the sanctions," he said, as families adopt long-term strategies to acquire food and adjust to a spare diet.
The health-care system, one of the best in the Middle East before the war, is functioning once again despite shortages. Bridges and other infrastructure are being rebuilt.
Distribution of relief supplies has overcome the obstacles Mr. Broderick confronted when he first arrived in Baghdad. Authorities, determined to control aid dispersement, halted distribution through mosques and churches, but Mr. Broderick found government distribution channels that he could monitor effectively.
The Ministry of Health, after an early refusal, is now cooperating with relief agencies.
The CRS worker is not supposed to discuss political issues. Overall, he says, the country has "stabilized."
This conforms with the view of U.S. government experts, who add that as a result, Saddam Hussein is now more entrenched than he was a year ago.
"He is stronger in the sense that he's still there. Just surviving is an achievement," a U.S. official said, adding that the dictator has reinforced his already multilayered and fierce personal security.
He's in charge of Iraq up to the 36th parallel, that is. Above it, in the allied-protected zone, Kurds are relishing a growing sense of autonomy that eases their deprivation and the devastation left by last year's crushed uprising, according to Dr. Gazi B. Zibari, another Baltimore resident who recently returned.
But according to the Johns Hopkins Hospital surgeon who recently returned after a three-week visit, wildly inflated food prices and a "dangerous" health care situation also exist in Kurdish areas of northern Iraq.
Dr. Zibari, an Iraqi Kurd who fled with his family in 1975 and is now a U.S. citizen, said that in a visit to a hospital in Dohuk, in Northern Iraq, he found pharmacy shelves empty, no chemicals to develop X-rays, practically no anesthetics and a lack of simple antibiotics. Children, with no immunization, die in large numbers, says Dr. Zibari, who specializes in organ transplants. The region also has little fuel and no cement or construction materials, he said.
There, the causes are different. The Kurdish region maintains trade with Turkey, but is pinched by an embargo imposed by Iraq, not the United Nations. Much of the deprivation, Dr. Zibari says, stems from institutions being stripped by Iraqis of anything of value before the region came under protection of the United States and its allies.
Many Kurds continue to live in the tents that last spring crowded the mountainous border with Turkey, he says.
But Dr. Zibari, a strong Kurdish nationalist, says Kurds have replaced Iraqis as border guards. The Pesh Merga militia acts as a regional police force. Having elected their own parliament, Kurds are starting to take control of government institutions. And as long as allies promise protection against the Iraqis, they have the promise of cultivating tomatoes, grapes and apples on farmland with abundant water, and perhaps developing resorts in the spectacular mountains.
"The [allied] planes fly very low many times every day. It's what makes Kurds go on," Dr. Zibari said.