On August 6, 1999, the Halabja Post Graduate Medical Institute (HMI) was established at four centers in Iraqi Kurdistan to begin to study and treat long-term effects of chemical, biological and radiological weapons on men, women and children.

HMI's genesis followed 15 months' collaboration between the Washington Kurdish Institute (WKI) and Dr. Christine Gosden, a Professor of Medical Genetics (University of Liverpool, UK) researching in fields of Fetal Medicine and Cancer. Working with  initial grants from the US State Department and UK Department for International Development, WKI has also received support from the Swiss Federal Ministry of Foreign Affairs, several international humanitarian organizations, and Washington area philanthropist Abe Pollin.

Persistent Genocide
Populations of towns in northern Iraq, especially the town of Halabja, represent the largest civilian populations ever exposed to chemical and biological weapons. 250 population centers and 31 uninhabited strategic areas  are known to have been attacked by Iraqi forces from April 1987 to August 1988.  In addition to chemical weapons use, for which there is forensic evidence, the Iraqi regime may also have used weaponized biological and radiological agents during the attacks. The population of northern Iraq is 4 million, and initial estimates suggest that as many as 250,000 people may have been exposed at some level. (Saddam's regime also used chemical weapons against Shi'ites and marsh Arabs in southern Iraq following the Gulf War. Additionally, an estimated 100,000 Iranian soldiers also survived Iraqi chemical attacks during the Iran-Iraq War.)

Of all the atrocities committed with weapons of mass destruction, none proved more horrific than the attack on Halabja, which took place over three days in March 1988. Halabja was bombarded with a concoction of chemical weapons which included mustard gas, and the nerve gases sarin, tabun and VX.  Five to seven thousand people of 80,000 inhabitants died immediately and a further 20,000 to 30,000 were injured, many severely.  Initial studies indicate approximately 52% of current inhabitants were exposed at the time of the attack.

While these weapons had many terrible direct effects such as immediate death, or skin and eye burns, Iraqi government documents indicate they were used deliberately for known long-term effects, including cancers, birth defects, neurological problems and infertility.  Inexpensive in terms of death per unit cost, there is evidence that these weapons were used in different combinations by Ba’ath forces attempting to discern their effectiveness as weapons of terror and war.   It is believed that the Iraqi arsenal included at least a dozen chemical and biological agents, including those mentioned above, and others such as anthrax, hemorrhagic conjunctivitis virus and rotavirus (causes gastroenteritis and diarrhea in infants and children).

In December 1995, the UN Secretary General, reporting UNSCOM's findings to the Security Council, documented the weaponization of irradiated zirconium in 1000-pound bombs, which had been test dropped in patterns calculated to deliver 2 curies of radiation over an area of one square kilometer.  While thus appearing to deliver conventional munitions, the radiation delivered  can sterilize as much as 30% of those exposed and causes birth defects and cancers.  Irradiated zirconium's short half-life enabled reentry into attack sites after two to three months, when no traces of radiation would be found.

Until now, the weapons used in the attacks and their effects have not been quantified, nor have methods of treatment for survivors been developed.  No internationally accepted institution has established exactly how many died due to lingering effects of the attacks, their ages or where or how they died.  There is no information about how many members of the population now suffer long-term effects of the weapons or what the effect has been on population structure as a result of infertility, fetal and infant deaths, and susceptibility to early mortality in vulnerable groups such as children, the elderly and pregnant women. Treatment and research is further complicated as a significant proportions of the affected populations have migrated throughout the region and abroad.

Program Origins
In January 1998, ten years after Halabja was gassed, Dr. Gosden, visited Iraqi Kurdistan with a documentary film team to undertake a first medical study of long-term effects. Working with local doctors, Dr. Gosden examined more than 700 patients and surveyed miscarriages, children's deaths, cancers and causes of death in Halabja. Serious medical problems, including rare cancers, congenital malformations in children, miscarriages, etc., were documented and recounted in the Washington Post, on the CBS TV show "60 Minutes" and in testimony before the US Senate Judiciary Committee.

Visiting Washington in April 1998, Dr. Gosden linked up with WKI. In November 1998, WKI hosted a seminar in Washington entitled "Halabja: Healing a Community, Helping the World."  Participants, including Iraqi Kurdish doctors and medical school deans, international NGO representatives, Kurdish political leaders, scientists and various officials, considered the feasibility of humanitarian, medical and research responses in the region.

In April 1999, with a grant from the US Department of State's Bureau for Democracy, Human Rights and Labor, WKI and Dr. Gosden began to study the feasibility of treatment and research programs, and started related education/outreach activities. Working with Mr. Bakhtiar Amin, a Kurd who is Director of the Washington-based Human Rights Alliance, Dr. Gosden and Mike Amitay conducted programs in Geneva, New York, Washington, Norway, Sweden, Italy and the Vatican, meeting with with officials, Kurdish community members, journalists, relevant experts and international humanitarian organizations operating in northern Iraq.   Seeking direct support for medical programs, including donations of medicines and medical equipment, program personnel also have sought cooperation to develop an environmental testing regime to help determine what agents were used and whether they still pose hazards. Efforts are being made to encourage governments to provide indirect support for treatment programs through their own NGOs working in the region. WKI conducted public seminars at several United Nations venues, the US Council on Foreign Relations, the Middle East Institute, and Olaf Palme Center for International Peace. Dr. Gosden delivered remarks at the UN Human Rights Commission and during related Working Group meetings. Articles were published in Disarmament Forum, the bulletin of the United Nations Institute for Disarmament Research, and the Washington Post.

Establishment of Halabja Post-Graduate Medical Institute
From August 2 - 6, 1999, WKI and Dr. Christine Gosden convened a seminar in Cartigny, outside Geneva, Switzerland. Attending were the Mayor of Halabja, representatives of the Kurdistan Democratic Party (KDP), the Patriotic Union of Kurdistan (PUK), the Islamic Movement of Kurdistan (IMK), the Health Ministers of the Kurdistan Regional Governments, officials of various governments, including defense researchers, UN agency personnel, international NGOs working in Iraqi Kurdistan and regional doctors, including Deans of Medical Colleges in Suleymania, Erbil and Dohuk.

Participants agreed to establish the Halabja Post-Graduate Medical Institute in centers at three medical colleges (Dohuk, Erbil, Suleymania) and in the town of Halabja. An academic-based structure, HMI aims to  integrate humanitarian and medical responses, while laying a sensitive and ethical foundation for stringent science necessary to determine long-term affects of chemical weapons.  It is hoped that HMI activities will help develop the regional medical infrastructure, empower local doctors and enable international exchanges to work and study in the region

Since being established, HMI centers have undertaken the following activities:

1. Medical Survey to identify all major medical problems and disability in 40,000 adults and children in order to provide prioritized care to those with greatest needs as a result of chem/bio exposure: HMI personnel are implementing survey using an innovative pictograph form.

2. Systematic study to determine frequency and types of cancers, congenital malformations, stillbirths and patients with serious or lethal medical conditions in order to effectively develop palliative care, prevention and treatment programs.

3. Mapping 281 known WMD attacks in Iraqi Kurdistan

Projected activities will help develop medical treatment programs for people suffering with little or no assistance for more than 12 years.  Carefully integrated research can help establish a dose-response basis for specific weapons in relation to major medical conditions and underlying genetic, biochemical and physiological mechanisms. HMI activities can forward important study of principal long-term effects of WMD on civilian populations, inform about WMD use throughout the Iraqi theater of conflict, and can assist preparedness efforts around the world.