The number of Iraqi children who are born underweight or suffer from malnutrition has increased sharply since the US-led invasion, according to a report by Oxfam and a network of about 80 aid agencies.
The report describes a nationwide catastrophe, with around 8 million Iraqis - almost a third of the population - in need of emergency aid. Many families have dropped out of the food rationing system because they have been displaced by fighting and sectarian conflict. Others suffer from the collapse in basic services caused by the exodus of doctors and hospital staff.
Although the security crisis forced Oxfam and other agencies to withdraw their foreign staff from Iraq to Jordan within a year of the invasion, many Iraqi non-governmental organisations still work in the country and receive supplies from abroad.
"The fighting and weak institutions mean there are severe limits on what humanitarian work can be carried out," said Jeremy Hobbs, the director of Oxfam International, yesterday as the report, Rising to the Humanitarian Challenge in Iraq, was published.
But, the report says, more could and should be done to help the Iraqi people. The Iraqi government, in particular, could do more. It should double cash payments for the 1 million families headed by widows from the current $100 (about £49) a month. Nine of every 10 conflict-related deaths since 2003 have been of men, and earlier wars and repression also left many families without a male breadwinner.
At least 4 million Iraqis depend on food assistance, but a third of those who have had to flee their homes in the last year cannot get subsidised rations because they are not registered in a new home. The report urges the government to give the homeless temporary identity cards to allow them to get food.
It calls on western donor governments, which have shifted money out of humanitarian assistance towards reconstruction, to reverse that trend. Most development projects have been forced to slow down or stop anyway, whereas aid money can be spent effectively - and the need is dire.
Forty-three percent of Iraqis are in "absolute poverty", partly because of a 50% unemployment rate. Basic services in 2003 were poor after a decade of sanctions and under-investment by the Saddam Hussein regime. But they have worsened since. The number of Iraqis without access to adequate water supplies, for example, has risen from 50% in 2003 to 70% now.
Eighty percent lack effective sanitation, and diarrhoeal diseases have increased. Most homes in Baghdad and other cities have only two hours of electricity a day.
Children are suffering the most, with 92% showing learning difficulty because of the pervasive climate of fear. More than 800,000 have dropped out of school, because they now live in camps for the displaced or because schools have had to be taken over to shelter the homeless.
Around 40% of Iraq's teachers, water engineers, medical staff and other professionals have left the country since 2003.
The Oxfam report comes as Unicef and the UN agency for refugees jointly appealed for $129m to help to get tens of thousands of uprooted Iraqi children back to school. Saying a generation of Iraqis could grow up uneducated and alienated, the agencies presented a plan to support Syria, Jordan, Egypt and Lebanon in providing schooling for 155,000 refugees. Altogether, more than 2 million Iraqis have fled to nearby countries. About 500,000 of them are of school age and most currently have limited or no access to education.
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