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Lynn L. Amowitz, MD, MSPH, MSc; Glen Kim, MD; Chen Reis, JD, MPH; Jana L. Asher, MS; Vincent Iacopino, MD, PhD

JAMA. 2004;291:1471-1479.

Context  Although human rights abuses have been reported in Iraq, the full scope of these abuses has not been well documented.

Objective  To assess the prevalence of human rights abuses since 1991 in southern Iraq, along with attitudes about women's health and human rights and women's rights and roles in society, to inform reconstruction and humanitarian assistance efforts in Iraq.

Design  Cross-sectional, randomized survey of Iraqi men and women conducted in July 2003 using structured questionnaires.

Setting  Three major cities in 3 of the 9 governorates in southern Iraq.

Participants  A total of 1991 respondents representing 16 520 household members.

Main Outcome Measures  Respondent demographics, information on human rights abuses that occurred among household members since 1991, women's health and human rights, opinions regarding women's rights and roles in society, and conditions for community health and development.

Results  Respondents were a mean age of 38 years and were mostly of Arab ethnicity (99.7% [1976/1982]) and Muslim Shi'a (96.7% [1906/1971]). Overall, 47% of those interviewed reported 1 or more of the following abuses among themselves and household members since 1991: torture, killings, disappearance, forced conscription, beating, gunshot wounds, kidnappings, being held hostage, and ear amputation, among others. Seventy percent of abuses (408/586) were reputed to have occurred in homes. Baath party regime-affiliated groups were identified most often (95% [449/475]) as the perpetrators of the abuses; 53% of the abuses occurred between 1991 and 1993, following the Shi'a uprising, and another 30% between 2000 and the first 6 months of 2003. While the majority of men and women expressed support for women's equal opportunities for education, freedom of expression, access to health care, equality in deciding marriage and the number and spacing of children, and participation in community development decisions, there was less support among both men and women for women's freedom of movement, association with people of their choosing, and rights to refuse sex. Half of women and men (54% and 50%, respectively) reported agreeing that a man has the right to beat his wife if she disobeys. Fifty-three percent of respondents reported that there were reasons to restrict educational opportunities for women at the present time and 50% reported that there were reasons to restrict work opportunities for women at the present time.

Conclusions  Nearly half of participating households in 3 southern cities in Iraq reported human rights abuses among household members between 1991 and 2003. The households surveyed supported a government that will protect and promote human rights, including the rights of women. However, currently, neither men nor women appear to support a full range of women's human rights.

Author Affiliations: Physicians for Human Rights (Drs Amowitz and Iacopino and Ms Reis), Divisions of Women's Health and General Internal Medicine, Brigham and Women's Hospital and Harvard Medical School (Dr Amowitz), and Division of General Internal Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School (Dr Kim), Boston, Mass; and the Martus Project, Palo Alto, Calif (Ms Asher).

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