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May 6, 2003, 8:45 a.m. Najaf Sisters The truth about civilian casualties. By Jim Lacey n the fifth floor of Najaf's Teaching Hospital lay two sisters injured by American forces during the liberation of the city. Esraa, a wide-eyed six-year-old, had just undergone surgery to amputate her leg below the knee; it had become infected after a shrapnel wound. In the bed beside her lay her 14-year-old sister, Nor. She had taken two shrapnel wounds to the leg, but was expected to make a complete recovery. Dr. Ali, who was accompanying me, said he knew the girls and that their house had been near some of the most severe fighting in Nanjaf. Both girls were awake when I entered the room, but did not attempt to speak. When I tried, through Dr. Ali, to express some measure of the sorrow I felt for them, the only reply came from the family members: "It is as Allah wills." It may be the will of Allah, but it was done by the hand of man. War can exact a terrible price from the innocents caught up in it, and Esraa and Nor are paying that price in full. Unbelievably, they were the only two children I found in the hospital. At the end of almost four days of shelling, air attacks, and hard infantry fighting, I went to visit the hospital with a measure of trepidation. Having witnessed much of the battle and seen the destruction in the areas where paramilitary forces had put up a fight, I fully expected to encounter dozens — if not hundreds — of children like Nor and Esraa. Despite the sadness I felt for the damage done to the lives of both girls, I will be forever thankful I did not find what I expected. If it had been in any city in the America, Najaf's hospital would have been closed down. The building is in a severe state of disrepair and there is filth everywhere. Bloody gloves and medical equipment litter the hallways. Urine and blood samples lie around rooms collecting flies. The burn unit's door is locked to keep it sterile, despite there being a large window missing in the door. A doctor explained as I got on an elevator, "Sometimes it lets us out. Sometimes it does not." He smiled and added, "It is like Saddam." Immediately upon my arrival, I was surrounded by doctors and staff eager to show me around and answer questions. I asked the only female doctor present how many patients they had treated who had been injured in the fighting, and how many of them were men. She replied that they had treated about 600 patients and that they were mostly men. Dr. Ali quickly corrected her and they began to argue in Arabic. He then announced that it had been about half men and half women. Dr. Ali insisted on being my escort for the remainder of the visit. He explained that the hospital's fifth and sixth floors were reserved for civilians who had been injured in the war. Men were on the sixth floor, women and children on the floor below. The first room off the elevator was filled with the men who had suffered the worst injuries. None of them spoke as the doctor showed me each of their many wounds. I went from room to room without saying a word. It was hard to look at the broken bodies lying in such unsanitary conditions, but I also noticed something else. There was only one man who seemed to be over age 40 on the entire floor. Of the 46 patients I counted, 45 appeared to be in their early twenties. When I visited the women's and children's floor, most of the rooms were empty. Besides Esraa and Nor, there was only one middle-aged woman, who had been wounded in the side by shrapnel. She also was expected to make a full recovery. I asked Dr. Ali why, if these were all civilian casualties, there was not an even distribution of males and females and among age groups. Why did the overwhelming number of them appear to be men of military age? He offered no explanation, but continued to insist that the men were all civilians. He then added that many civilians had been killed, too, and I should check the morgue and see. When I did try to check the morgue, they would not allow me to see any of the wrapped bodies, but did let me go through the paperwork. At my request, a clerk pointed out where the name was supposed to be on each form. Most of the name blocks were blank. Pressed for an explanation he said, "They are not known here." It was only then that it struck me that most of the men lying in the hospital had no family around them — unlike Esraa and Nor, who were surrounded by family members. The clerk's statement probably meant that these men were fighters from Baghdad, who had no relatives in Najaf. Besides what I saw at the hospital, I do know of at least one three-year-old girl killed during the fighting. She had been living with her family in a block of homes that received heavy Iraqi mortar fire the night before American troops moved into the area. Iraqi paramilitary forces reportedly would telephone to houses along the routes from which they were expecting the Americans to approach. If anyone answered the phone, they fired the mortars. The adults in the house knew not to answer the phone; the little girl did not. As we were leaving, Dr. Ali explained that he was wearing mourning clothes for his brother, who had just died of cancer. He went on to explain that the disease had been caused by some weapon America had used in the first Gulf War, in which his brother had been a soldier. He added, "America is at fault for [my] brother and many others and [will] need to make it right in Iraq." It is heartbreaking to witness suffering like Esraa's and Nor's. But the truth is that, considering the intensity of the fighting, the civilian casualties in this war were remarkably few. There are several reasons for this. While American weapons have become much more lethal, they have also become more discriminate, allowing commanders to hit the exact target they are aiming at and avoid collateral damage. The low level of casualties is also a testament to the skill and bravery of many of our young soldiers, who often accepted significant additional risks to themselves in order to ensure minimal civilian losses. Wars always involve an element of brutality. The suffering of innocents is particularly hard to bear. Only the prospect of better lives for the overwhelming majority of the people of Iraq will ever begin to repay Esraa for the loss of her leg. It will require a sustained effort — by both the U.S. and the Iraqi people — to ensure that she can one day be a part of the celebrations that were going on in the streets around her hospital room as I left. As for Dr. Ali, he surely had his own reasons for lying, and for trying to paint America in a bad light. — Jim Lacey, a New York-based writer, was a war correspondent for Time magazine embedded with the 101st Airborne Division during Operation Iraqi Freedom.