IMPEACH BUSH

(05-23) 04:00 PDT Baghdad -- Hanna Yousef Tamer watches hopelessly as her year-old daughter, Mahdi, writhes on pink sheets in a crowded ward of the Ibn Al-Baladi Pediatric Hospital in the Shiite neighborhood of Sadr City. The feeble child cries and looks around the bustling room through hollowed eyes.

Her body is wasted from malnutrition and dehydration. But with the hospital lacking basic medication and intravenous fluids, doctors and nurses can't do much to help Mahdi. And while precious drugs are available in pharmacies, the little girl's family can't afford them. Tamer, 27, lost another daughter, Roqia, in 2005 when the 2-year-old died of the same disorders.

"Unfortunately, this is becoming common," said Saad Mehdi, 35, a pediatrician at Ibn Al-Baladi.

The mortality rate among Iraqi children younger than 5 rose 150 percent between 1990 and 2005, according to a report released this month by the U.S. humanitarian aid group Save the Children. In its most startling terms, the group estimates that 1 in 8 never makes it to his or her fifth birthday.

The report also said inadequate prenatal care has caused more birth defects and deaths, and that Iraq faced a grave humanitarian crisis even before the latest war. But most physicians here agree the 4-year-old conflict has had an unmistakable impact.

Iraq's child-mortality crisis is distressingly visible in Sadr City, a sprawling and embattled Shiite slum of 2 million residents in east Baghdad, home to many of the country's poorest people.

Pediatricians at Ibn Al-Baladi said leaking sewage and the lack of potable water has contributed to a startling increase in water-borne diseases, such as typhoid, which can place children at risk for circulatory failure, infections and possibly death if not properly treated.

Shortages of medicines, equipment and doctors have only made things worse, hospital officials said. The 34 pediatricians at Ibn Al-Baladi cope daily with hundreds of cases, often without antibiotics, intravenous drips, cardiopulmonary monitoring equipment, CT scans or MRI machines.

On a recent morning, the corridors of Ibn Al-Baladi were bustling with adults frantically shuttling children in their arms, while others lugged bags packed with blankets and clothes, and flagons filled with hot tea. In one hallway, a group of women clad in traditional black abayas sat on the floor feeding bottles to infants.

The hospital's wards were crammed with children like year-old Tahar Nahdi, who was suffering from a severe chest infection. The boy lay pale and unconscious on his back while his mother, Hassna Rhani, 35, swatted flies from her son's face. Ali Kareem, 25, a nurse attending Tahar, who has been ill for the past three months, said the hospital has no antibiotics to fight the little boy's infection and no intravenous fluids to alleviate his dehydration.

Rhani said that for the past five weeks, her family has been unable to afford the $5 necessary to buy Tahar four daily doses of antibiotics that are available in pharmacies outside the hospital.

"The majority of the families that come here can't afford the medications," Kareem said.

On the other side of the room, 4-month-old Doha Ahmed, anemic and malnourished, fidgeted in the arms of her grandmother, Sabira Ali. Doha has spent more than 13 days in the hospital during the past month, but her health continues to decline, Ali said. Doha's mother, who was home caring for her four other children, already lost a child two years ago under similar circumstances, Ali said.

In Sadr City, the lack of prenatal care has become more significant since Ibn Al-Baladi was forced to close its obstetrics wing more than a year ago after it was damaged in fighting. Reconstruction is moving slowly, according to the hospital's assistant director, Salam Mosan Bohan. For now, everything takes place in the main hospital.

Earlier this month, inside a wing of Ibn Al-Baladi's second floor, small incubators were filled with premature newborns, along with those suffering from birth defects. Some were clinging to life.

Taif Saif was one of the fortunate few.

The 7-day-old infant wrestled with a piece of gauze wrapped around his eyes as protection from the glow of a fluorescent light -- treatment for jaundice that he has had since birth due to anemia. Pediatrician Manam Husham says Taif's blood disorder was easily detectable through standard prenatal testing. And while his ailment is curable, he is still vulnerable to neurological disorders.

"We have many cases like this," Husham said. "It's become normal."

The frustrations, after a while, are easy to sense among the doctors at Ibn Al-Baladi.

"We have to deal with it," Husham said, referring to the harsh conditions in Sadr City and Ibn Al-Baladi. "We're trying to save as many lives as possible."

Health-care crisis for young Iraqis

According to a report by Save the Children, a U.S. humanitarian group, the rate of mortality among children younger than 5 in Iraq rose by 150 percent between 1990 and 2005. The report's key points:

-- In 2005, 122,000 Iraqi children died before age 5, or 125 per 1,000. In contrast, 36 per 1,000 died before age 5 in Iran; 15 per 1,000 in Syria; and 7 per 1,000 in the United States.

-- 46 percent of children younger than 5 suffering from diarrhea are not given oral rehydration treatment.

-- 24 percent of children younger than 5 with suspected pneumonia are not seen by a health care provider.

-- 12 percent of children younger than 5 are moderately or severely underweight.

-- 21 percent of Iraqi children suffer from severely or moderately stunted growth.

-- Only 35 percent of children are fully immunized.

-- 28 percent of births are not attended by a skilled health professional.

-- Iraq's infant mortality rate has increased by some 37 percent in the past four years.

This article appeared on page A - 13 of the San Francisco Chronicle