In April 2004, U.S. Marines bombarded the Iraqi city of Fallujah in one of the most intense standoffs of the Iraq war. The siege began after four employees of the American security company Blackwater were killed and their bodies burned. An eight-month standoff followed until the Marines stormed the city in November, using artillery and aerial bombing against rebel positions.

U.S. forces later admitted that they had employed white phosphorus as well as other munitions. Even though six years have passed since the deadly battle, the chemicals used to fight it have had a lasting legacy among the city's inhabitants.

Iraqi doctors in Fallujah have complained for the past several years that they are overwhelmed by the number of babies with serious birth defects, ranging from a girl born with two heads to children whose lower limbs are paralyzed. They said they were also seeing far more cancers than they did before the battle for Fallujah between U.S. troops and insurgents.

These claims have recently been supported by a survey showing a four-fold increase in all cancers and a 12-fold increase in childhood cancer in children under age 14. Infant mortality in the city is more than four times higher than in neighboring Jordan and eight times higher than in Kuwait.

The survey of about 4,800 individuals in Fallujah was carried out by a team of 11 researchers who visited 711 houses in Fallujah in January and February of this year. The researchers asked house members to fill out a questionnaire giving details of cancers, birth outcomes and infant mortality.

The study, entitled "Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005-2009", is the result of these questionnaires. Compiled by Dr. Chris Busby, Malak Hamdan and Entesar Ariabi, the report concludes that anecdotal evidence of a sharp rise in cancer and congenital birth defects is indeed occurring in Fallujah.

Infant mortality was found to be 80 per 1,000 births compared to 19 in Egypt, 17 in Jordan and 9.7 in Kuwait. The report says that the types of cancer are "similar to that in the Hiroshima survivors who were exposed to ionizing radiation from the bomb and uranium in the fallout". Researchers also noted a 38-fold increase in leukemia, a 10-fold increase in female breast cancer and significant increases in lymphoma and brain tumors in adults.

Another major finding of this study was the dramatic change in the sex ratio between newborn boys and girls. In a normal population, the number of boys to girls is generally 1,050 boys born to 1,000 girls. But the sex-ratio in Fallujah of babies born from 2005 and onward is 850 males to 1,000 females. The sex-ratio is an indicator of genetic damage that affects boys more than girls. A similar change in the sex-ratio was discovered after Hiroshima.

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