A Post-Conflict Assessment of Breast Cancer in Kuwait Using Mixed Methods

Abstract

The Gulf War oil well fires lasted over eight months in 1991. The subsequent environmental contamination has had real, yet poorly documented impacts, on Kuwait health. The chemical fallout from the war makes it a unique case study of conflict, environmental degradation and health. The life course approach serves as the conceptual basis for this dissertation. By developing a modified ethnographic approach suitable for Kuwait, I was able to collect and procure qualitative and quantitative data in a site-specific, systematic manner. From the cancer registry data, we notice a significant shift in breast cancer rates which began around 1999, increases 7-10 additional cases/100,000, and continues until present. Leukemia and thyroid cancers are also increasing more rapidly than in other Arab countries not affected by the war. From the clinical case-control study, we identified an association between stress and the appearance of breast cancer in Kuwaiti women. Also, women who self-identified as trauma victims were more likely to have breast cancer than healthy women. From the qualitative study, we learn about the environmental health community's concerns around breast cancer. One woman stated that "it's like the flu...every family has it." Since the late 1990s breast cancer has become a common occurrence in Kuwaiti households. Many of the participants felt that their voices had not been heard by the government. In fact, they felt that the government was actively downplaying the role of the residual Gulf War pollution on the development of cancer in Kuwait. It is suggested that the government carry out further monitoring and surveillance of leukemia and breast cancer in Kuwait in addition to executing a full clean-up of the Kuwaiti desert.