In Aradah, a southern Iraqi town of just over 50,000 people, the end of the day arrives quietly, veiled in a haze that seems to rise from the earth itself. The sun lingers low and heavy, casting long shadows across the dusty lanes. The smell of sun-warmed tomatoes rises from crates stacked at market stalls, where vendors call out prices with the ease of routine. A butcher wipes his hands on his apron and returns to trimming lamb hung from metal hooks. Motorcycles zigzag through crowds, their engines humming above the murmur of street chatter. Plastic chairs rest empty outside tea shops, their paint chipped and pale. For a moment, the town might pass for any other — worn, weathered and alive.
But the sky tells a different story.
A thick plume of smoke rises beyond the rooftops, darkening the horizon like a bruise. From every alley and storefront, a pillar of soot can be seen trailing endlessly into the sky. Its source lies just beyond the edge of the city: the gas flares of West Qurna 2, one of Iraq’s largest oil fields, operated by the Russian energy giant Lukoil. The flames never go out. Their orange glow is as constant as the dust.
Sadiq Howair walks the streets of Aradah with the poise of a man accustomed to being needed. His shoes are polished, his beard carefully trimmed, his dark hair neatly combed back. There’s a quiet elegance to him. But beneath the formal composure lies a deeper reality: the weight of the dead.
The 41-year-old man is not a doctor, a government official or a lawyer. He is a high school manager. Yet here in Aradah, among cracked sidewalks and oil-stained skies, Howair has become the custodian of loss, the one who counts what others no longer dare to. “I don’t need to take notes,” he says with a faint smile. “I remember everyone. I know by heart their faces, their stories and their diagnoses. I also know what killed them.”
As he moves through the market’s din, voices reach out to him. “Any word from Baghdad?” asks a man gripping a blue folder of test results from a private hospital. “They found a tumor in my daughter’s brain,” says another, his voice brittle. Howair replies gently, with the same rehearsed nod, a few comforting words, a worn smile. He never promises justice — only that he’ll try. “Here in Aradah, age is a luxury. People don’t grow old but, if they do, they’ll witness their loved ones suffer,” he says.
In the past two years, Howair has documented more than 3,000 new cancer cases in this town of just 51,000 residents. He organizes community meetings and demonstrations, drafts letters and appeals to officials, but the flares keep burning. In this place devoid of formal accountability, Howair has become its living substitute. For many, he is the only trace that someone, somewhere, is counting the victims of the oil industry.
In the province of Basra, home to nearly 3 million people, prosperity and peril share the same pipeline. The oil sector provides nearly 90% of the country’s state revenues, propping up budgets, salaries and reconstruction promises. But for those living in the industry’s shadow, the costs of this dependence are carried in their lungs and bloodstreams.
When Iraq opened its oil sector to foreign investment in 2009, it unleashed an era of extraction unlike any in its modern history. Major global firms quickly claimed their stakes: BP in Rumaila, Italy’s Eni in Zubair, ExxonMobil in West Qurna, Russia’s Lukoil in West Qurna 2, among others. Production surged from 2 to 4 million barrels per day, earning Basra its reputation as the beating heart of Iraq’s energy economy.
Yet alongside that growth came infrastructure gaps the size of legal loopholes. Without systems to capture excess gas produced during oil extraction, companies have relied on flaring: the open-air combustion of gas. Iraq, a signatory to the World Bank’s Zero Routine Flaring initiative, burned nearly 24 billion cubic yards of gas in 2023 alone, ranking third globally, behind only Russia and Iran.
The air in Basra bears the brunt of this fire. A study by researchers from the University of Basra, published in the September 2024 issue of the journal Environment Asia, concluded that all but one of the pollutants measured near the Rumaila field exceeded both Iraqi and World Health Organization safety thresholds, some by significant margins. Particularly alarming were the levels of particulate matter, which is linked to respiratory disease and premature death, and which the International Agency for Research on Cancer has classified as carcinogenic. The study also found that these pollutants are not confined to oil sites: They drift as far as central Basra, carried by shifting winds into densely populated neighbourhoods.
The findings align with those in a study on “Air Pollution in the Southern Part of Iraq and Its Health Risks” that was published as a book chapter earlier this year, which demonstrated an increase in gaseous pollutants in the same province caused by oil fields and refineries. The study warned, in particular, that communities living near flaring zones face an elevated risk of cancers, cardiac disease and respiratory failure.
Under Iraqi law, no refinery or flare stack may operate within 10 kilometers (6 miles) of a residential area. In practice, this regulation is ignored. In places like Aradah and more generally in the province of Basra, homes sit just hundreds of yards from blazing towers of fire. The legal minimum distance exists only on paper.
In 2022, the BBC published a confidential report from Iraq’s Ministry of Health, attributing a 20% rise in cancer cases in Basra between 2015 and 2018 to air pollution. Another leaked document from the Basra Health Directorate, also revealed by the British broadcaster, indicated that the actual number of cancer cases was more than three times higher than the official figures suggested. While the Ministry of Health had reported 2,339 new cancer patients in the governorate in 2020, the internal document painted a very different picture: 8,587 newly diagnosed cases. According to the latest official statistics, cancer was diagnosed in 3,305 inhabitants of Basra in 2023. But, on the ground, few believe the official line.
“They are lying to avoid acknowledging the ongoing sanitary crisis,” Howair says. “We see the real numbers on the street, in our home and in the overcrowded cemeteries.”
In the south of Iraq, the number of cancer patients, like the smoke, is hard to escape. So too is the sense that law, science and governance have all been dimmed by the flames.
Among the scattered tombstones of the Hasan al-Basri cemetery in Zubair, southern Iraq, a group of men take turns smoothing the soil atop a fresh grave. Ayser al-Yaqoub, 32, straightens up from his father’s resting place, removes his cap and runs a hand over his sweat-slicked brow. When he looks at his palm, strands of dark hair cling to the skin. He closes his fingers over them quickly — as if to contain what the chemotherapy keeps taking.
He knew this moment would come. The diagnosis — lymphoma — arrived two years ago, but in Aradah, cancer is rarely a surprise. “Around here, it’s like catching a cold,” he says, matter-of-factly. “Everyone gets it eventually.” His 7-year-old nephew is ill and, since his daughter’s birth, al-Yaqoub has been quietly fearing for her too.
For 17 years, al-Yaqoub has driven oil workers in and out of Rumaila, one of the largest oil fields in the world. Each day, his bus passes the infernal flares that pierce the desert sky like open wounds. “The landscape stays the same,” he says, “but my passengers disappear.”
When al-Yaqoub received his diagnosis, he turned to a familiar procedure: posting a request for aid in the Basra Oil Company (BOC) workers’ WhatsApp group. The company didn’t seem to be surprised by his illness. It simply responded. “You fill in your cancer type and your employment status,” he explains, showing his pay slip. Beside the numbers, a line reads: “500,000 [Iraqi dinars] — cancer illness.” It amounts to the equivalent of roughly $380, disbursed every two months. “Why would BOC pay for our treatment if they aren’t doing anything wrong?” he asks.
Al-Yaqoub is not alone. Across Basra’s oil fields, hundreds of workers live in this silent entrapment: employed by the companies they believe are killing them, paid just enough to fund their own treatment. The checks arrive on time. But the silence is deafening.
Near the gates of West Qurna 2, the sky simmers with toxic haze. The torch of Lukoil’s refinery burns around the clock, spewing unfiltered gas into the air. From its gates, a procession of workers in blue overalls spills out into the heat, their backs bent, eyes downcast, skin scorched by exposure. “Here, oil owns everything: our health, our breath, even our deaths,” murmurs Haider Abed, a mechanic. He watches the plume stretch across the sky. “I know what this work is doing to me. But I can’t quit. My parents are both sick. My salary pays for their chemo.”
The workers around him — engineers, welders, refinery technicians — tell stories of tumors, of infants born with malformations, of infertility, of lungs that fail and colleagues who vanish between one shift and the next. A generation is quietly unraveling. “We all know what’s happening. We all lost too many family members and colleagues,” says one. “In the last three years, both my parents and three of my cousins have died of cancer. I’m afraid my turn will come but we don’t have any other choice. This is our bread,” says Jafar, a refinery worker.
They once fought against the oil giants. In 2018, Basra’s streets rang with protest — angry calls for clean water, electricity and justice. But that defiance has since wilted. “Now, we get on the bus, go home and, tomorrow, we do it again,” Jafar says. His voice trails off like a prayer spoken too often to still be believed.
In 2022, the Iraqi government acknowledged what many in Basra had long suspected. Minister of Environment Jassem al-Falahi stated publicly that the alarming surge in cancer cases was directly tied to pollution from oil production. The statement marked a rare moment of institutional candor. That same year, former Minister of Electricity Luay al-Khateeb echoed the warning, citing “poisoned gases burned into the air” by unregulated oil operations as a key driver of the health crisis.
Despite these admissions, three years later, the position of the health authorities has changed, dismissing any impact of the oil companies on public health. “The increase in cancer cases is a national phenomenon, linked to demographic growth and improved diagnostic capabilities,” says Ministry of Health spokesperson Saif al-Badr, using figures to back up his assertion. “The number of new cancer cases aligns with the population.”
According to statistics provided by the country’s health authorities, Basra ranks sixth among Iraq’s cities in terms of the number of cancer cases. Nothing to be alarmed about, then. “There may be problems at [the] local level, but there is no significant statistical difference between the country’s different governorates,” al-Badr insists, pointing to the investments made in Basra by his ministry in the oncology field. To further refute the accusations, Dr. Sura Yassin, the head of the Iraqi Cancer Control Committee, refers to a study carried out by the Ministry of Oil. “There is a genetic and environmental cause to the cancers diagnosed in Basra. According to the survey, no correlation between oil companies and cases of cancer has been established. The recommendation was to open more health centers,” Yassin says. Despite requests, New Lines has not been given access to the contents of this study.
At the institutional level, this shift in rhetoric reverberates through the corridors of Basra’s hospitals. Dr. Abbas Abdulzahra Alhasani, director of Basra Children’s Hospital, walks confidently through newly renovated oncology wards, where the number of pediatric beds has more than doubled thanks to funding from the Italian oil company ENI. “We collaborate with Italian doctors. Our staff has been trained by them,” he says, gesturing toward a golden plaque bearing the logos of ENI and the Basra Oil Company — a symbol of what is called a “social welfare” initiative.
According to Alhasani, the oil sector is now “a partner in health care.” He credits the industry with enabling the introduction of nuclear medicine and reducing the cost of vital scans like PT tests. When pressed on the growing number of cancer cases, his tone tightens: “It’s the same everywhere in Iraq. People eat processed food, there are genetic issues. This is not specific to Basra.”
A similar ambivalence surfaces at Al-Sadr Teaching Hospital. Its director, Dr. Rafid Adil Abood, acknowledges an uptick in respiratory and skin ailments linked to oil industry emissions. But he resists linking those same emissions to cancer. “Yes, there is benzene in the air. Yes, it’s a carcinogen. But perhaps the dose isn’t toxic,” he posits. Then, a metaphor to close the argument: “After Hiroshima and Nagasaki, did every Japanese develop cancer?”
Yet, by Abood’s own admission, blood cancers are unusually common in Basra, more so than in other provinces. And tests conducted by his team have shown rising levels of benzene in both the air and water. Still, he maintains there is no exceptional cancer crisis in the region. “If Basra had higher rates, I would investigate. But it doesn’t. So I don’t.”
In Iraq, the Ministry of Oil commands a vastly larger budget than its health counterpart, and medical institutions increasingly rely on energy companies for infrastructure. Doctors and directors toe the official line. In the south, the air may be thick with toxins, but the records remain clean.
Investigating the cancer crisis in Basra is like pressing against a wall: The stories are overwhelming, but the evidence is always “not enough.” Doctors and experts are reluctant to speak. In the courts, “Where’s the document that says this flare caused that tumor?” has become the refrain. While suffering is rampant, formal attribution remains elusive. “There are too many contracting companies in one area,” says one legal expert. “It’s almost impossible to identify which one violates the safety standards.”
The lawyer Atheer al-Misawi knows this wall too well. The head of the Human Rights Commission at the Basra Lawyers’ Union has assisted over 200 families since 2019, most of whom never made it to court. “When people decide to file complaints, the accused oil company often offers them jobs or financial compensation. Many of my clients give up,” he says. Some are less fortunate. “One former oil worker,” he recalls, “sold his house and borrowed heavily to get chemotherapy abroad. When he sought redress from the company, they simply ignored him.”
The cost of persistence is steep. Al-Misawi has been forced to flee his home following threats. “They came to my house to intimidate me,” he recalls. “Risks are real. It comes from the government, the companies, militia and those who profit from silence.”
On March 10, 2021, a man named Hassan Latif Daoud brought a case against Lukoil. He had developed chronic kidney failure while living near West Qurna 2. The court acknowledged that flaring levels exceeded environmental limits. Five independent experts confirmed it. Still, Daoud’s case against Lukoil was dismissed. The judges ruled there was “no direct causality” between the pollution and his illness, according to the judgment reviewed by New Lines.
In 2024, the legal fight crossed borders. Hussein Julood, father of 21-year-old Ali, who died of leukemia after growing up near BP’s Rumaila site, filed the first-ever Iraqi lawsuit against an oil company in a British court. Ali had documented his life near the flares for the BBC. His family’s lawyers at Hausfeld argue that toxic emissions led to his death.
Yet back in Iraq, silence endures. “The Ministry of Health and most doctors refuse to list pollution as a cause,” al-Misawi says. “They’ll write ‘unknown’ or blame genetics.” Without that acknowledgment, cases collapse. “The health system collaborates with no one. Victims must build their own legal arguments, without support from the very institutions meant to protect them,” the lawyer explains.
Even scientific data, when it exists, rarely penetrates the courtroom. Mehdi al-Tamimi, head of the Independent High Commission for Human Rights in Iraq, has made it his mission to confront this institutional denial. His stance is unequivocal. “The government is shutting its eyes. The numbers they publish are well below reality. These statistics are falsified,” he alleges.
Al-Tamimi claims to have reviewed a 2022 internal report from the Basra Health Directorate confirming more than 9,500 new cancer cases in a single year — nearly triple the official figures. “When I raised the discrepancy, the Ministry of Health threatened to sue me for defamation,” he recalls. The ministry later claimed the figure included cases from neighboring provinces. “But when I sent them the files proving the cases were all local, they quietly dropped the case.”
What is more alarming, he adds, is that these numbers have only grown more precise. He refers to a 2018 report forecasting 800 new cancer cases per month in Basra. The last such document, dated 2022, was the final one shared with his office. Since then, silence.
Al-Tamimi draws heavily from studies led by Dr. Shukri al-Hassen. One of its more recent surveys, conducted in 2023 for the BBC, revealed a high concentration of benzene, a known carcinogen, in the air of cities and villages located near flare sites. While the WHO has stated that there is no safe level of exposure to benzene, values from 3 up to 9.6 micrograms of benzene per cubic meter have been observed in cities like Rumaila, Nahran Omar, Qurna, Zubair and al-Huweir. The same study showed that 70% of the sample collected from children living in areas close to oil flares contained high levels of PAHs (polycyclic aromatic hydrocarbons) in their urine. According to the Leon Berard cancer research center in France, exposure to PAHs is associated with an increased risk of various cancers, in particular cancers of the skin (melanoma), lung, bladder, liver and breast.
“We used this to pressure the government to act, to reduce emissions,” al-Tamimi says. “An oil minister once promised Basra would be free of flaring by 2018. The promise was postponed to 2020. Then 2023. Now they say 2027.” After a BBC documentary, “Under Poisoned Skies,” revealed the scale of exposure, hospital donations doubled. But the flaring? “It never stopped,” he says.
The human rights advocate has reached out to international organizations such as the United Nations Development Programme (UNDP), to no avail. In response to his allegations, the organization stated that “UNDP does not have any data on the subject matter because our operations in the past few years were focused in other parts of Iraq where there has been significant damage due to the conflict” with the Islamic State group.
For the lawyer al-Misawi, the obstacles to resolving the crisis are both structural and strategic. Oil companies in Basra do not comply with safety standards, he says, while the ministries of health and the environment and the Basra governorate fail to enforce relevant laws. Ultimately, officials would rather retain the employment created by the oil industry than challenge it, he explains. The corruption is deep. “Many Iraqi officials have relatives who work in these companies. It keeps everyone quiet.”
In a dimly lit office inside a modest government building in Basra, a senior official at the local branch of the Iraqi Housing Fund, speaking on condition of anonymity, addresses the situation with the ease of someone long past diplomacy. He does not raise his voice; he doesn’t need to. “We work with the numbers. In this building, we all know what’s happening,” he says, gesturing toward the thick stacks of patient files and death certificates that rise like sediment on his desk. “Doctors refuse to publicly acknowledge the sanitary crisis, but these documents speak on their behalf. There is an increase in the number of cancer cases. We shouldn’t be afraid of speaking up.”
In 2022, Iraq’s Ministry of Construction, Housing, Municipalities and Public Works launched a national initiative, offering small plots of land and financial assistance to families of cancer patients. In southern Iraq, the program, approved by the Council of Ministers, sparked fragile hope among the people suffering from cancer and their families. Yet, in the province of Basra, two years after the launch of this initiative, not a single payout has been made. No land has changed hands. Not one dinar has reached the sick or grieving.
Within the Iraqi Housing Fund, figures are staggering: 7,800 applications from patients still undergoing treatment and over 25,000 from the families of those who didn’t survive. “Most of them come from north Basra and the city center,” the official explains; neighborhoods that sit in the shadows of flare stacks, in towns like Nahran Omar and Rumaila, “where you can smell the fuel in the air.”
“I don’t speak as a doctor,” he continues. “I speak as someone who processes the paperwork. The numbers we see do not align with those the health ministry publishes.”
During the interview, an elderly man steps into the room, clutching a plastic folder. Inside is the death certificate of his aunt, who died of pancreatic cancer. She lived in a nearby oil flaring field. “My neighbor has been diagnosed with breast cancer. She’s 35.” Nothing out of the ordinary for the employees of the Iraqi Housing Fund.
“Most of these cases are from the flare zones,” says another employee. “A lot of the applicants work in oil.” He hesitates before adding, “We want to map the data. Just a basic chart, showing the case density by neighborhood. But we’re not allowed.”
He leans forward, lowering his voice. “Still, I can tell you without doubt that the hot spots will be the places where the flares don’t sleep.”
For the senior official, the pattern is undeniable. “Oil companies have full responsibility. They could easily buy these unlivable lands and help resettle families. Instead, we’re left to count.”
Yet even these numbers, he cautions, fall short of the full toll. “The figure of 7,800 applicants does not reflect the real number of people sick or dead from cancer. Many seek treatment abroad or in other provinces. Countless others aren’t in our databases. The numbers I’m giving you today are not the full picture.”
He is candid about what frustrates him most. “Inside the Iraqi Housing Fund, we’re the direct witnesses to this rise. We see the names, the constancy of the requests. And yet doctors in Basra and officials at the Ministry of Health continue to insist that there is no increase. The numbers clearly contradict this statement. They know the truth but won’t name it.”
In Basra, cancer doesn’t knock. It slips in quietly, like dust through a window, until there’s nothing left to say. No longer a blow, simply the sentence of staying. Passed without trial, served in silence.
And yet, in the shadow of the flares, a quiet resistance has long been smoldering.
In the cracked lanes of Nahran Omar, a village of 2,000 people, where the sky never darkens and the air smells faintly of fuel, Mayor Bashir al-Jabri moves from house to house with a memory sharpened by loss. For over a decade, he’s done what the state has refused: kept count.
He knows the names. He knows the dates. He knows how many were once 16, like the boy whose house he passed earlier today. According to him, in 2012, around 40 people were suffering from cancer or had died from the disease. By 2024, the number had risen to over 385, equivalent to 19% of the population of Nahran Omar. In just six months, the mayor has registered 85 new names: new patients, new families destroyed.
Sometimes, that effort yields results. In 2014, after years of pressure, the Ministry of Oil agreed to pay a few hundred euros to a handful of families. At other times, the flare stacks fall silent for a few days, just long enough for the complaints to fade. Then the fire returns. Louder.
Still, people keep documenting. In al-Jabri’s home, stacks of records rise like brittle monuments: prescriptions, blood test results, death certificates folded at the corners. Across Basra, others do the same. It’s not an uprising, but a scattered archiving of pain, a fragile insurance against denial.
From poisoned soil to courthouse steps, from human rights offices to the long lines outside the Iraqi Housing Fund and the chants that once filled Basra’s streets — the voices rise. Not in unison, but in persistence. A mother with a folder of scans. A mayor with a ledger. A lawyer with too many names and too few verdicts. They speak, even as the institutions built to hear them refuse to listen.
And when reparations come, they arrive quietly, without acknowledgment or apology — a hush compensation masquerading as aid. Most are handed over in cash, discreet and untraceable. Others appear on the pay slips of oil company employees, reduced to a vague line item beside their monthly wages. What never arrives is what matters most: recognition. Not of loss, which is everywhere, but of the accountability of a system that shuts its eyes to the silent killing and tacitly permits its continuation.
Despite mounting pressure and public allegations of falsified health data — voiced by the lawyer al-Misawi, the human rights defender al-Tamimi, staff from Iraq’s Housing Fund and dozens of citizens spoken to by New Lines for this report — officials from the ministries of health and oil have not responded to inquiries. Requests to Sura Yassin, of Iraq’s Cancer Control Committee, also went unanswered.
In the province of Basra, there is no courtroom for this case. No verdict, no defense, no appeal. But here and there, in homes stitched between oil fields, people keep the evidence. Just in case someone decides to look.
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