War in Iraq has caused a public health disaster that has left the country’s medical system in tatters and increased the risk of disease and death, according to a report released Tuesday.

Medact, a British-based charity that examines the impact of war on health, said cases of vaccine-preventable diseases were rising and relief and reconstruction work had been mismanaged.

“The health of the Iraqi people has deteriorated since the 2003 invasion,” Gill Reeve, the deputy director of Medact, told a news conference to launch the report.

“Immediate action is needed to halt this health disaster.”

The report, which is based on interviews in Jordan with Iraqi civilians, relief organizations and health professionals who worked in Iraq, called for Britain to set up an independent commission to investigate civilian casualties and to provide emergency relief and a better health system.

“The 2003 war exacerbated the threats to health posed by the damage inflicted by previous wars, tyranny and sanctions. It not only created the conditions for further health decline, but also damaged the ability of Iraqi society to reverse it,” it said.

Iraq had high mortality before the 2003 war. The report details a recurrence of previously well-controlled illnesses like diarrhea, acute respiratory infections and typhoid.

Postwar security worries limit access to health care, particularly in flashpoint areas. The quality of health services is poor because of chronic under-funding, poor physical infrastructure, mismanagement of supplies and staff shortages.

One in four people in Iraq still depend on food aid and more children are underweight or chronically malnourished than in 2000, the report added.

“Maintaining adequate care is a real problem,” said Mike Rowson, the executive director of Medact.

Iraqis increasingly rely on self-diagnosis and traditional healing and buy prescription medicines in the marketplace. “The U.N., traditionally responsible for coordinating humanitarian crisis responses, has been marginalized while U.S. assistance has been characterized by damaging political in-fighting,” the report added.

Rowson said a lot of money had been pledged for reconstruction but very little had been distributed to rebuild the Iraqi health system. “The political situation is key to making health improvements in Iraq,” he added.

The report urges coalition forces to monitor casualties and re-evaluate the impact of weapons used in populated areas.

“We hope that by highlighting health we can make sure that all sides in the conflict know the price the civilian population is paying for the ongoing violence,” Rowson added.