Prior to the clashes, a medical team had assembled in Najaf and diagnosed Sistani with heart problems. They determined that he needed urgent treatment that was not available in Iraq. Before he could leave for London for treatment, however, fighting broke out between the Mahdi Army and US-Iraqi security forces and quickly spread throughout the city.
Sistani would travel to London via a short layover in Beirut, but the Najaf-Baghdad journey was fraught with danger. Besides the clashes in Najaf, neighborhoods just to the south of Baghdad and areas around the airport, to the west of Baghdad, were militant hotspots. Iraq’s national security adviser, Mowaffak al-Rubaie, suggested that Sistani travel to the Baghdad airport in a US helicopter, repainted with Iraqi insignia, but this idea was rejected. Instead, Sistani made the perilous journey on his own, in a three-car convoy.
In Lebanon, no one except parliament Speaker Nabih Berri was informed of Sistani’s brief transit due to fears that word would spread and militants in Iraq might realize he would be traveling from Baghdad airport. As one of the most high-profile leaders of Shiite Muslims, Sistani would have been a prime target for al-Qaeda-affiliated Abu Musab al-Zarqawi and other Salafist or Baathist insurgents in Iraq.
As Sistani underwent surgery in London, the fighting in Najaf worsened with each passing day. Initial efforts to convince Sadr to agree to a UN-mediated cease-fire through Hezbollah officials in Beirut failed. Sistani’s aides in London were in contact with Iraqi, Lebanese and Iranian officials to find a way to end the conflict. Khamenei even sent a message directly to Sistani, warning of a coming massacre in Najaf. Khamenei said Iran had not intervened or taken a position out of respect for Sistani, because Iranian officials did not want to take a public position that might contradict him.
Sistani immediately replied that the Iraqi government, led by Prime Minister Ayad Allawi, would not continue military operations once Sadr agreed to the terms of a peace initiative. In this, Sistani was effectively throwing the ball back in Sadr’s, and even Iran’s, court.