Doctors Needed
By Anna Badkhen
San Francisco Chronicle
20 May, 2003
"Doctor! Is there a doctor here?" a man hollered, his shriek echoing off the tiled hallways of the Al Yarmuk emergency hospital.He ran bellowing down hallways pushing his father, Abdul Wahed Kamel, on a stretcher. Kamel's abdomen and thigh, slashed by a robber's knife, spurted thick blood, leaving a dark red trace on the gray floor.
Kamel's son shoved the stretcher into the emergency room. Sputtering and shaking with fear, he explained why it took him more than an hour to bring in his father: Because the phones in Baghdad have not been working since the war, he could not call an ambulance or even a taxi.
Saad al Ani, the doctor on duty, listened quietly, feeling Kamel's neck for a pulse. Then, he pronounced him dead.
"Daddy, Daddy!" Kamel's son roared, hitting the wall, the stretcher, his dead father's bleeding body, the relatives who tried to restrain him. Male nurses dragged him out into the street. A woman with an X-ray in her hand followed, then paused by the door.
"Iraq," she shrugged.
Along with all public services, this country's once-proud health system has collapsed in the aftermath of the U.S.-led war.
The ambulance service doesn't work, and many patients die before they get to a doctor. Electricity is unreliable, and doctors often have to postpone surgeries until it is too late.
DOCTORS STRUGGLE
Many doctors have stopped going to work, afraid of robbers. Most hospitals have been looted, stripped bare of medication and equipment, while unpaid emergency room doctors struggle for the lives of their patients: pregnant women, men with heart problems, children dying from diarrhea, and a never- ending stream of victims of street violence.
In addition, no one cleans the streets, and garbage is rotting everywhere in the sweltering heat, breeding disease.
The World Health Organization said last week that Iraq needs at least $20 million to revive the health system, money that the country -- weakened by war,
international sanctions, ravaged by a corrupt government and shattered by the anarchy that replaced it -- does not have.
The U.S. Army's 3rd Infantry Division is guarding Al Yarmuk, but no American aid has been offered.
ONE ROLL OF TAPE
As he began his Friday shift at 8 a.m., Dr. Ani inspected the shelf where his equipment was laid out and shook his head at what was available -- two dozen plastic syringes, a box of unsterilized gauze, one roll of medical tape and a pair of surgical scissors submerged in a blood-tainted liquid. No painkillers. No clean water. Too little IV fluid. Too few nurses.
And no electricity.
A U.S. missile had disabled Al Yarmuk's generator on April 5, four days before the fall of Saddam Hussein's government, and now the hospital depends entirely on Baghdad's erratic power supply. By noon, the hospital was an oven, its ceiling fans still.
Relatives stood around dirty beds, fanning their loved ones with old X-ray negatives, scraps of paper, tissues, the palms of their hands. One patient ripped a piece of bandage from the cast on his leg and used it to wipe his sweating face. Walking among the cots, Ani shrugged at the futility of it all.
A 3-year-old girl, struck by a car, had sustained head injuries, but Ani could not check for skull fractures because there was no electricity to power the X-ray machine. Across the room, a man with appendicitis moaned, a male relative clutching his hand. Without electricity, the doctors could not operate. Without surgery, the appendix would rupture and the man would die.
Ani had to make do with what little he had.
"IV fluid," he ordered, making a sweeping gesture at the ward. If nothing else, his patients would not die of dehydration.
'DURING THE WAR IT WAS BETTER'
"Don't you think this is a crime?" he asked. "During the war it was better, because at least we had electricity, and we hadn't been looted.
"Now, we don't know what, I don't know what . . .," he mumbled, then walked briskly away.
In the surgical ward, Mohammed Taban, an assistant surgeon, leaned against a wall in the hallway, his eyes half-closed. Someone called for help, but Taban did not move. His superior had disappeared, and there were no other doctors or nurses around.
"We can't operate without power -- we can't operate without painkillers. We can't help these people. We are useless," he said, then looked away.
A few doors down, 14-year-old Ronza Shershabi started bleeding again from the gunshot wound in her wrist, which a surgeon had examined an hour earlier.
Looking with disgust and fear at her bloodstained lime-green pajamas, Shershabi sat up on her dirty cot. "There is no care here," she said. "Nobody is treating me. I want to go home. Mama! Look, I'm bleeding again."
Her mother began to cry. Suddenly, a surgeon appeared in the doorway.
"Any volunteers to give blood?" he asked, distractedly. Without waiting for an answer, he walked away. Shershabi's eyes filled with tears.
Seconds later, screams filled Ani's ward again.
INJURIES FROM RAPISTS
Nuhat Dali shrieked as she pushed the wheelchair with her husband, Faraj, into the room. Blood was streaming down his naked arms and back from two large gashes -- wounds sustained while protecting his wife from a gang of rapists.
Ani and two other doctors swarmed around, trying to stop Nuhat from clinging to her injured husband and move him onto a cot at the far end of the room.
By the time the doctors finally put Faraj on an IV, a new wave of patients had flooded in. A man groaned in a wheelchair, blood flowing out of a cut on his shoulder. Relatives lowered onto the floor a woman who had had a heatstroke: There were no more cots available.
Next to her, a man examined a bullet hole in the arch of his foot. Another man bled from his thigh. A teenager nursed what looked like a broken wrist. Burns and blisters covered a little boy's stomach and chest.
Doctors and parents shuffled around, placing two or even three child patients on a single cot. The scene grew more surreal -- for a minute, the room was full of crying parents with half-naked children in their arms. Faraj moaned, twisting on his cot as a doctor put stitches in his arm without anesthesia.
Ani darted across the room, rushing from one patient to another, bloodied latex gloves on his hands. A child cried. The man with the cut in his shoulder had lost a lot of blood and now lay completely motionless as a doctor examined his arm.
"There are no nurses, no plaster, just this," Ani said, breathing heavily as he pulled a roll of medical tape out of his pocket.
It was 2 p.m., and he was down to six syringes. The unsterilized gauze was all gone. And he had no more IV fluid.