U.S.
Gives Iraqi Hospitals Broken Promises In Place Of Medicine
By Dahr Jamail
07 July, 2004
The New Standard
Baghdad ,
Jul 5 - Despite promises of over $1 billion in US funding, hospital
patients in Iraq continue to suffer ongoing hardship. Problems plaguing
Iraqi hospitals fifteen months into what has been a brutal, bloody occupation
range from ongoing medicine and equipment shortages to an overall lack
of proper medical infrastructure.
"We are getting
less medical supplies now than we were during the sanctions," said
Dr. Namin Rashid, the Chief Resident Doctor at Yarmouk Hospital. "Paul
Bremer came here and talked a lot at the beginning of the occupation,
but nothing has changed," Rashid added, referring to the recently
departed civilian administrator of the Coalition Provision Authority.
Standing near an
overcrowded and understaffed emergency room, Dr. Rashid additionally
pointed out that his hospital is getting only half the supplies it received
prior to the US-led invasion in March 2003.
At Al-Kerkh General
Hospital, Dr. Sarmad Raheem is an orthopedic surgeon who is also the
assistant manager of the hospitals chief doctors. "We are
short of everything here," he said. According to Dr. Raheem, the
hospital was suffering from a shortage of basic antibiotics and medications
such as hydrocortisone and painkillers. "We even have to send our
patients to the market to buy plates and screws they need for their
own operations," he said.
During a tour of
the hospitals critical care unit, Dr. Raheem stopped to point
out an overflowing toilet, from which human feces spilled onto an already
messy bathroom floor. "We cant afford cleaners," he
said, "and [we] even lack ultra-violet lights for sterilizing our
equipment."
Many doctors throughout
hospitals in Baghdad complain of insufficient electricity and clean
water, for which they blame foreign companies who have failed to live
up to their reconstruction contracts.
A recent report
by the International Committee of the Red Cross (ICRC) stated that hospitals
in Baghdad are running out of medicine and facing water and electricity
shortages. Florian Westphal, a spokesperson for the ICRC, told reporters
in Geneva, "There is no doubt really that the resources and staff
of these places are really stretched to the limit."
In the impoverished
slum area of Sadr City, home to over 1.2 million people, doctors in
Chuwader General Hospital spoke of even worse shortages. "We are
short of every medicine," said Dr. Qasim Al-Nuwesri, the General
Manager of the hospital. "This rarely occurred before the invasion.
It is forbidden, but sometimes we have to reuse [intravenous kits],
even the needles, because we have no choice."
Chuwader Hospital
has endured outbreaks of diseases that Dr. Al-Nuwesri says could have
been avoided. "Of course we have typhoid, cholera, kidney stones,"
he said. "But we now even have the very rare Hepatitis Type-E...
and it has become common in our area."
Hepatitis E is associated
primarily with ingestion of drinking water contaminated by human feces.
Miscarriage during pregnancy is a common result of the disease, and
perinatal transmission of Hepatitis E has become common at Chuwader
Hospital.
The disease can
be easily averted as long as hospital staff and patients are able to
avoid contaminated food and water. Unfortunately, Dr. Al-Nuwesri said,
the hospital only receives fifteen percent of the clean water necessary
for adequate operations.
Many doctors throughout
hospitals in Baghdad complain of insufficient electricity and clean
water, for which they blame foreign companies who have failed to live
up to their reconstruction contracts. Under the Geneva Conventions,
which the United States has signed, occupying powers are responsible
for supplying and maintaining the civilian infrastructure of occupied
territory.
Ahlan Bari, the
Head Manager of nurses at Yarmouk Teaching Hospital, said that the hospital
only has eight hours of electricity per day without generators. "Our
generators often break down, and we lack fuel for them at times,"
she said, standing inside the hospitals busy lobby. "Just
last week we had a patient die on the operating table because we had
a power outage and couldnt run our equipment."
Dr. Abdullah Younis,
the head manager at Al-Noman Hospital in the Adhamiya district of Baghdad,
said he faced many equipment shortages as well.
"We only have
two X-ray machines, and one is very old," Younis said while pointing
out the 1970s vintage diagnostics appliance. "And of our five cardiac
monitors, the two primary units are broken, and the three that are functioning
are of very bad quality."
The blood cooler
lacked parts, the intensive care unit needed monitors and one of their
two ambulances was out of order, according to Dr. Younis. He also said
that their laboratory lacked basic testing equipment, and the hospital
sometimes lacked supplies such as gauze and rubber gloves.
After a recent fact-finding
mission to Iraq where he surveyed 25 hospitals, clinics and pharmacies,
Dr. Geert Van Moorter, a Belgian physician, found that the health care
system had deteriorated since his previous study a year earlier. His
report, published by Medical Aid for the Third World, observed: "Nowhere
had any new medical material arrived since the end of the war. The medical
material, already outdated, broken down or malfunctioning after twelve
years of embargo [international sanctions], had further deteriorated
over the past year." Medical Aid for the Third World is a Belgian
non-governmental health and human rights organization that strongly
opposed the US-led invasion of Iraq.
According to Dr.
Talat Al-Mukhtar, a medical doctor in Baghdad, corruption and the lack
of infrastructure are the leading problems plaguing the Iraqi health
care system. He said that pharmacies overcharge hospitals for medications,
and there was nothing that doctors could do about it. "There is
no government office to complain to when the pharmacies are overcharging
us or our patients because we have no infrastructure," he said
angrily.
"Medicines
are pouring in from everywhere now and are unregulated and uncertified,"
complained Dr. Al-Mukhtar. "The main problem is that the distribution
of narcotics is out of control, and there are unregistered HIV patients
who are giving blood because there is no longer mandatory testing [of
donors]."
He added, "Everything
is worse now for doctors in Iraq than [it was] during the sanctions,
except the pay."
Dr. Mukhtar said
that under Saddam Husseins rule, doctors only earned $3 per month
and sometimes sold medications on the black market to augment their
income. But while corruption existed before the invasion, he said, it
is far worse now.
The Deputy
Minister of Health, Dr. Amer Al-Khuzaie, said that his ministry was
allocated $1 billion of the $18.6 billion set aside by the US government
for rebuilding Iraq.
But Al-Khuzaie says
the Ministry of Health does not have control over the funds. Instead,
USAID, the governmental body responsible for allocating Iraq reconstruction
funds, distributes all money through contracts to foreign corporations
on behalf of Iraq. The corporations then spend the funds as they see
fit.
"Bechtel, via
USAID, has the contracts for distributing the subcontracts and money
for rebuilding and rehabilitating our hospitals," Al-Khuzaie said
in his office at the Health Ministry.
Asked why the lack
of supplies and rehabilitation of the hospitals was still a problem
fifteen months after the invasion, the deputy minister replied: "Usually
they use the excuse of the security situation in Iraq. But then why
dont they allow Iraqi companies to do the work?"
Al-Khuzai didnt
seem surprised that the US government would favor American companies
when handing out lucrative reconstruction contracts. "Surely every
country passes their money through their contractors," he said.
"We could do the work and use Iraqi subcontractors. The problem
is that they want their own companies to do it."
According to Agence
France-Presse, former occupation chief Paul Bremer admitted in February
that Coalition spending on the Iraqi medical system was inadequate.
"Its not nearly enough to cover the needs in the health care
field," Bremer said.
Dr. Khuzaie said
that he knew the hospitals were recently due to receive $300 million
from the Coalition Provisional Authority, but they have not received
anything yet.
The Coalitions
own Health Ministry spokesperson did not return calls or emails before
the CPA was dissolved and its staff departed from Iraq last week, and
as of July 4 had still not responded.
The deputy minister
said that every time a request has been made for more funding from the
Coalition, responses have been delayed for up to two months. "We
have requested over $500 million for equipment and only have $300 million
of this amount promised," he said frankly. "Yet we still only
have promises."
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