Posted by Sadie from D006060.N1.Vanderbilt.Edu (220.127.116.11) on Tuesday, August 19, 2003 at 9:21AM :
Published on Monday, August 18, 2003
Miami Herald, via commondreams.org
U.S. Slow to Cure Iraqi Healthcare Ills
by Daniel Williams
BAGHDAD - Four months into the U.S. occupation of Iraq, the capital's hospitals are in disarray, operating mostly through improvisation.
Though wartime memories of injured and wounded civilians laid out in hospital corridors are fading, the healthcare situation in Baghdad remains bleak. Patients shuttle from hospital to hospital, uncertain about what level of care various facilities can provide. Persistent problems with electrical and water supplies, as well as irregular deliveries of such essentials as anesthetics and oxygen, continue to plague hospitals, health officials say. Fear of robbery deters some doctors from going to work, and female nurses virtually have disappeared from wards for fear of traveling, especially in the evening.
U.S. administrators argue that things are getting better in all spheres of life in the city, but Iraqis are increasingly impatient. While they concede that prewar Iraqi healthcare was inadequate, many find it hard to accept that the United States, with its vast wealth and military might, is unable to ensure rapid provision of basic services.
''Certainly, people had it in their minds that things would get better. It is when they need real help that they see the problems and get desperate,'' said Mohammed Salah, who was injured in the Aug. 7 car bombing at the Jordanian Embassy in Baghdad. The three people with Salah, in a passing car as the blast occurred -- two Iraqis and a Jordanian driver -- were killed.
Since the blast tore flesh, nerves and blood vessels away from both his arms, fracturing one of them, Salah has endured a dispiriting odyssey in his search for treatment. A passing motorist took him to Yarmouk Hospital, Baghdad's largest. The day after the blast, when doctors postponed an operation because of a lack of oxygen canisters, Salah became fearful. Three days and two hospitals later, an Italian Red Cross tent hospital agreed to admit him, care for his wounds and fight the infection that threatened his arms and perhaps his life. ''It is like a paradise here,'' he said from his bed at the field hospital.
''This is a confusing period,'' said Nada Doumani, a spokeswoman for the International Committee of the Red Cross. ``It is hard to figure out who is responsible for what. Most hospitals are open, but how they are running is the question.''
Doumani said the problems stem partly from occupation authorities' removal of directors who belonged to deposed President Saddam Hussein's Baath Party. Their absence has created administrative confusion in many hospitals. ''Iraqis are having problems making decisions, taking the initiative,'' she said.
Security is also a crippling problem. Since gunmen ambushed and killed a Red Cross worker driving through central Iraq last month, the Red Cross has curtailed travel, especially late in the day.
American officials seem resigned to maintaining a sort of status quo for the time being and fully restructuring the system later. Jim Haveman, the senior U.S. advisor to the Iraqi Health Ministry, said, ``The system is running and basic services are being provided.''
The main goal now is to prevent epidemics, Haveman said. As for the long term, he said, ``we're starting from zero.''
The U.S. civil administration in Iraq has budgeted $210 million to support hospitals, clinics and forensic laboratories for the final six months of the year. The budget includes funds for drug purchases, repair and maintenance of equipment, child nutritional programs and specialized programs such as post-trauma stress care.
It has become clear that the United States alone will be unable to rebuild the Iraqi health system and that Iraqi resources will be insufficient for the time being, Haveman indicated. An international donors conference is scheduled for October in Madrid, and organizers hope to attract hundreds of millions of dollars in pledges. ''The donor community will have to step forward. Don't expect oil revenue to pour in and solve the problem,'' Haveman added.
Jalal Massa, a cardiologist who runs the private Samaritan Hospital, said that the Hussein-era legacy of corruption hobbles progress. ''There is no need to romanticize the past,'' he said. ``People could get care if they were willing to pay bribes -- to ambulance drivers, the doctors, everyone. It might be tempting to go over to an entirely private system . . . but how many Iraqis can pay?''
Copyright 1996-2003 Knight Ridder
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