IRAQI HOSPITALS AILING UNDER OCCUPATION
...This report supports the conclusion of many observers that the war and occupation -- and sanctions prior to that -- are primarily to blame for the appalling state of healthcare in Iraq today. Up to 1990, Iraq had one of the best healthcare systems in the Middle East. This was the result of a deep commitment by the Iraqi health professionals to serve their patients well; a long-term, quality-oriented planning by successive Iraqi governments since the 1930s; and well-functioning and disciplined -- albeit sometimes heavy-handed -- government structures. Since a few months, an autonomous government is claimed in Iraq, although both its legitimacy and its autonomy are highly questionable. It can easily be argued, based on international law, that the existence of this government doesn’t change the US’s status as an occupying power. In any case, the US was the occupying power in Iraq for the period covered by this report. As such, the US was responsible for conforming with all international law, especially humanitarian law and human rights law, regarding the situation of healthcare in Iraq...
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IRAQI HOSPITALS AILING UNDER OCCUPATION
Dahr Jamail, http://dahrjamailiraq.com/
BRussells Tribunal
 |
Issued and endorsed by:
  
* Also: Asian Women’s Human Rights Council, Association of Humanitarian Lawyers < http://www.webcom.com/hrin/parker/welcome.html > ,
SOS Iraq < http://www.irak.be/ >
* This report is submitted as evidence to the Jury of conscience during the culminating session of the World Tribunal on Iraq < http://www.worldtribunal.org/main/? > , Istanbul 23-27 June
I. INTRODUCTION
II. THE STUDY
III. SUMMARY OF FINDINGS
IV. CASE STUDIES
A. Equipment and Medicine Shortages
B. US Military Interfering With Medical Care
C. Lack of Water and Electricity Affecting Medical Care
V. CORRUPTION AND CRIME
VI. BRAIN DRAIN
VII. RECONSTRUCTION CONTRACT WORK IN LIMBO
VIII. CONCLUSIONS
IX. SECTIONS OF GENEVA CONVENTIONS I, III AND IV OF 1949, RELEVANT TO HEALTH RIGHTS AND HEALTH CARE
I. INTRODUCTION
Although the Iraq Ministry of Health claims its independence and has received promises of over $1 billion of US funding, hospitals in Iraq continue to face ongoing medicine, equipment, and staffing shortages under the US-led occupation.
During the 1990s, medical supplies and equipment were constantly in short supply because of the sanctions against Iraq. And while war and occupation have brought promises of relief, hospitals have had little chance to recover and re-supply: the occupation, since its inception, has closely resembled a low-grade war, and the allocation of resources by occupation authorities has reflected this reality. Thus, throughout Baghdad there are ongoing shortages of medicine of even the most basic items such as analgesics, antibiotics, anesthetics, and insulin. Surgical items are running out, as well as basic supplies like rubber gloves, gauze, and medical tape.
In April 2004, an International Committee for the Red Cross (ICRC) report stated that hospitals in Iraq are overwhelmed with new patients, short of medicine and supplies and lack both adequate electricity and water, with ongoing bloodshed stretching the hospitals’ already meager resources to the limit.[1]
Ample testimony from medical practitioners in the interim in fact confirms this crisis. A general practitioner at the prosthetics workshop at Al-Kena Hospital in Baghdad, Dr. Thamiz Aziz Abul Rahman, said, "Eleven months ago we submitted an emergency order for prosthetic materials to the Ministry of Health, and still we have nothing," said Dr. Rahman. After a pause he added, "This is worse than even during the sanctions."[2]
Dr. Qasim al-Nuwesri, the chief manager at Chuwader General Hospital, one of two hospitals in the sprawling slum area of Sadr City, Baghdad, an area of nearly 2 million people, added that there, too, was a shortage of most supplies and, most critically, of ambulances. But for his hospital, the lack of potable water was the major problem. "Of course we have typhoid, cholera, kidney stones…but we now even have the very rare Hepatitis Type-E…and it has become common in our area," said al-Nuwesri, while adding that they never faced these problems prior to the invasion of 2003.[3]
Chuwader hospital needs at least 2000 liters of water per day to function with basic sterilization practices. According to Dr. al-Nuwesri, they received 15% of this amount. "The rest of the water is contaminated and causing problems, as are the electricity cuts," added al-Nuwesri, "Without electricity our instruments in the operating room cannot work and we have no pumps to bring us water."[4]
In November, shortly after razing Nazzal Emergency Hospital to the ground,[5] US forces entered Fallujah General Hospital, the city’s only healthcare facility for trauma victims, detaining employees and patients alike.[6] According to medics on the scene, water and electricity were "cut off," ambulances confiscated, and surgeons, without exception, kept out of the besieged city.[7]
Many doctors in Iraq believe that, more widely, the lack of assistance, if not outright hostility, by the US military, coupled with the lack of rebuilding and reconstruction by foreign contractors has compounded the problems they are facing.
According to Agence France-Presse, the former ambassador of Iraq Paul Bremer admitted that the US led coalition spending on the Iraqi Health system was inadequate. "It’s not nearly enough to cover the needs in the healthcare field," said Bremer when referring to the amount of money the coalition was spending for the healthcare system in occupied Iraq.[8]
When asked if his hospital had received assistance from the US military or reconstruction contractors, Dr. Sarmad Raheem, the administrator of chief doctors at Al-Kerkh Hospital in Baghdad said, "Never ever. Some soldiers came here five months ago and asked what we needed. We told them and they never brought us one single needle… We heard that some people from the CPA came here, but they never did anything for us." [9]
At Fallujah General Hospital, Dr. Mohammed[10]said there has been virtually no assistance from foreign contractors, and of the US military he commented, "They send only bombs, not medicine."[11]
International aid has been in short supply due primarily to the horrendous security situation in Iraq After the UN headquarters was bombed in Baghdad in August 2003, killing 20 people, aid agencies and non-governmental organizations either reduced their staffing or pulled out entirely.
Dr. Amer Al Khuzaie, the Deputy Minister of Health of Iraq, blamed the medicine and equipment shortages on the US-led Coalition’s failure to provide funds requested by the Ministry of Health.[12]
"We have requested over $500 million for equipment and only have $300 million of this amount promised," he said, "Yet we still only have promises."[13]
According to The New York Times, "of the $18.4 billion Congress approved last fall, only about $600 million has actually been paid out. Billions more have been designated for giant projects still in the planning stage. Part of the blame rests with the Pentagon's planning failures and the occupation authority's reluctance to consult qualified Iraqis. Instead, the administration brought in American defense contractors who had little clue about what was most urgently needed or how to handle the unfamiliar and highly insecure climate."[14]
The World Health Organization (WHO) last year warned of a health emergency in Baghdad, as well as throughout Iraq if current conditions persist. But despite claims from the Ministry of Health of more drugs, better equipment, and generalized improvement, doctors on the ground still see "no such improvement."[15]
II. THE STUDY
From April, 2004 through January, 2005, the author and his colleague surveyed 13 hospitals in Iraq in order to research how the healthcare system was faring under the US-led occupation. While the horrendous security situation in Iraq caused the researchers to confine the survey to hospitals primarily in Baghdad, hospitals west, north, and south of the capital are included in this report.
Hospitals surveyed:
Al-Karama Hospital, Sheikh Marouf, Baghdad
Falluja General Hospital
Saqlawiya Hospital
Amiriat Al-Fallujah Hospital
Balad General Hospital
Alexandria Hospital, Babylon Province (just south of Baghdad)
Al-Kena Hospital, Baghdad (Prosthetics/Rehabilitation)
Yarmouk Hospital, Baghdad
Baghdad Teaching Hospital (Baghdad Medical City)
Chuwader Hospital, Sadr City, Baghdad
Al-Noman Hospital, Al-Adhamiya, Baghdad
Al-Kerkh General Hospital, Baghdad
Arabic Children’s Hospital, Baghdad
III. SUMMARY OF FINDINGS
Early in 2004, prior to this report, Dr. Geert Van Moorter, a Belgian M.D., conducted a fact-finding mission to Iraq where he surveyed hospitals, clinics, and pharmacies. Van Moorter concluded: "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, had further deteriorated over the past year."[16]
Findings in this report suggest that Dr. Van Moorter’s statement remains true today, albeit with the continued deterioration of equipment, supplies, and staffing, further complicated by an astronomical increase in patients due to the violent nature of the occupation of Iraq. This report documents the desperate supply shortages facing hospitals, the disastrous effect that the lack of basic services like water and electricity have on hospitals and the disruption of medical services at Iraqi hospitals by US military forces.
This report further provides an overview of the situation afflicting the hospitals in Iraq in order to highlight the desperate need for the promised "rehabilitation" of the medical system. Case studies highlight several of the findings and demonstrate that Iraqis need to reconstruct and rehabilitate the healthcare system. Reconstruction efforts by US firms have patently failed, while Iraqi contractors are not allowed to do the work.
The current model in Iraq of a "free trade globalized system," limited in fact to American and a few other western contractors, has plainly not worked. Continuing to impose this flawed and failing system on Iraq will only worsen the current healthcare crisis.
Compounding the problems due to a lack of equipment and medicine in Iraqi hospitals, occupancy rates at all but one of the hospitals surveyed was between 80-100% because of heavy fighting, car bombs, and an exceedingly high crime rate in occupied Iraq.[17] [IDEM]
Hospital
|
X-Ray
|
Ventilator
|
Ambulances
|
Pharmaceuticals
|
Lab Supplies
|
US Military Incursions
|
Al-Karama Baghdad
|
Have ……….. 6
Working……. 2
Total Needed ..6
|
Have ……..… 10
Working…….. 4
Total Needed ..10
|
Have ……..… 4
Working…….. 2
Total Needed .. 5
|
Supply Sporadic
|
Supply Sporadic
|
Sporadic
|
Fallujah General
|
Have ……..… 5
Working…….. 2
Total Needed .. 7
|
Have ……..… 8
Working…….. 3
Total Needed .. 8
|
Have ……..… 5
Working…….. 2
Total Needed .. 6
|
Supply Sporadic
|
Supply Sporadic
|
Sporadic
|
Balad General
|
Have ……..… 3
Working…….. 1
Total Needed .. 4
|
Have ……..… 5
Working……..2
Total Needed .. 5
|
Have ……..… 3
Working……..1
Total Needed ..3
|
Supply Sporadic
|
Supply Sporadic
|
Sporadic
|
Alexandria (south of Baghdad)
|
Have ……..… 3
Working…….. 1
Total Needed .. 3
|
Have ……..… 3
Working…….. 1
Total Needed .. 3
|
Have ……..… 4
Working…….. 1
Total Needed .. 4
|
Supply Sporadic
|
Supply Sporadic
|
Sporadic
|
Al-Kena, Baghdad
|
Have ……..… 2
Working…….. 1
Total Needed .. 4
|
Have ……..… 4
Working…..... 2
Total Needed .. 4
|
Have …….… 2
Working…..... 1
Total Needed ..3
|
Supply Sporadic
|
Supply Sporadic
|
None
|
Yarmouk, Baghdad
|
Have ……….. 4
Working……. 3
Total Needed. 5
|
Have …….…. 28
Working….... 16
Total Needed...28
|
Have ………… 6
Working…….. 4
Total Needed… 6
|
Supply Sporadic
|
Supply Sporadic
|
Frequent
|
Baghdad Teaching
|
Have ……...… 7
Working...….. 4
Total Needed.. 4
|
Have ……….. 20
Working..…. ..20
Total Needed…0
|
Have ………… 4
Working…….. 4
Total Needed ... 6
|
Supply Sporadic
|
Supply Sporadic
|
None
|
Chuwader General
|
Have ………... 13
Working….… 6
Total Needed .. 13
|
Have ……..…14
Working…… 7
Total Needed ..12
|
Have ……….... 5
Working……... 3
Total Needed .. 10
|
Supply Sporadic
|
Supply Sporadic
|
Frequent
|
Al-Noman Baghdad
|
Have …….…. 2
Working….... 1
Total Needed .. 3
|
Have ……….. 5
Working……. 3
Total Needed .. 6
|
Have …………. 2
Working……… 1
Total Needed .. .3
|
Supply Sporadic
|
Supply Sporadic
|
Frequent
|
Al-Kerkh General
|
Have …….…… 6
Working……... 5
Total Needed… 5
|
Have …..…… 9
Working…..... 3
Total Needed.. 9
|
Have ……….… 5
Working……… 2
Total Needed….5
|
Supply Sporadic
|
Supply Sporadic
|
Sporadic
|
Arabic Children’s
|
:: Article nr. 12845 sent on 21-jun-2005 20:40 ECT
www.uruknet.info?p=12845
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