Very sick, and not getting
better By Alexander Casella
GENEVA - Five years after the American
invasion of Iraq, the humanitarian situation is
one of the world's most critical, according to a
recent report issued by the International
Committee of the Red Cross (ICRC) in Geneva.
Currently, about 1 million Iraqis are
reported missing and are considered as having
either been killed or abducted. Some 2 million
have fled to neighboring countries and an
additional 2.5 million have been internally
displaced - this in a population estimated at 27.5
million people. But the greatest level of
deterioration had been the virtual collapse of the
health care system. This was a process that
started well before 2003.
From the early
1980s, the Iraqi health care system did not
keep
pace
with the country's population growth and existing
facilities became increasingly strained. Sanctions
imposed after 1990 further compounded the problem
and forced health authorities to shift their
emphasis towards the provision of emergency
services at the expense of public heath and
infrastructure maintenance.
Thus, at the
time of the American invasion, the Iraqi health
care system was already under considerable stress.
Rather than contributing to redressing the
situation, the occupation and ensuring resistance
only precipitated the crisis and brought the
system close to a total collapse.
According to official Iraqi figures, of
the 34,000 doctors registered in 1990, at least
20,000 have left the country. Since 2003, more
than 2,200 doctors and nursed have been killed and
more than 250 kidnapped. There are currently 172
public hospitals with 30,000 beds, well short of
80,000 beds needed, plus 65 private hospitals.
Practically all are in sub-standard condition and
are short of equipment and drugs. Interventions
such as open-heart surgery are no longer practiced
and the only choice, for those who can afford it,
is to seek treatment abroad.
Lack of
qualified staff, and in particular midwives, has
had a direct impact on infant mortality rates in
particular and on the level of care in general.
Lack of medical facilities is compounded by the
poor security situation. In many areas road
checkpoints and curfews have restricted movements
to the point in which access to a hospital in the
event of an emergency has become impossible.
While private clinics provide marginal
better services and security than public
hospitals, most of the population can't afford the
cost. A private sector doctor charges between US$2
and $7 for a consultation, a fee beyond the means
of the average Iraqi who earns on average $5 a day
when not unemployed.
Compounding the
effects of the health care crisis is the lack of
sanitation. Inadequate treatment of sewage,
constant breakdown of water treatment plants due
to equipment failure and electricity shortages,
outdated piping and illegal connections have
resulted in a major shortage of drinking water.
Restrictions on chlorine, essential for
water sterilization but also an ingredient on the
making of explosives, have further hampered
efforts at water sterilization. With most Iraqis
no longer able to rely on public services for
clean water, the only alternative is bottled water
at a cost of some $50 per month per family. It is
an alternative that most can't afford, and the
cholera outbreak of 2007 was directly attributed
by the ICRC to the combination of a collapsing
healthcare system and the increasing lack of
sanitation.
The ICRC, as a matter of
policy, has left the finger pointing to others and
has chosen to focus on the facts rather than on
their cause. Thus, the report not once refers to
the "United States" and the invasion is qualified
as the "outbreak of the war". This restraint,
however, is only a matter of cosmetics and it is
not even necessary to read between the lines to
view the report as a damning indictment of the
consequences of the US invasion of Iraq.
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