Monday, September 8, 2008

Vital signs improve, but Iraqi medicine still sick

There are 138 days until Jan. 20, 2009.,0,7492073.story

Vital signs improve, but Iraqi medicine still sick

Returning doctors face crime, violence

Associated Press

September 8, 2008


A kidney specialist who fled Iraq's bombings, kidnappings and sectarian killings 20 months ago has reported back to work at his Baghdad hospital - one of roughly 800 doctors who have returned over the summer.

Doctors are just a tiny group among Iraq 's more than 4 million refugees and displaced, but Iraq 's health minister says their homecoming sends a message to other emigres that security has "improved dramatically."

Still, the nephrologist, who came back from Britain in July, remains cautious. He mostly sleeps at his workplace, Baghdad 's Surgical Hospital , because he fears being attacked en route to his hometown, an insurgent stronghold north of Baghdad . He refused to give his name for publication because he still fears being targeted.

For every doctor who comes back, nine stay away.

About 8,000 physicians, most of them specialists, have abandoned jobs at government health centers since the U.S.-led invasion in 2003, most seeking refuge abroad and a few hundred heading to the relative safety of Iraq 's Kurdish region. Many ran from a violent campaign by extremists and criminal gangs that targeted Iraq 's elite.

Their departure has further crippled a health care system troubled by corruption, mismanagement and a lack of equipment and drugs. Only four of 10 elevators work at the 17-story Surgical Hospital, and patients wait a month for root canal treatment at a Baghdad dental hospital because surgeons lack electricity and anesthetics.

The health minister, Dr. Salih al-Hasnawi, said getting doctors back was key to turning the situation around. Al-Hasnawi has floated the idea of turning Baghdad's Medical City, a five-hospital complex near the Tigris River , into a safety zone for visiting emigre specialists.

He has even come up with a catchy name - the "White Zone" - similar to Baghdad 's fortress-like "Green Zone" for international staff. He promoted the plan in a meeting in Jordan with Iraqi doctors.

Iraq needs 100,000 doctors and has only 15,500, said Adel Muhsin, a top Health Ministry official. Egypt and Jordan, paupers compared with oil-rich Iraq , have almost four times as many - 24 per 10,000 residents to Iraq 's six per 10,000.

Dr. Muneeb al-Huwaish, an Iraqi rheumatologist who has settled in the Jordanian capital of Amman , says he likes the idea of the White Zone, but that it's not enough to lure him back.

"When you leave the hospital and go home, you don't know what will happen to you," said the 61-year-old, who fled Iraq in late 2004 after being seized by a dozen gunmen outside his Baghdad clinic. During a struggle, the abductors broke his right arm with a rifle butt, but released him five days later for $40,000 in ransom.

Al-Huwaish's experience isn't unusual.

In the past five years, Iraq 's doctors, professionals and academics have been targeted by militants trying to widen chaos or by extortion gangs going after the wealthy. Since 2003, at least 620 medical professionals, including 134 doctors, have been killed and many more threatened.

In late August, an anesthesiologist, Dr. Tariq Qattan, was abducted in the northern city of Mosul . When his family couldn't pay $15,000, the kidnappers killed him and dumped his body in a street.

In Basra in southern Iraq , Dr. Khalid al-Mayahi, a neurosurgeon, was grabbed on his way home from work one evening in February, and his body was found in a street the next morning with three shots to the head. A colleague, neurophysiologist Dr. Wathib al-Amoud, said he later received text messages from the kidnappers saying al-Mayahi was killed because of alleged contacts with U.S. and British forces.

Under the previous health minister, militants even infiltrated the health care system.

The minister's deputy at the time was seen as loyal to the anti-American Shiite cleric Muqtada al-Sadr, and some hospitals were transformed into bases for al-Sadr's Mahdi Army militia. Gunmen would seek out wounded Sunnis or attack Sunnis who claimed bodies of relatives at morgues.

During that time, as much as $1 billion in public medical supplies is believed to have been sold on the black market, according to congressional testimony earlier this year by a U.S. government watchdog.

The new minister, while acknowledging there has been some corruption in most Iraqi ministries, said he believes that figure is far too high. He said that he's fighting corruption and that the supply of medication has improved in the past year.

Yet many hospitals remain underequipped and pharmacies understocked - a state of affairs Iraqis find difficult to accept when their government could end the year with a $79 billion budget surplus.

As an incentive, the government has sharply increased doctors' salaries. Specialists now make $2,000 to $3,000 a month, while under Saddam Hussein's rule, doctors would earn as little as $30.

But some doctors may be gone for good.

Dr. Zaid al-Sharbaqi, 29, a general practitioner who left Baghdad in 2006, has settled in faraway Stockholm , studying Swedish in preparation for the local medical exams.

"I'm dreaming to go back to Iraq , but I think the situation is still dangerous for all Iraqis," he said. "Every day, I become more and more tired when I listen to the news."

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