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Posted 2:03 PM by Mary

ICRC on Iraq's Healthcare crisis

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.

Labels: health, Iraq, Red Cross