The ouster of Saddam has brought with it a new set of challenges. Last March the Iraqi Minister of Health, Ali al-Shammari, a loyalist to radical Shia cleric Moqtada al-Sadr, resigned his post amid allegations of corruption and abuse of power.
Without so much as a phone call from a family member, it is likely that the nameless Iraqi man will be sent to Medical City, a public hospital in Baghdad that currently houses more than 2,000 Iraqis at any given time. Typically, Iraqi patients must meet one important criterion in order to be discharged to Medical City.
Iraqis at the Air Force hospital receive unparalleled medical services, but usually for less than a week.
“We will not send Sunnis to the two ‘functioning’ Iraqi public hospitals in Baghdad,” explains Stresino. “Tikrit Teaching Hospital was tried for Sunnis, but it does not appear to be functioning at this time. We take care to send only patients who meet a minimum standard of care—trach in place if needed, wounds closed, PEG tube for nutrition—as we are advised that nursing care in the Iraqi health-care system is extremely limited, so patients who require too much intense care are not given it. We really try to encourage families to take patients whenever possible, as the family will provide better nursing care according to what we have been told.”
Like hospitals throughout Iraq, Medical City is compromised by a number of issues.
“Many things were not enough,” says Ameir Al-Mukhtar, who served as director general and consultant surgeon of Medical City from February 2004 to August 2006. “We had a CAT scanner where the wire was cut deliberately by a medical terrorist, so that the machine became a useless piece of steel. Our medical equipment would be sabotaged, and the Ministry of Health does not help with repairing it. I could not buy instruments or medicine even if I had the money. I could buy a TV or a fridge, but I could not buy aspirin or antibiotics.”?
Al-Mukhtar explained that bureaucratic hassles with the Ministry of Health prevented him from accessing medical funds. While money issues still plague the hospital, security concerns remain the greater difficulty.
Dr. Gene Bolles, operating in Iraq, saw two very different levels of care.
Image courtesy of Dr. Gene Bolles.
The U.S. military does not provide security for Iraqi hospitals; the Facilities Protection Service (FPS), a security-officer force overseen by the Iraqi Ministry of the Interior, manages that duty. It is fraught with corruption. Units within the FPS are known to have ties with Moqtada al-Sadr’s militia and have carried out murders and kidnappings in the organizations they are supposed to protect. “My bodyguard was kidnapped and killed,” says Al-Mukhtar. “My cousin, who was employed at Medical City for $60 a month, was killed. Six months before I left, I ended up with a team of 15 bodyguards.”
“I wanted to work freely in my hospital, but I could not,” says R. A. (name withheld for security reasons), an Iraqi physician who recently fled Iraq because of threats on his life. “They [the Iraqi Ministry of Health] made many limitations on us. We worked cautiously. Now it is just like the Saddam regime. Just as we were afraid to say that Saddam was wrong, we are afraid to say Sadr is wrong.”
In some cities, Iraqi patients have been murdered in their hospital beds for being on the wrong side of the local insurgency. Former intelligence officers in the Saddam regime are now allegedly in charge of security in at least one of Iraq’s public hospitals. “I would see an average number of 75 patients a day,” R. A. explains. “But sometimes we received an unbearable number, more than available beds. Many of the patients died in front of my eyes due to the lack of life-saving drugs and anti-ischemic drugs, and the lack of chest tubes.”
“The medical-care system in Iraq is in shambles,” says Gene Bolles, former chief of neurosurgery at Landstuhl Regional Medical Center (LRMC), Germany, where American soldiers are taken after leaving Iraq. “It’s almost minimally functioning. There have been over 2,000 doctors killed and assassinated in Baghdad, with many more in Mosul.” Iraq had 34,000 doctors prior to the invasion; 18,000 have since fled the country.
Bolles looks the military type: a stubbled head, a tough, stocky build, and a firm grip. Looks can be deceiving, though. Bolles claims that his tenure turned him into an advocate for peace.
While Bolles was serving at LRMC, he saw the horrors of war played out on American bodies each day. On rare occasions, a different type of patient arrived. Bolles remembers one in particular: a general in the Kurdish army who was wounded by friendly fire.
“He had a very bad intracerebral injury, a massive hemorrhage in the brain,” Bolles says. “I took him to surgery, removed the blood clot, and did a decompressive craniotomy—and he survived.”
Bolles soon learned that his patient happened to be the brother of Iraq’s president. As a token of gratitude, Bolles received an invitation to tour the Iraqi health-care system. The trip, which took place in May 2006, left an indelible impression on him.
