Ten thousand doctors have fled the country. Two thousand have been killed. Some hospitals lack the rudimentary elements of care: hygiene, clean water, antibiotics, anesthetics and other basic drugs. Oxygen, gauze, rubber gloves, and diagnostic instruments such as X-rays are absent or rarely evident. This is Iraq today.
Before Iraq suffered through an embargo and two wars with the United States starting in 1990, its healthcare system was considered one of the best in the Middle East. Iraq had well-trained physicians and modern facilities. Today, the healthcare system barely exists at all, with few healthcare workers and hospitals that are battlegrounds.
According to Save the Children, an independent non-profit humanitarian organization, in 2005, 122,000 Iraqi children died before they reached their fifth birthday. Since 1990, there has been a 150 percent increase in the mortality rate for Iraqi children. The under-5 mortality rate per one thousand live births in Iraq is 125; in Egypt it is just 33. Iraq’s record in children’s healthcare now ranks in the bottom three countries in the world.
With the current conditions of Iraq at war, the death statistics continue to spiral upward. The diseases of the developing world are affecting Iraq’s children – pneumonia and diarrhea. Malnutrition is wreaking havoc with the growth of Iraq’s next generation. The London Guardian reports that in addition to these many physical traumas, millions of Iraqi children have been psychologically traumatized by the war.
The body count estimates of Iraqi deaths are often cited to be over one hundred thousand. From this number one can estimate that the number of injured and disabled Iraqis must be in the hundreds of thousands. While there are no definitive data on Iraqi adult patients seeking medical help, one recent report from the Washington Post notes that the thousands of injured Iraqi security forces have no place to go for immediate treatment and no long term rehabilitation for their loss of limbs or other physical injuries. This lack of treatment for Iraqi patients is surpassed only by the lack of psychiatric and psychological treatment. Compounded by the inherent societal stigma associated with mental illness (which is prevalent even in developed countries such as ours), these Iraqis endure suffering beyond our western comprehension of the recovering soldier or child.
Nearly one billion dollars has been allotted for healthcare reconstruction. While that seems like a sum large enough to fix the problems, no one really knows where that money has gone. The healthcare infrastructure in general is crumbling. Ordering anything for healthcare facilities takes months upon months. Hospital buildings remain in disrepair. The inflow of new doctors is down to a trickle. Many teaching hospitals are not functioning for lack of teaching physicians. Most of these faculties of the medical school have fled the country for fear for their lives. This is compounded by the fact that many medical students either are leaving the country or changing their course of study to other fields.
What is even worse and inhumane is that patients in hospitals are not safe – they are potential hostages for kidnapping and murder. As a result, many injured Iraqis do not seek hospitalization for either fear from insurgents or sometimes arrest by Iraqi or U.S. forces. No one respects the sanctity of hospitals in violation of the Geneva Convention.
International law places the burden of maintaining order, safety, and well-being of an occupied nation on the shoulders of the occupying power. Our political and military leaders estimate the number of our soldiers that will die or be injured due to an invasion. However, an additional element our leaders need to consider is the well-being of the nation we conquer. The human suffering of the invaded nation is detriment to our moral standing in the world.
Adil E. Shamoo born and raised in Baghdad is a professor at the University of Maryland School of Medicine and is a contributor to Foreign Policy In Focus. He writes on ethics and public policy and can be reached at: ashamoo@umaryland.edu.
