Introduction

The daily toll of violence-related fatalities in Iraq has dominated the headlines around the world, but the fate of those injured in the conflict and the prospects of those who fall ill in a country whose healthcare facilities are in a woeful state has received little attention.



Shortages of hospital staff and drugs, crumbling medical facilities and outbreaks of disease are making life miserable for millions of Iraqis, a new special report by IWPR reporters can reveal.



The World Health Organisation cites Iraqi government estimates that almost 70 per cent of critically injured patients with violence-related wounds die while in emergency and intensive care units. The primary causes, it says, are a shortage of competent staff and a lack of drugs and equipment.



Iraq’s central government controls the supply of drugs to all the country’s medical facilities, but supplies often don’t make it to the provinces. The health service’s central warehouses are located in a dangerous area of Baghdad, and medicine is often just as likely to end up being sold on the black market as it is to be delivered to pharmacies and hospitals. The drugs shortage has seriously undermined healthcare provision in provinces such as Karbala and Kirkuk.



In Kirkuk, a public hospital manages to struggle along amid the chaos. Its drugs run out after just a week and even needles are in short supply. The hospital has come under pressure to provide treatment for the area’s growing displaced population and increasing numbers of violence-related deaths. It’s no easy task, but the few remaining doctors and nurses do their best to cope with the conditions.



Doctors were among the first to leave Iraq, most of them doing so after receiving threats from insurgents early in the conflict. Many are among the millions of Iraqis who have fled to Syria and Jordan.



For those who choose to stay in Iraq, the risk of falling victim to sectarian strife is not the only one they face. People are vulnerable to a range of illnesses because of the poor sanitary conditions. Aid agencies have long been warning of the dangers of water-borne illnesses breaking out because of inadequate sanitation.



These fears have been realised in northern Iraq, where IWPR reports that 13 people have died from a cholera outbreak that has spread to three provinces. Thousands of people with cholera-like symptoms have flooded hospitals in Erbil, Kirkuk and the relatively stable province of Sulaimaniyah. Health officials blame the Kurdish government for failing to improve what they say is a polluted water supply system.



And when militia groups are not fighting each other, it seems they are intent on making life even more miserable for the sick, injured and infirm. In Baghdad, Sunnis say their lives are at risk in some local hospitals, where Shia militiamen prowl wards. And in Basra, Shia militias have jeopardised the construction of a paediatric hospital, killing and threatening those involved in the project.



Tiare Rath is IWPR’s Middle East editor.