Violence Drives Doctors From Iraq

Patient care in Iraq has been the main casualty of an exodus of experienced doctors caused by rising levels of crime and violence.



Those who leave are replaced by younger doctors with more limited experience - a problem in Iraq, where many people suffer from chronic complaints including heart disease, diabetes and hypertension.



Aziz Ali, a 40-year-old resident of the al-Zafaraniyah neighbourhood south of Baghdad, has had heart disease and blocked arteries since before the 2003 war. Now he is worried because his doctor has gone.



"He left the country because he was threatened," said Ali. "I have tried three others but I feel uncomfortable with them. The one I'm using now is an inexperienced student. I think my case has gone from bad to worse."



Like other professionals, Iraqi doctors have been targeted for attack and kidnapping because of their relatively high income and social status.



Dr Alaa Hussein, manager of the health ministry's labour development department, says 400 medical specialists have left the country since early 2004. His ministry has tried to tempt doctors back to Iraq, but rising violence has kept them from returning - 176 medical workers have been killed over the same period, while others have been abducted and held for ransom.



"We are trying to fill the gaps by [employing] recent graduates to meet hospitals’ needs," said Hussein. "At the present time, we have no alternative."



In some tense areas around Baghdad and in the so-called Sunni triangle, licensed nurses have replaced doctors.



"The doctor left the health centre in our area after his colleague was killed,” said Saad al-Zawbai, a 49-year-old resident of Qan Dhari, 25 kilometres west of Baghdad, who suffers from cardiac problems. “We don't want the nurse to treat us."



Those doctors still practicing have moved their clinics into residential areas or inside medical compounds for safety. They only open in the morning and leave in the early afternoon because of curfews and poor security. Most of Baghdad now shuts down by the evening.



Healthcare provision is in such a poor state even compared with the era of Saddam Hussein’s rule, let alone international standards, that many families have been driven to learn basic medical care themselves. Some take their own blood pressure and try to get prescriptions without consulting doctors.



Mauna Falah, a 28-year-old schoolteacher, has become an unofficial neighbourhood nurse. She looks after her parents, both of whom have high blood pressure and diabetes, and she now treats her neighbours as well.



Falah says she monitors their blood pressure and sometimes gives them injections, "so that they don't have to leave home to see a doctor".



"My parents don't trust the new ones now that the specialists have fled the country," she explained.



The minority who have sufficient money travel abroad to countries like Jordan, Syria and Egypt for treatment.



Dr Majeed al-Naomi, who runs a private clinic in the Iraqi capital, said he carried out an operation in Jordan last year because it was easier to treat a patient there than in a Baghdad hospital.



"Healthcare in Iraq since 2003 is worse than during the sanctions," said al-Naomi. "At that time we had little equipment and medicine, but in the last three years we have lost almost all the specialists."



Daud Salman and Zaineb Naji are IWPR trainee journalists in Baghdad.