Special Report: Health Services in Iraq

Kirkuk Hospital Staff Soldier On

   

Hard-pressed doctors at province’s only hospital treat up to 500 patients a day - even more when the bombs strike.

By an IWPR reporter in Kirkuk (ICR No. 233, 19-Sep-07)

Kirkuk's public hospital, built under the British mandate in the 1940s, resembles a decrepit castle. Heat and humidity have swept away the colour of the walls, which are crumbling and spattered with blood.

Patients and doctors say the province's main public hospital is unsanitary, ill-equipped and overcrowded. Yet the facility is practically all that Kirkuk has in the way of state medical provision.

The facility receives about 80 per cent of patients in the province, or about 500 patients per day. Most days, five to ten surgeries are conducted, but when the bombs strike, victims come through the emergency department by the dozens.

"It's not an exaggeration to say that healthcare in Kirkuk is in a crisis," said Dr Nabil Sabir, a gastroenterologist. "It's getting worse and needs to be addressed immediately."

The problems stem primarily from Kirkuk's poor financial and medical resources. Despite the city’s vast, untapped oil wealth - the province is believed to hold 60 per cent of Iraq's oil - poverty is prevalent, and public services are limited.

Iraq's healthcare system began severely deteriorating under the United Nations-imposed sanctions in the 1990s and has only become worse since that time.

The hospital and other public health services in Kirkuk are further strained by the increasing violence and the growing number of displaced people who have come here from more troubled parts of the country.

Despite the pressures on the hospital, the central authorities are slow to provide supplies of medicines and it has to rely on support from aid agencies, such as the International Committee of the Red Cross, in emergencies.

The United States military has sought to alleviate some of the problems by supplying basics such as intravenous
bags and burn blankets, so too has the Kurdistan Regional Government, which hopes to incorporate Kirkuk into Iraqi Kurdistan.

But what’s provided does little to address the hospital’s needs - as a result of which many of the poor in the province, particularly the displaced, go without care.

"No supplies," said Khadija Hama-Rashid, a nurse who manages the hospital's operation room. “That's why we only treat emergency cases.”

Nadhim Jihad, manager of the hospital’s warehouse where medicine and other supplies are stocked, reports that the hospital only has 20 per cent of the resources it needs.

The Kirkuk directorate of health estimates that the province as a whole receives 60 per cent of the medical supplies required by the hospital and other public clinics.

"We send patients' family to get drugs from the markets," said Mustafa Hussein, director of the intensive care unit in the hospital.

Murad al-Salihi, the hospital's deputy director, said demand for drugs and other supplies has soared as violence has spiralled. Medical staff have had to treat dozens of serious injuries in the aftermath of devastating bomb attacks, yet central government rarely sends enough supplies - and those that it dispatches are vulnerable to sabotage by insurgents.

“Trucks transport drugs and [other] supplies that we cannot receive by air, and they are frequently attacked [on the trip from Baghdad]," said Salihi. "It's a difficult process.”

As if this wasn’t bad enough, staff also have to cope with the aging building’s poor facilities and inadequate equipment. The hospital, which was built in the 1940s, needs a complete internal and external renovation. Available medical technology is outdated - x-ray machines are over 30 years old. The only advanced piece of equipment is a CT scanner - but that broke down last year and has not been replaced.

Ilham Ali, a gynaecologist and the department's supervisor, said his unit simply can’t deal with all the cases it receives, “We don't have enough beds or other supplies like air conditioners and water coolers."

The US and Iraqi authorities recognised shortly after Saddam Hussein's fall from power in April 2003 that Kirkuk's healthcare system was in trouble, but little has been done to support it.

Both pledged to improve medical service provision, with US engineers in 2004 assigned to build at least five clinics. But a report last year by the US Special Inspector General for Iraq Reconstruction said that the clinics "were found to be far from complete and were poorly constructed".