Plastic Surgeons Mask Anbar’s Scars

People physically scarred by the conflict say they have been shunned because of their appearance.

By Uthman al-Mukhtar in Fallujah (ICR No. 302, 25-Aug-09)

The scar that ran along the left side of Noor Ali’s face was a daily reminder of a time – and a life – that she wanted to forget.

Ali, 28, was sitting next to a window in her house two years ago when a car bomb exploded outside, hurling shards of glass at her and leaving a wound that stretched from her eye to her neck.

After the incident, she was stared at, mocked and pitied by friends and strangers and her fiancé broke up with her. She could not get a job, and wore a scarf to shield her face.

Last week, Ali underwent surgery that has removed 90 per cent of her scar.

“I am eager to leave the house with total confidence,” she said. “There’s nothing to stop me anymore. I want to find a job and start a new life.”

Anbar, a conservative, largely Sunni Arab tribal province in western Iraq, is recovering from years of war between insurgent groups and United States troops.

Since the guns were silenced, demand for reconstructive surgery has emerged in Anbar’s two main cities, Fallujah and Ramadi.

Scarred victims of Anbar’s recent violent history say they are shunned because of their appearance, but the province’s plastic surgeons provide a new lease on life.

According to a report released in July by Anbar’s health directorate, an estimated 100 people with war-related injuries undergo reconstructive surgery in the province each month. Between 130,000 and 250,000 US dollars is being spent on the procedures in Anbar monthly, the report said. Most of the patients are women.

Walid al-Ani, who has been a plastic surgeon for 12 years, nearly gave up his practice due to lack of demand some years ago. Today, he advertises on the radio and his clinic – in a bullet-pocked building in Fallujah - is teeming with patients.

Saad Nasir, a 44-year-old bank employee, recently took his wife to see Ani for skin grafts. In March 2006, she suffered severe burns on her back when the US military dropped flares during clashes with insurgents. One of the flares set their house alight.

At a cost of 3,000 dollars, the grafts “are not risky, but they are expensive”, Nasir said.

Unemployment remains one of Anbar’s most pressing problems, but many appear to have the money to spend on plastic surgery.

"I’ve never seen such demand for [plastic] surgery like there is now,” said Ani, whose office walls bear before-and-after pictures of his success stories. “Things changed for the people of Anbar after the war.”

Ani performs two to three procedures a day and refers more complicated cases that require repeated surgery to experts in Amman, Dubai or Damascus.

Fallujah general hospital is capitalising on the demand by opening a new plastic surgery unit. Eleven Iraqi doctors are currently receiving training in Germany under a grant from the US government’s provincial reconstruction team, and the hospital is purchasing specialised medical equipment.

The unit has yet to open but Mohamad al-Mohamadi, a consultant at the hospital, said there have already been dozens of inquiries from patients seeking surgery.

“This unit could double the hospital’s revenue,” he said.

The procedures are especially popular among single young women who say prospective husbands will not consider a wife with physical imperfections.

Some are combining war-related surgeries with cosmetic touch-ups. When Ali went under to get her scar fixed, she also elected to have her eyebrows lifted.

Layla Jasim, a 30-year-old patient of Ani’s, began gaining weight after her brother was killed.

“I want to get liposuction,” said Jasim, who weighs 95 kilogrammes. “I’m still single and I want to look better.”

Ani estimates that three-quarters of his patients have conflict-related injuries, but his practice also offers cosmetic procedures such as liposuction, skin lightening, lip and breast augmentation and eye lifts.

Women are an important clientele, and he has hired a female doctor for some women patients who are uncomfortable being treated by men.

He said that religious leaders and tribal chiefs have no objection to procedures for serious medical problems but frown upon cosmetic surgery.

“It’s seen as a type of betrayal of the future husbands” of single women, he said.

But women are not the only ones seeking treatment.

Haitham Taha, 31, suffered third-degree burns and lost parts of his ears as the result of a roadside bomb in 2005. Taha, from Karma, a town south of Fallujah, said he quit his job at a local supermarket “because people were too disgusted to take anything from my hands”.

“I couldn’t stand looking at myself in the mirror,” Taha said. “I haven’t left the house for three years. I didn’t want to see any of my friends.”

He recently underwent a six-hour operation performed by Ani at a private hospital in Baghdad and will have further surgery in six months to repair his ears.

“When the security improved, I decided to forget anything that would remind me of that dark period and headed to the plastic surgery clinic,” he said. “Today, I’m 70 per cent healed, thank God.”

Uthman al-Mukhtar is an IWPR journalist in Fallujah.