News Feature - Iraq Report
Hospitals under pressure as doctors move abroad

Dr Muhammad Abdel- Sattar, 36, is packing his bags as he discusses on the phone with two colleagues the best time to leave for the airport.

In December 2006 Abdel- Sattar sent his family to Jordan after three times receiving threats from militants. Recently his car was shot at in front of his house, and he has now decided to leave the country – and his job as a leading oncologist in Baghdad, IRIN reports.

“I love my country and would like to stay to help my people but I’m scared that any time a militant will come and shoot me dead,” Abdel-Sattar said. “I’m leaving with two other doctors – a cardiologist and haematologist.

We know how hard it will be for the remaining doctors but we have had enough.” According to the Iraqi Medical Association (IMA), the shortage of doctors and nurses in Iraq is now critical and having a devastating effect, especially on small towns and villages.

“Our latest research shows that up to 75% of doctors, pharmacists and nurses have left their jobs at universities, clinics and hospitals,” Walid Rafi, a senior member of the IMA, told IRIN. Of these, at least 55% have fled abroad, he added. According to Rafi, low salaries and the shortage of equipment and medicines, are other push factors.

“Medical staff earn US$50- 300 per month. They might persevere for a while but if the opportunity arises, they don't think twice and leave the country,” Rafi said.

Difficult times for patients

It is often hard enough to get to a hospital but the real problems begins once a patient gets inside. It can take hours to see a doctor or nurse, Seif Abdel-Rahman, 29, a shopkeeper and resident of Baghdad’s Yarmouk District, said. If you are lucky enough to see a doctor, the next problem is getting the medicines, which are either unavailable or exorbitantly expensive at private pharmacies.

“After four hours trying to get a doctor to examine my three-year-old son, I got the prescription but the medicines weren’t available, said Um Fariz, 25, from Hayfa District in Baghdad.

Militants

But the worst is when militants break into hospitals in search of specific people, some of whom, including doctors, get kidnapped. “Two of my colleagues were kidnapped because they were treating injured patients from a different sect,” Ibrahim Rawi, a Baghdad hospital doctor, said.

“It is common in our hospitals to see patients kidnapped or thrown out of their beds to make room for a new patient from the same sect as the attackers,” Rawi said. A senior official in the Ministry of Health, who preferred anonymity, said doctors and hospital managers were at the mercy of militants.

“Inside our ministry there are a huge number of militants controlling our daily jobs. They have information about what is happening in the building – from the cleaning staff to the financial department – and no one dares complain. Whoever does is unlikely to reach his home alive,” he said.

Blood sellers find market niche in Baghdad

As the Iraqi National Centre for Blood Donation (INCBD) urges Iraqis to donate more blood to help meet increasing demand, individuals wishing to sell their blood congregate at hospitals in the hope of being able to make some money. Those offering rare blood types are best able to cash in, reports IRIN.

“In many cases, desperate families look for blood sellers who can be found around the hospital and at the [Baghdad’s main] blood centre,” Abdallah Farhan Ahmed, a surgeon at Medical City Hospital, said. “The most expensive blood types are the rare ones and we cannot force people to give them for free.”

Ahmed said “agents” also stand in front of the INCBD offering blood. They charge US$20-30 for every 350 cu. cm of blood. In a country where, according to Iraq’s Ministry of Labour and Social Affairs, unemployment stands at over 38%, the sale of blood is an attractive option for many.

“I need to feed my family, and others need blood to save their loved ones and it is a fair exchange. I come here every month to sell my blood. I know I should do this less frequently but I’m unemployed and my family needs to eat,” said a blood seller who preferred anonymity.

The continuing violence in Baghdad has kept the demand for blood high: “The increase in violence in Iraq has prevented us from storing adequate blood supplies,” said Maruan Haydar, a senior official in the Ministry of Health.

“We are requesting donations of all types of blood… especially rare types like AB and O,” he said. Ahmed told IRIN that at least one in five operations in the hospital require a blood transfusion and that on many occasions they had to postpone operations because the type of blood required was not available. “We perform operations only in emergencies. Heart and brain operations are being postponed until the right blood is available – and that sometimes might take over two weeks,” Ahmed said.

Dangerous area

According to Haydar, since January 2006 the number of blood donors has been decreasing as the level of violence has increased in the Bab al-Muadham District of Baghdad where the INCBD has its premises.

“The centre is located in one of the most dangerous areas of the capital and people are scared to take the risk [of going there to donate blood] but we have to continue with our appeal,” Haydar said.

“We have asked the Ministry of Interior to reinforce security in the district to allow people to donate blood in safety, but the presence of different militias has brought fear.” The centre has issued many appeals for blood donations in the past three years but according to officials the problem is now critical.

Abu Muhammad Farez, 41, has been donating blood to the centre for the past eight years, but he has told IRIN that this will be his last time as security has been deteriorating and he cannot take any more risks. “To reach the centre I was stopped at checkpoints manned by militias and local police… Because I have a long beard they accused me of being a supporter of the insurgents,” Farez said.

“I know it is ridiculous but they didn’t believe that someone was in that area to help other Iraqis rather than kill them. “Unfortunately I have decided to stop donating blood until I feel secure enough to return to the centre,” Farez added.