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UN Office for the Coordination of Humanitarian Affairs |
IRAQ: Some hospitals become breeding ground for disease
BAGHDAD, 28 January 2004 (IRIN) - Walking through the corridors of the largest children's hospital in Iraq, chief resident doctor Qasim Ali Abid explained that the cause of death among his patients was from secondary infections caught while undergoing in-patient treatment.
"The major cause of death in this is hospital is from infections," Abid told IRIN in the corridors of the oncology department at the Central Teaching Hospital in Baghdad.
Hospital statistics put the secondary infection rate at 80 percent for patients that enter the hospital for treatment for another illness - a staggering rate for a Middle Eastern country like Iraq.
Iraqi hospitals have been slow to recovery 10 months after the US-led invasion of Iraq and the toppling of Saddam Hussein's regime on 9 April. They have been chronically short of medical supplies, trained doctors and money. Most were looted in the power vaccum that followed Saddam's downfall.
This has had made it difficult for staff to refurbish their facilities and treat patients following the war, despite personal efforts to improve their facilities with little or no money.
At the Central Teaching Hospital in Baghdad, there is open sewage on the premises mixing with drinking water. "There is sewage blocking the pipes," Abid said. "It is now in the water supply." Rubble from pre-war maintenance remains inside the building and there are only two bathrooms per floor of the four floor building for all patients, nurses, doctors and family members.
As Abid walked through the corridors of the cancer ward, he explained that all these factors made it difficult for doctors to protect children from airborne bacteria, causing a life and death struggle between doctor's efforts and the unhealthy conditions surrounding the doctors and patients.
"We often contaminate the wound with the antiseptic we use," he stressed. "If we just had the right facilities, we could help more patients."
The young Iraqi-educated doctor stressed that children with leukaemia recovering from chemotherapy treatment are particularly susceptible to bacterial and viral infections because the treatment kills the red and white cells in the body. "The therapy kills everything," Abid said. "We can't keep the children isolated after treatment. The doors and windows are open all the time."
Despite these conditions, doctors at the hospital point to some improvements, though not many, since US President George Bush declared the end of major conflict on 1 May.
Dr Ahmed Mohammed, the assistant director of the technical department, explained that the hospital had been chronically short of medicines needed to treat the dramatic rise in cancer patients after the conclusion of the 1991 Gulf War. Mohammed said the hospital in Lestant, a neighbourhood in West Baghdad, had now started to receive plenty of medical supplies from abroad, mainly from Jordan.
"Over the last few months, we have received specialised medicines and medical supplies from NGOs from Japan, Spain and the United States," Dr Ahmad Mohammed said.
Mohammed also explained in his office, where a new computer has been installed, that the hospital could now distribute medicine to patients without charge. "Before the war, we had a system of self-finance where we were forced to charge the patients for everything," Mohammed said. "Now we are providing medicines and the hospital stay for free," he explained following assistance from NGOs.
He explained that the hospital charges 250 (US $0.25 cents)Iraqi dinar per visit for the 1,500 outpatients that come from as far as Basra, Najaf and Samawah each month. The in-patients that stay for an average of 3-5 days - sometimes two weeks - do so free of charge.
Mohammed also said that there was a programme with the International Medical Corps NGO to transfer some patients to the King Hussein Cancer Centre in Amman, Jordan. But Abid stressed that the problems facing the hospital were larger than the issue of medical supplies. "We can get the medicine we need," Abid said. "There are so many other problems. "We are suffering. It is the same before April and now."
The hospital building - built in 1985 - is in total disrepair. There are metal girders everywhere. Water and sewage pipes lie torn up from the floors. Half the hospital has been closed because of poor pre-war and post-war maintenance. There are no air conditioning units. Over the summer, temperatures rise as high as 50 degrees Celsius.
The hospital also lacks a sufficient supply of nurses. According to Abid, there are three nurses on duty in the oncology ward in the morning, but by mid-afternoon and through the night there is only one nurse for over 50 patients. "We should have 20 hospitals in Baghdad to face the needs of the medical community," Abid said. "There are only four children's hospitals in Iraq."
At the Central Teaching Hospital, there is little available space. In one ward, Dr Ghaffar Thamer pointed out that there was nearly double the amount of patients in the available space.
"We have six patients in this ward," he said. "There is only really space for about 30 patients." This has led to patchwork medical practices. Abid explained that the lack of space in the hospital and throughout Baghdad had forced the doctors to treat young cancer patients as out-patients.
"We have the clinic open on Saturday, Sunday and Thursday," Abid said. "We treat the patients with chemotherapy then send them home." He also said that the testing of blood samples at the hospital was usually inaccurate. "All our results are unreliable at the lab," Abid said. "We have a very low capacity of investigation".
Thamer explained that he was often forced to travel to his home town of Karbala to get intravenous drips for his patients because they can't be found in Baghdad. Both doctors have approached the Ministry of Health and the US-led Coalition Provisional Authority (CPA) for financial and structural assistance.
"The Americans came here and said 'Hi and bye'," Abid said. "They have provided us with nothing so far." Thamer echoed these views: "The Americans are here with their guns and bombs," he said, adding that they needed security and support. "We don't even have security inside the hospital."
This has forced doctors to carry most of the burden themselves. "Doctors and hospital staff often donate blood to the patients, if we are unable to get supplies from the blood bank," Thamer said.
The doctors also pool money from their monthly salaries of around 350,000 (US $350) Iraqi dinar per month for the patients families. "We provide the medicine for free, but families need food, clothing and other material," Abid said. Despite the challenges the two men face, they both agree that there job is worth it. "There is no work better than being a doctor," Thamer stressed. "It is frustrating, but I would do no other work."
Themes: (IRIN) Conflict, (IRIN) Health & Nutrition, (IRIN) Human Rights
[ENDS]
This material comes to you via IRIN, a UN humanitarian information unit, but may not necessarily reflect the views of the United Nations or its agencies. If you re-print, copy, archive or re-post this item, please retain this credit and disclaimer. Quotations or extracts should include attribution to the original sources. All materials copyright © UN Office for the Coordination of Humanitarian Affairs 2004
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