PRESS CONFERENCE: Reconstruction: Dr. Jafar, Lt. Col. Purdue, Maj. Guinan, Nov. 12, 2008
Multi-National Force-Iraq
Dr. Jafar, Iraqi MoH, Lt. Col. Purdue & Maj. Guinan, USACE, discuss Corps of Engineers’ progress.
PRESS CONFERENCE:
Dr. Assam[ph] Jafar, Director, Iraqi Ministry of Health
Lieutenant Colonel Jared Purdue, U.S. Army Corps of Engineers, Gulf Region Division, Water Branch
Major Dan Guinan, U.S. Army Corps of Engineers, Gulf Region Division, Programs Division
DATE: November 12, 2008
TRANSCRIBED BY: SOS INTERNATIONAL LTD.
PARTICIPANTS:
Dr. Assam[ph] Jafar
Lieutenant Colonel Jared Purdue
Major Dan Guinan
REPORTERS:
Hedzila[ph] Zowi[ph] from Sabah Newspaper
Shayma[ph] Atalla[ph] from Al Furat Satellite TV Channel
Haidl[ph] Al Qatbi[ph] from Radio Sawa
Assan[ph] Samur[ph] from Al Huriya TV Channel
Layla[ph] Shumeri[ph] from BUK Media
Hadil[ph] Iraqi from Al Taakhi Newspaper
Unidentified reporters from the Amadal[ph] News Agency and Dustur Newspaper
REPORTERS 1-10
*REP1 = REPORTER 1
*INT = INTERPRETER
DR JAFAR: [Speaks in Arabic.]
INT: Welcome for the Arab and foreign media here in our work conference...joint conference for the Ministry of Health...Iraqi Ministry of Health and the MNF forces...Multi-National Forces. I’m Dr. Assam[ph] Jafar, Director.... Lieutenant Colonel Jared Purdue and Major Dan Guinan from Gulf Region Division are here with us today. This conference, it is based to talk about cholera issue in Iraq and the final developments.
As you’re aware that cholera is epidemic in Iraq. All the numbers indicate 900 cases for cholera each year during the 18...last 18 years. The Ministry of Health, with all scientific research, is dealing with this issue as it has always dealt with it. The base for our cholera emergence is not within the responsibility of the Ministry of Health but as...that cholera is a water transported disease so, based on the statistics and numbers available at the Ministry of Health in Iraq, the majority of the cases that have emerged, whether in 2007 or 2008, are all within the area that are not...that do not have serv-...water services. And some cases have emerged in areas that do have water services.
The reasons for this disease is the water cut and it depends on the electric power. There are other problems – they have been from the accumulations of the previous years of destruction that was targeting the infrastructure of Iraq with all its factors. The sector...the service sector was among these targets. Also, the sewage system has lots of damages. The sewage water is mixed with the water networks, the matter that leads to the water pollution by the time the citizen would use it. Other problem: the citizens are violating the water networks, the matter that leads to leakages of polluted water to the main tankers. This is the problems we are living with.
But the Ministry of Health, through its cholera operation room, with cooperation with the relevant ministries through meetings and discussions to discuss the reality and the situation and to find the ways and methods to overcome these obstacles and to provide safe water. Also, the measures to spread awareness among citizens about how to use water and how to treat it. Also, how to deal with the sewage water. All these issues, with the efforts of Ministry of Health and relevant ministries, have led to a major decrease in the registered cases at the laboratories of Ministry of Health.
There is a very key point that the Ministry of Health dealt with all...frankly with the media and provided them with the exact numbers. Maybe the update would happen twice or maybe three times within...per day once information were available. But our remarks about the reflection of these numbers on the life of citizens and the action taken by certain media agencies may be by...they would highlight the accumulation of cholera cases as it is increasing even though we were dealing with it with all the frankly and honest.
Ninety-nine percent of these numbers...daily numbers, they have received the treatment at the health clinics and they are all doing well. But the message...the media neglected to pass this message...this part of the message. They would cut our message and that...we, at the Ministry of Health, we decided not to deal with numbers with media.
But in general, there is an epidemic. There have been some increase in Babil Province. There is another con-...emergence in Diwianiyah Province, Al Hamza Kada[ph], eastern.... Also, we, at the Ministry of Health and also the relevant ministries, we paid visited...continuous basis. Also, our offices will target these cases in order to monitor the situation. Also, the other offices – such as water, sewage, power – we instructing...we’re instructing them in order to deal with this case. This is total information about the situation.
Now I would allow my colleagues to offer their information. Then we would open your questions. Thank you.
LTC PURDUE: Good afternoon. I’m Lieutenant Colonel Jared Purdue of the U.S. Army Corps of Engineers’ Gulf Region Division of the Water Branch. My office manages programs to improve potable water systems across Iraq.
We are proud to work with many great engineers in the Ministry of Municipalities and Public Works and in the Baghdad Water Authority to provide clean, safe water to Iraq’s people. We have a strong partnership to deliver vital services to the people of Iraq. The Gulf Region Division has launched 660 projects worth $1.6 billion U.S. in the sectors of potable water, sewer, and water resources. Five hundred of these were potable water projects which have brought clean water to nearly 5 million people. Other organizations within the coalition have completed hundreds more water projects.
Our team, which includes our Iraqi government partners and numerous Iraqi construction companies, has built 5 major, new water treatment plants and repaired or expanded many more. The largest project is the Nasiriyah Water Treatment Plant, completed last year. At this time, we are in the process of turning over the new Sadr R-3 Water Treatment Plant to the Baghdad Water Authority. This plant provides high quality water to hundreds of thousands of people in the Sadr City area. Together with the Iraqi government, we are improving the water distribution networks to ensure the clean water produced in this plant is delivered to the home. In fact, my staff was at the water treatment plant yesterday reviewing some of these actions and preparing for turnover and they brought me back this sample of water and you can see how clean and beautiful it is. The Gulf Region Division has also supported the sustainment of these new facilities by providing training, tools, and equipment to the government workforce.
While there is much work to be done, the planning and engineering abilities that I have seen in the Iraqi government inspire confidence. Many more municipal service improvements for Iraq are on the way. Although we, in the Gulf Region Division, are not in the health care business, our projects have a direct impact on improving the quality of life for millions of Iraqis. Clean water reduces the incidence of disease that we’re discussing here today.
Thank you. Shukran. Major Guinan.
MAJ GUINAN:
Thank you, sir. Good afternoon. I am Major Dan Guinan with the U.S. Army Corps of Engineers, Gulf Region Division, Programs Division.
I am proud to be here today and to be a part of this combined Iraqi and United States undertaking in improving the medical care your excellent physicians provide. Through various funding programs, we have helped transfer more than 133 completed primary health care clinics and 23 hospitals. An additional 6 health clinics and 10 hospitals are under construction for turnover at a later date. These hospitals and clinics provide modern facilities for the treatment of millions of patients in all parts of the country. The map provides an overview of the primary health clinics across Iraq.
While the clinics provide a clean, modern work space, it is the physicians and staff that make the difference. To help attract the premiere physicians to lead these facilities, the Ministry of Health and Gulf Region Division have taken steps to improve the quality of life for the physicians at many of these clinics and hospitals. One of the features we incorporate into the design and construction of the larger hospitals and clinics is physician living quarters. At 17 of the primary health clinics, we provide on-site accommodations for physicians. Each physician is provided a suite that includes a bedroom, kitchen, living room, and bathroom. The suites are pre-furnished with amenities such as refrigerators, microwaves, televisions, and beds.
At larger hospitals, there are even more living quarter spaces available for the physicians. These range from resident living spaces within the facilities to separate buildings within close proximity of the main hospital which are capable...these facilities are capable of housing up to 16 physicians.
We are fortunate today to have with us part of the team responsible for the construction of a recently opened facility that has several on-site residences. Lieutenant Commander Frank Cervasio is with us today and can provide additional details during the upcoming question and answer period.
Thank you again for the opportunity to share some of the great work we are able to accomplish in cooperation with the Ministry of Health for the great people of Iraq. Sir.
DR JAFAR: [Speaks in Arabic.]
INT: Now, our brothers and sisters, we start with the ladies here for the questions.
REP1: [Asks question in Arabic.]
INT: Hedzila[ph] Zowi[ph], Chief Editor Deputy of Sabah Newspaper. Sir, do you have support from the Ministry of Health? Who is responsible for the current situation? Do you have improvements in the cases?
DR JAFAR: [Speaks in Arabic.]
INT: Through my introduction, I made it clear that cholera problem emerged from water. So safe water, there would be no cholera cases absolutely. It is not that we are running from responsibility, but we are highlighting the responsibilities. The Ministry of Health, its responsibility is within monitoring and diagnosing the cases and then treating the cases. These are the limits of Ministry of Health. Within the WHO testifying that the Ministry of Health did not make any....
Our responsibility, it is joint responsibility. We do not hold ourselves unresponsible to deal with this case for...from the aspect of spreading awareness and hygiene in order...how to deal with water and personal hygiene. Also, other...the relevant ministries are responsible. Their responsibility is not a small part.
Also, we need to get the citizen safe water. There are big numbers of citizens in our communities. They do not have water networks. There are areas where the networks are available, the pipes are there, but there is the problem of the continuity of pumping water through these pipes to these citizens. We all are aware about the negative effect about the power cut, how they’re affecting the production of water. Other ministries, many of them, they have responsibility in this.
But I would like to emphasize that the operation room at the Ministry of Health, through collecting and gathering the relevant ministry’s high-ranking officials from them, we all share joint responsibility, joint efforts to face this issue. Thank God, the percentage of cases of cholera in 2008 is very low compared with 2007.
The...your other question. There are nine mortalities since the disease emerged until today. Four of them, they did not reach to the health care facilities. They did not receive the treatment due to the distance or maybe negligence of the family members. The percentage...the major percentage or the other cases, all of them have received the needed and the necessary treatment and they’re all doing well now. Thank you very much.
REP2: [Asks question in Arabic.]
INT: As-Salāmu `Alaykum. Shayma[ph] Atalla[ph], Al Furat Satellite TV Channel. Sir, you mentioned about some improvement in Babil Province and Al Hamza Sherpei[ph]. Did you witness improvement in the southern provinces or on certain...did you launch a campaign?
DR JAFAR:
[Speaks in Arabic.]
INT: Thank you. At the start with the Ministry of Health, we have a yearly plan which is placed from the center and then the health offices at the provinces would take their instructions from the center. To deal...not each diarrhea case is cholera. The number of diarrhea within...cases, within the statistics of Ministry of Health, through the numbers, we would make a central plan and we would have a speed monitoring. This is within the responsibility of Ministry of Health. Other offices – such as water, sewage, power, other sectors.
I frankly would like to say, I’m not biased, but we have sensed a positive effect...impact about the joint groups that have reached the provinces such as Maysan Province. It was the first province where cholera emerged, but these fast movements by the Ministry of Health and Environment and Social Awareness led to control the disease.
I would like to emphasize that the place where it first emerged was not well serviced. The environment there was not good. But, thank God, we managed to control the situation. Until now, only three cases have emerged at Maysan Province which is an indicator that efforts succeeded to deal with this case. The numbers at the other provinces are very low and are under control.
Yes, there are provinces such as Babil, Diwianiyah provinces. I would like to emphasize that our field teams there, these areas were not serviced....well serviced. They don’t have water networks. Some of the citizens there, they are violating by living in these areas. These areas are not inhabited...are not serviced. That’s what led to the disease...the emergence of the disease in the first place. Deserted areas, yeah. Thank you.
REP3: [Speaks in Arabic.]
INT: Haidl[ph] Al Qatbi[ph], Radio Sawa. Doctor, we’ve seen the cases of cholera. It started by the end of summer and it escalated. Did it reduce now? Did it stop? What...when was the last case recorded?
DR JAFAR:
[Speaks in Arabic.]
INT: Choler...as I talked earlier, cholera is an epidemic...is endemic in Iraq so we’re expecting it all year long. But once the suitable degrees were available, the cases would emerge. The...August ‘til December is the active time for cholera. That’s why on August, at Maysan Province, we indicated the first case there. The indicator increased in September and October.
Now, I would like to emphasize that the number of cases are reducing. Cholera stopped. And I would like to emphasize that there have been days where big numbers were recorded. But now I would like to highlight that the last week...or the last ten days, we did not record...only 20 to 25 cases across Iraq.
REP4: [Asks question in Arabic.]
INT: Assan[ph] Samur[ph], Al Huriya TV Channel. Doctor, we always hear on the security and now on the health level that all was...our problems are due to the accumulations of previous years. There have been six years now. You did not detect the symptoms, only now?
DR JAFAR: [Speaks in Arabic.]
INT: Thank you very much. Honestly, if you were living here with us in Iraq, you would touch the reality. But I’d like to tell the media figures that it is not possible to forget the decades of destruction targeting infrastructure for the Iraqi community and the cut in services sector. Since 1985, Ministry of Health, with cooperation with the provincial councils and other.... But we have a general hospital. We did not witness any new hospitals since the year of 1985. These years of negligence have affected the situation. There have been no care for the health facilities. It is not possible to talk....
Another point, 2003 until now, we all have experienced the unstable security situation and the attempts of the enemies of Iraq to hinder Iraq from standing on its feet as Iraq represents an economic power, scientific power. That’s why they targeted the scientific figures. They are...that’s why they migrated out of the country. Also, tar-...the direct targeting for power...electric power projects and hospitals, all our resources have been exploited. It is not possible to deal without [unintelligible] that we’re...our...in our way for improving and there are lots of projects and suggestions also attraction. Some companies are coming to Iraq in order to invest. Thank you very much.
REP5: [Asks question in Arabic.]
INT: Amadal[ph] News Agency. Doctor, why...what is the reason for the difference in numbers with cases, like between Baghdad and Babil?
DR JAFAR: [Speaks in Arabic.]
INT: Yes, the legal and technical and ethical factors. Ministry of Health is the only responsible...authority for giving numbers and statistics related to the health situation. The numbers that are given by the Ministry of Health are based upon facts and scientific research. Also within the approval of the WHO. So any figure or any other side would try to provide the media with other numbers and statistics, the media should make sure about this information received other...from other places other than the Ministry of Health.
Our statistics are based upon technical and scientific factors. We know how to deal...how to target...how to detect cholera and how to treat it and what’s the situ-...what is the exact situation. There are some diarrhea cases, there are some cholera cases. You need to separate between the two. Many of our brothers who make statements to the media, they keep saying...they would say there are big numbers with diarrhea cases. I would approve if they would say this. But they are unqualified to diagnose the case...the type of the case. The technical officials are the ones who are authorized.
Also, there are some parts and sides who are trying to underestimate and to make less of the efforts of the Ministry of Health. Ministry of Health now represents the Iraqi government. By trying to disform[sic] the figure of Ministry of Health, they are targeting the Iraqi government. So believe this is the main reason behind the difference in numbers given by the Ministry of Health and the numbers given by nonqualified officials. Thank you.
REP6: [Asks question in Arabic.]
INT:
Layla[ph] Shumeri[ph], BUK Media. You said 2008 indicated a reduction in 2007. What...how...what are the cases in each year? You talked about cholera, but you didn’t talk about anthrax.
DR JAFAR: [Speaks in Arabic.]
INT: I’m referring to the numbers about cases. In 2007, 4,000...over 4,000. Now the Ministry of Health does not publish the accumulated numbers. But the numbers we have reached until this day are less than one-quarter of the number of last year. Also, the mortalities are less than half of the mortalities of last year. This is according...as much as cholera is related.
About anthrax, it appeared in Aqara District. It emerged due to unhealthy treatment with animals. The animals might be trans-...mice carry this disease. So we had a report that indicated the death of numbers of animals in Aqara area. Also, people who have developed the symptoms were in contact with these animals.
Also, in Kurdistan region, with cooperation with the agricultural ministry there, with the federal ministry and...of health and federal Ministry of Agriculture, we worked to prevent more cases. We provided vaccines and the...for this...the people in these...this area. Also, these cases have been under control. I would like to emphasize again, there were...the citizens there did not develop the...other symptoms there. Thank you.
REP7: [Asks question in Arabic.]
INT: Hadil[ph] Iraqi. Al Taakhi Newspaper. Everybody knows cholera spreads in a very big way. I have met a number of officials. Each official tries to blame the other part. So I believe that all the ministries are involved in this. But I would like to say, some would blame the citizen himself. The citizen – he’s suffering from the lack of potable water. Why would they blame the citizen?
DR JAFAR:
[Speaks in Arabic.]
INT: Thank you. I have a remark I would like to mention. One of our media...our reporters said the emergence of cholera in Iraq.... We, as Ministry of Health, our statistics...available statistics from previous years. Cholera existed in Iraq but the media pressure...the previous government used to have pressure against media to keep the information from them and so withheld some information and numbers. It is the responsibility of the system. By announcing these cases, there would be some...there have some cases of cholera. They were not...they targeted as...in this way because the authorities withhold the information. But I mentioned previously that the numbers exactly are 900 cases. You would get the average if you mentioned....
We’re not trying to avoid the responsibility, but we are undividable part from the government. But the minister of health, he emphasizes during his meetings about providing services to the citizen that do not give burdens to the citizen more than he can handle.
Yes, the citizen, maybe he has a role in the spread of this disease. But when he listen to the instructions and talk to the advisors of Ministry of Health how to deal with this situation and how to purificate the water used at his house or to use chlor pills...chloride pills. Ministry of Health have imported millions of thousands of these pills and were distributed to the water facilities. Also, to train the citizen how to use the pills. Also, to instruct the citizen about how to follow the right measures...the right methods for the personal hygiene. Also, the sewage water. This is the role of the citizen – how to wash the fruits and vegetables. Also, how to wash his hands. This is the role of citizen. Also, the role of the citizen is to rush to the health facility once he develop the symptoms.
We have sent our message. I wouldn’t say acro-...to all Iraq. But the majority to the citizens how to deal scientifically with these cases. Also, I would say the responsibility to deal with this problem, it is a joint responsibility. The ministries which are not in direct responsibility, such as the education ministry. The Ministry of Education should include the health instructions within the teaching programs and to teach the teachers how to train the students about these instructions for...in order for better future on the cultural and health level and not to focus about....
Yes, the responsibility.... I believe the national and the ethical responsibility is upon the media. The...their duty is not only to get the break-...news break and the headlines, but their ethical responsibility, humanitarian responsibility also, to...they should put a concentration to spread awareness and to instruct the citizen how to treat with this situation with less emphasizing...emphasis on the action and the power of the statement.
The channels that are dealing with health messages given by the Ministry of Health, they would mention that the Ministry of Health calls for certain instruction. They are dealing with our instruction as if it...they are making a commercial for products. They’re forgetting their role – the ethical role, humanitarian role – in protecting the citizen.
These are examples about the joint responsibility. It is not only the responsibility of Ministry of Health. Yes, when we take a percentage of responsibilities we would see some differences between the ministries. But it is a joint responsibility at the end.
REP8: [Asks question in Arabic.]
INT: To wash the hands with warm water...about washing hands. I’m not with the subtitle on the TV channel, but I think it is a non-modern thing. I have received a number of emails criticizing that. Do you think it is some...the Iraqis need someone to tell them to wash their hands? I believe this subtitle on TV channels is kind of....
DR JAFAR:
[Speaks in Arabic.]
INT: It is not an emotional case. We’re dealing with the reality. Let me give you some points. Our community has many classes, cultural-based. Some are from countryside, some are from city. Some are.... This is through our direct contact with these classes of the society. Yes, there are some community who are in need for these messages and focus. And emphasize the message is not targeting a certain class, those who do not...those who have safe water. Some families would say we do not have soap. There are a number of items...a number of details on this subject. But this subtitle and this message, we sense reality in it more than emotional message as if we’re underestimating the citizen or the Iraqi community.
REP9: [Asks question in Arabic.]
INT: Dustur Newspaper. Do you have concerns about anthrax spread? And in case it happened, what are your measures...what are your precautionary measures?
DR JAFAR:
[Speaks in Arabic.]
INT: As I have mentioned, anthrax is of the joint diseases that is transportable between animals and human. The animals outside Kurdistan region are vaccined against anthrax and they do not face a threat concerning this disease. But the possibility of some animals from our Kurdistan region and from the neighboring countries might enter the country. Even though it is a very low possibility that we have...we do have checkpoints at the borders.
But the main point is how to deal safely with human products and with animal products. And those who are in direct contact with animals such as butchers and cookers, they need to pay attention to the necessity of taking the precautionary measures through wearing the gloves and the right shoes because the disease would...they are...they would be infected through wounds on the skin. Also, through the safe contact with meat and the leather, animal’s leather. Also, to report any mortality against the animals. Also, to pay attention to this case and to report it to the hospitals...the pet hospitals that are related.
REP10: [Asks question in Arabic.]
INT: Sir, you have talked about the anthrax and the cooperation between Ministry of Health and Ministry of Agriculture and the vaccine. Did you manage to stop the disease?
DR JAFAR: [Speaks in Arabic.]
INT: At the same area itself, some cases appeared among the animals and they died. The remaining animals were vaccined against this disease. The work...the citizens who are in direct contact with these animals, they developed some kind of skin infections. The infections are not as transferrable from individuals. After over a month for the emergence of these cases, no further cases appeared until now, not in the animals or humans.
Any questions for the guests here? No comment? Okay then. Thank you very much for all the media figures here, for all media channels.
My last request. Do not be biased to the Ministry of Health or to any other side. The citizen is our responsibility. We are executive figures and media figures. We need to pay attention to the citizen as he is our last call. Thank you very much.
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