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Iraq’s health system, once envy of the region, is in crisis

Apr 28,2021 - Last updated at Apr 28,2021

Sanctions kill ordinary folk while elites carry on as usual.  This should be the lesson of the US and its Western allies, which impose sanctions on countries, which do not do their bidding.

The latest example of how sanctions impact the innocent was the fire at Iraq's Ibn Al Khatib Hospital, which killed at least 82 and wounded 110 patients.  Although sanctions were largely lifted in May 2003, 23 years of a harsh regime has deprived the country of the means to care for its people.  The advent of COVID has worsened the healthcare deficit and shown the Iraqi health system to be broken.

As Iraq's COVID cases spiked, an oxygen cylinder exploded and detonated others, which were improperly stored at the hospital.  The fire spread quickly in the middle of the night at a time relatives were at the bedsides of 30 patients in the intensive care unit.  The hospital, built in 1959 of flammable materials, had no fire alarms or sprinklers to douse the flames.  Fire extinguishers were old and not working.

Although Prime Minister Mustafa Al Kadhimi suspended the health minister, promised a probe into the inferno, and declared three days of national mourning, this incident has seriously challenged his vulnerable sectarian administration, which, like all the others installed after the 2003 US invasion and occupation, has failed to deal with rampant corruption and mismanagement.

The Iraqi health system, once the envy of other countries in the region, was created during the period of British occupation when medical schools were obliged to teach in English so doctors could go abroad for specialisation and keep up to date by reading English-language medical journals. 

This practice continued following the ouster of the British in 1958 during the republican revolution, which toppled the king. Citizens of countries neighbouring Iraq used to travel to Baghdad for medical care. 

The health system has deteriorated since sanctions were imposed in August 1990 before the 1991 Gulf war.  International statesman Prince Sadruddin Aga Khan was sent to Iraq after that conflict by the UN to report on the humanitarian situation. He warned the Security Council that sanctions were destroying Iraq's health structures, which provided primary care to nearly the entire population.  His warning was ignored. Iraqi citizens have suffered not their rulers.

Under the punitive sanctions regime, chlorine for purifying water, essential medications for chronic illnesses, and medical devices and machinery were barred or irrationally rationed. 

Half-a-million Iraqi children died of malnutrition and disease between August 1990, when sanctions were imposed, until the spring of 1996, when the US allowed the UN to sell Iraqi oil to fund purchases of food and medical supplies. While the situation improved somewhat, hospitals continued to be starved of essential medicines, spare parts for existing equipment, and other items. 

The coup de grace came after the 2003 US war on Iraq when destruction of infrastructure and incompetent occupation policies compounded the damage inflicted by sanctions. Targeted by militants, doctors and other medical staff fled the country in droves.  Electricity became a major national problem, which has not yet been resolved.  

Homes, hospitals, and commercial enterprises have had to rely on private generators for power, deepening the divide between those who can afford to pay two electricity bills and the majority who cannot. Water became insufficient for the needs of the populace. At Basra port, in the south, demonstrations have repeatedly erupted against the government due to its failure to provide potable water.  

The US imposition of a sectarian regime dominated by fundamentalist, pro-Iranian Shiite politicians who returned from exile has shifted the balance of influence in the country in favour of Tehran which is now blamed by protesters, along with its rival Washington, for the desperate state of affairs in Iraq. Cabinet and administrative posts are allocated on the basis of a candidate's affiliation with a political party or leader rather than his fitness for the job.  Health Minister Hassan Al Tamimi, for example, was nominated for the post by powerful Shiite cleric Moqtada Al Sadr.

Baghdad's Governor Muhammad Jaber Al Atta who is a member of the coalition led by former prime minister Nouri Al Maliki, was also suspended. Maliki, who served as prime minister from 2006-14, is blamed for the boom in corruption, mismanagement, and persecution of Sunnis who flocked to takfiri groups, including Al Qaeda and its spawn, seeking to topple the government or create radical emirates.

Iraq has had more than a million cases of COVID and 15,400 deaths.  Daily cases range between 6,000-8,000 but demand for vaccinations is low, partly due to distrust after decades of low investment in medical facilities and a lack of trust in vaccines and distribution networks, which may or may not have essential refrigeration.

Unlike Jordan, Lebanon and Syria, three countries with limited natural resources, there is no excuse for the terrible conditions in Iraq's health sector.  It is a rich country enjoying billions of dollars in annual oil revenues, which have been consumed by sectarian warfare and frittered away by corrupt politicians.  The absence of Iraq from the centre of the eastern Arab world weakens the region and negatively impacts its neighbours.

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