Doctors face life-threatening circumstances as Iraq's healthcare system is neglected

Doctors face life-threatening circumstances as Iraq's healthcare system is neglected
5 min read
28 August, 2019
Doctors in Iraq are being blamed for the country's failing healthcare system, facing threats of abuse and violence.
Doctors in iraq
Dr Thulfiqar was found dead in his medical practice in Baghdad one morning, after having collapsed while working for over 48 hours with no break in poorly equipped conditions.

Suffering from sleep deprivation and sheer exhaustion, his death is testament to the life-threatening conditions that Iraqi doctors face.

Yet for too long, doctors themselves have received the blame for Iraq's failing healthcare system, facing a separate threat of abuse and violence as a result.

Plagued by years of conflict, including the US-led war in 2003 dismantling the old state and the rise of Islamic State in Iraq and Syria, all of this certainly took its toll on Iraq's healthcare system.

Yet now doctors and aid workers complain that the government refuses to provide adequate medical supplies, making their essential, lifesaving difficult to carry out.

Not only do doctors therefore struggle to provide enough treatment to patients, they have found themselves victim of revenge attacks – often from gangs, creating a vicious cycle of a worsening healthcare in Iraq.

"Despite conflict after conflict taking their toll on Iraq, we see well-equipped health care centers and hospital are unable to perform because of violence against medical care that ends up destroying new equipment or scaring away medical staff," Salma Oda, spokesperson for the International Committee of the Red Cross in Iraq, told The New Arab.
Sometimes doctors actually use their own money to buy essential drugs and supplies to treat the patients
Neglected healthcare system

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While the Ministry of Health has not facilitated substantial vaccinations and other healthcare equipment, there is clearly a lack of funding and support for the medical sector. 

Otherwise avoidable medical problems for Iraqi civilians are rife within hospitals.  

"The government is so full of corruption that they don't supply the hospitals with their needs. Sometimes doctors actually use their own money to buy essential drugs and supplies to treat the patients," Karam Al Hafidh, dentist at a Baghdad general hospital, told The New Arab.

Countless patients have died in hospitals due to this lack of supplies, which the government has not provided.

"A young child suffocated after choking on a food particle. She died because doctors couldn't save her life because they lacked the needed bronchoscope, which wasn't provided by the Ministry of Health, in order to carry out the operation," she added.

Karam says it is entirely the government's fault for failing to provide these services; even after the war many hospitals had remained intact yet still are under-equipped. Many essential and new facilities are not being constructed, however.

In the Sadr City district in North-western Baghdad, around four hospitals serve a population of roughly 3.5 million.

While Iraqi media outlets, have claimed there were severe shortages of healthcare equipment and immunisation programmes, the World Health Organization in June refuted these claims, stating it was able to provide them.

Iraqi doctors bear the repercussions

Though the government is responsible for such mismanagement, it is Iraqi doctors who suffer the consequences, either from vengeful militias or patients' loved ones, while also suffering under unbearable working conditions.

"All of this again deprives millions of Iraqis of much-needed health care which make them even more frustrated with the service they are receiving or having to spend life-time savings to get medical treatment abroad," said Salma Oda.

This results in society blaming the doctors. Not only has the Ministry of Health often criticised doctors, Karam al Hafidh reports that even Iraqi media outlets depict them as responsible for healthcare shortcomings and patient deaths.

This vilification of doctors has even resulted an almost systematic targeting of them, as many face threats, harassment, physical violence, assassinations, and even kidnappings.

"Many doctors I know were targeted by tribal revenge in case of the patient's death, even if the patient was critically ill or arrived almost dead at the hospital," said Karam.

Dr Saif, a doctor in Baghdad, had recently been killed commuting to work, after the death of one of his patient.
Iraqi physicians had faced a widespread, systematic levels of attacks, on an almost daily basis.

In some cases, relatives or other close ones of deceased patients have stormed hospitals and targeted doctors whilst they were working.  
Over 20,000 doctors had fled Iraq since 2003
"These dire situations and the fear of their lives made many of them leave the country or consider it," said Salma Oda.

A Ministry of Health spokesperson announced that over 20,000 doctors had fled Iraq since 2003. Around 34,000 registered doctors worked in Iraq prior to this exodus, showing hospitals are now severely short-staffed.

Some doctors who remain in Iraq have avoided going to work after facing violence or harassment, fearing for their lives.

According to a survey conducted by the Health and Environment Volunteer Team, 70 percent of Baghdad's health personnel have expressed the wish to emigrate, while 98 percent responded that the number of health professionals leaving the country would decrease if a secure working environment could be guaranteed.

"Poor pay and intimidation, including tribal harassment, are the main reasons pushing doctors to leave. They are subject to daily offences and these include insults, abuses, assassination and threats to their life," said Karam.

Doctors had previously petitioned calling for allowing health workers to carry firearms inside their workplace for self-defence.

Karam added that work conditions make it unbearable and even dangerous for doctors to operate. Too often, doctors will end up working for 48 hours non-stop.

Due to high levels of exhaustion, many will struggle to perform their work effectively. Doctors working hours are not limited, while their salary of $700 a month – which creates unsustainable living conditions, will not alter based on extra working hours.

Though organisations like the ICRC and the Iraqi Red Crescent attempt to respond to this ongoing healthcare crisis, they alone are unable to meet the large healthcare demands, which the government has failed to alleviate.  

Without the government, and other international actors, playing a role in improving Iraq's medical sector and doctors' working conditions, and if the toxic societal stigma against doctors continues, the healthcare situation could further deteriorate.

Jonathan Fenton-Harvey is a journalist and researcher who focuses on conflict, geopolitics and humanitarian issues in the Middle East and North Africa. 

Follow him on Twitter: @jfentonharvey