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3/1/05
- In Critical Condition, by Paul Vitello In the aftermath of major bombings such as the one yesterday that killed 115 people and wounded 132, Americans are sure to see pictures of the bloodied victims being carried from the scene. These are among the few reliably available images we have of civilian life in Iraq these days. But when the wounded are carried off, what kind of hospitals do they go to? And what are their chances of surviving in them? Unlike the precise accounting for American soldiers killed and wounded, there has been no official count of the number of Iraqis killed or estimate of the survival rate of those wounded during the two years since the American invasion. But in the first study of its kind, an organization founded by a former Long Island physician offers a snapshot of the state of hospital care in Iraq - and it is, not surprisingly, a bleak picture. Despite some improvements,
such as higher pay for doctors and nurses now than under the Saddam Hussein
regime, there is a widespread breakdown of public health and critical
care, according to the study. "The hospitals
are filthy," said Dr. Michael Viola, director of Medicine for Peace,
an organization he founded 15 years ago, while chief of pediatric oncology
at Stony Brook University Hospital, as a vehicle for helping children
from war-torn countries. He and the group are now based in "There is practically no infection control going on," he said. "You have widespread hospital-borne infection spreading through the community." Cleaning and disinfecting procedures are almost nonexistent - in part because of lack of supplies and in part because of a breakdown in medical education during the last 10 years of the Hussein reign, he said. Most toilets in the hospitals don't work. Infectious waste and regular trash pile up uncollected. Drinking water is so scarce patients rely on their relatives to bring it. Sterile needles, gloves, masks, antiseptics, pain medications and anesthetics are all in short supply. It is hard to verify the report's findings, though they are in keeping with warnings issued over the past two years by several other aid groups, including the International Committee of the Red Cross. The report has been been widely circulated among non-governmental aid organizations and was featured last month on the Web site of the United Nations Office for the Coordination of Humanitarian Affairs, though it has received little media notice in this country. Medicine for Peace relied for its research on Iraqi contacts - doctors and other health care workers, mainly - that were made during dozens of aid missions its volunteers carried out in the years between the first Gulf War of 1991 and the invasion of 2003. Viola personally brought several children from Iraq to Stony Brook for medical treatment in those years. He has not been in Iraq, however, since the start of the latest war. The researchers surveyed 13 major hospitals in and around Baghdad. In some cases they worked surreptitiously, Viola said. In others, they relied on personal contacts to gain access to facilities, but in no case did the Iraqi volunteers want to be identified as working with an American organization. Conducting the survey was "extremely dangerous," Viola said, but necessary to bring attention to a problem that "is not on anybody's radar screen." Three of the surveyed hospitals suffered major bombing damage during the invasion. Five were looted extensively in March and April 2003. All were closed for long stretches between then and now. The survey found that despite higher wages since the occupation - 30 times higher in some cases - many doctors have fled Iraq in fear of abduction. "The abduction of physicians for ransom, and the targeting of prominent physicians for assassination have become major impediments to rebuilding a high quality health care system," the report said. In one of their most notable and relatively upbeat findings, the Medicine for Peace surveyors found the Al-Rashad psychiatric hospital, the only facility of its kind in Baghdad, slowly beginning to re-establish itself. Most of its 1,000 patients fled in April 2003, when looters invaded its wards to pillage and to rape the women inmates. Copyright (c) 2005,
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