Medicine for Peace Assesses Civilian Health in Iraq

First comprehensive study of health care in Iraq praised by international community.

It is difficult to assess health care delivery under the best of circumstances- but to conduct a careful study of civilian health in the midst of a war is a daunting challenge. A Medicine For Peace (MFP) Study Team, headed by Dr. Michael Viola, has done just that. It has produced the first comprehensive picture of hospitals in Baghdad since the start of the Iraq War in March 2003. The endeavor took a heavy toll— one of the members of the study team was shot and seriously wounded and is now convalescing in Jordan.

The MFP Report entitled, Civilian Health in Iraq: Assessment of Public Hospitals in Baghdad, concludes that health care in hospitals is below an acceptable standard of care and presents an ongoing danger to both patients and staff. Further, a critical situation exists in many hospitals that demands immediate targeted interventions.

Three of the surveyed hospitals suffered major damage from Coalition bombing during the invasion. Five were looted extensively in March and April 2003. All were closed for long stretches between then and now.

With great concern, The MFP Study Team noted that the majority of hospitals are generally unclean, unhygienic, and fail to follow "best practices" standards for infection control. Most toilets in the hospitals do not 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. The result is a health care system that is unable to provide adequate care during this period of enormous turmoil and violence in Iraq. The MFP report stressed that the abduction and the assassination of prominent physicians has had a chilling effect on the delivery of medical care in Baghdad.

"In the first study of its kind, Medicine For Peace offers a snapshot of the state of hospital care in Iraq - and it is, not surprisingly, a bleak picture. -New York Newsday

The MFP Study Team noted some improvements in the health system since March 2003, including a significant increase in the number of hospital staff, a 30-fold increase in the salaries of doctors and nurses (although still below salaries for the region), improved security at all hospitals surveyed, and instillation of auxiliary gasoline-driven electrical power generators in every hospital. These gains indicate that with sufficient funding and clear goals it is possible to make significant improvements in the battered health system.

The complete MFP Report and recommendations proposed to the Iraq Ministry of Health and other responsible agencies can be obtained at www.medpeace.org or at the UN relief website.

A child in a Baghdad hospital

The Clinic in Haiti’s L’Acul Mountains.

The town of Gros Morne is six hours north of the capital, Port-au-Prince, along the rocky dirt road to Cap Haitiene. There are 20,000 residents in Gros Morne and another 100,000 people who live in the surrounding mountains. The trip from Gros Morne to the MFP clinic in Charbe is an arduous, and at times dangerous, three hour trip into the L’Acul mountains. We travel the first leg in a land rover over washed-out, rocky roads crossing first the Riviere Blanche and then Riviere L’Acul. There are no bridges and while the river is only 4-5 inches deep where we cross, flash floods can raise the depth to 3-4 feet.

The road ends at Biscaye and we begin the trek up the mountain over dried out rocky river beds and narrow paths along a precipice. The path is impassable after nightfall, or if it rains because of the mudslides. Sturdy mules, who know the trail, are the only way to get medical supplies up the mountain.

Ms. Marie Pierre, our nurses aide has long experience in community health and the clinic is well stocked to combat the ravages of poor, rural Haiti: parasitic infections of the GI tract and skin, respiratory infections, and malaria. We have an aggressive vaccination program that includes vaccination “posts” in remote areas surrounding the clinic. Ms. Pierre is also tracking malnutrition in the region and we are responding with a therapeutic nutrition program. The mules lug the nutritional supplements up the mountain every few weeks. MFP has ambitious plans to modernize the clinic and extend our services to more people living under harsh conditions In the mountains.

The MFP donkey, loaded with medical supplies, trekking up the mountain to the clinic in Charbe, Haiti



Dr. Lewis Marshall with three orphan boys
in Gros Morne

Children’s Scholarship Fund For Girls embraces diverse Hispanic groups.

Hispanic girls have the highest school drop-out rate of any ethnic group in the United States. The CSFG began as a comprehensive tuition and remedial educational program to place refugee girls from El Salvador in safe and nurturing private schools in the U.S. Over the past 15 years the program has been expanded to assist other Hispanic girls and their families who are in need. Presently there are girls who came from Mexico, Panama, El Salvador, Honduras, Guatemala, Puerto Rico, Cuba and Peru in the program.

“Empowering parents to deal with the educational system is a critical element in the success of the CSFG.”

The remarkable success of the program as demonstrated by all girls progressing to University is due to involvement of parents, academic support, and the numerous role models the girls come in contact with. The goal of the CSFG is to enable students to become selfsufficient young women and to have a deep understanding of their Hispanic background. Sofia is a typical example of one of our students who is succeeding academically and has remained close to her family, her cultural traditions, and to younger students in the program.

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Sofia is a fifteen year old girl who escaped to the US with her family from political persecution in Peru in 1998. Her mother was severely injured in the flight from Peru. Her father now works parking cars. She experienced difficulties in her high school in an impoverished neighborhood of Long Island and was often physically accosted and solicited to take drugs. She was referred to the CSFG by a community social worker. The Fund placed her in a safe and protected allgirls college preparatory school commuting distance from her home. She responded well to the strong academic and nurturing atmosphere maintaining an A/B average. She now attends the State University of New York at Binghamton on an academic scholarship.