By Dr Cesar Chelala
Iraq’s dismal health situation is testimony to the invasion of the country by foreign forces, including now the takeover of important parts of its territory by “Islamic State” (IS). The Iraqi people have been the subject of mass executions, rape, torture and, in addition, the destruction of the country’s infrastructure. The international community has been mostly deaf to the needs of Iraqis, who have undergone difficulties much greater those they faced during the regime of Saddam Hussein.
Margaret Chan, the World Health Organization Director-General, recently said: “The situation is bad, really bad, and rapidly getting worse,” as she launched a new humanitarian plan for Iraq. If they don’t receive appropriate support, 84% of all health projects and centres run the risk of closure before the end of June.
It is estimated that since January 2014, 2.9 million people have fled their homes, 6.9 million Iraqis need immediate access to essential health services, and 7.1 million need easier access to water, sanitation and hygiene assistance. Presently, 8.2 million people in Iraq need immediate humanitarian support.
Women and children have not been spared the brutal consequences of the war. Survivors of gender-based violence and rape experience trauma and depression, and suicides among women and girls have risen markedly in recent years. Children’s health status has deteriorated markedly in the last 12 years. In addition, they have been used as suicide bombers and human shields and have been killed by crucifixion or buried alive.
Iraqis’ health status is a reflection of the deterioration of the country’s health system. Medical facilities, which in the 1980s were among the best in the Middle East, have deteriorated significantly after the 2003 invasion. It is estimated that during the war 12% of hospitals and the country’s two main public health laboratories were destroyed.
Sanitary conditions in hospitals remain unsatisfactory, and medications and trained personnel are in short supply. Even basic healthcare is unavailable in regions of the country under armed conflict. As a result of the collapsed sanitation infrastructure, the incidence of cholera, dysentery and typhoid fever has increased. Malnutrition among children and other childhood diseases have also increased.
Doctors in the thousands have been leaving the country, and those that remain are under constant threat to their personal safety. As Médecins sans Frontières (MSF) stated: “Until now, it is extremely difficult to find Iraqi doctors willing to work in certain areas because they fear for their security.”
Despite some government aid and reconstruction plans, several remote areas are excluded from state reconstruction and development efforts, leaving thousands of Iraqis without access to essential healthcare up to this day. As a result, thousands of Iraqis are obliged to sell their homes and possessions to seek healthcare abroad.
The widespread environmental damage caused by the war, including the degradation of forests and wetlands, destruction of wildlife, and increased air pollution, will have long-term impacts on people’s health. In addition, medical researchers have expressed their concern about people’s health being seriously affected by the use of white phosphorus and depleted uranium by American and British forces.
The continuing conflict has exacted a heavy toll on all Iraqis’ mental health and quality of life. “Many Iraqis have been pushed to their absolute limit as decades of conflict and instability has wreaked devastation. Mentally exhausted by their experiences, many struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental healthcare services that people can turn to for help,” said Helen O’Neill, MSF’s head of mission in Iraq.
We are facing nothing less than the almost total destruction of a country by an ill-advised invasion whose consequences are still being felt. Someday, somebody will have to respond for it.
Dr. Cesar Chelala is a winner of an Overseas Press Club of America award.