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Even if we are spared destruction by war, our lives will have to change if we want to save life from self-destruction.

– Aleksandr Solzhenitsyn

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September 26, 2008

In Baghdad, Even the Hospitals Are Sick

by Dahr Jamail

with Arkan Hamed

BAGHDAD - Not even the elevators work now at Baghdad Medical City, built once as the center for some of the best medical care.

One of the ten elevators still does, and the priority for this is patients who have lost their legs – and there are many of them. The rest, the doctors, patients and students at the four specialized teaching hospitals within the building complex, just take the stairs, sometimes to the 18th floor.

This is in a city that had been given dreams of great development five years back, around the time of the US-led invasion. And much of the corporate-led media in the US and Europe still insists that the situation in Baghdad has "improved".

The improvement that such media sees, no one in Iraq does. As with Baghdad Medical City, so with Baghdad, and so with Iraq. The elevators are just another reminder of a country that's not working.

"It's so bad here that patients who are moderate cases don't come for treatment at all," says Abdul Razak, an elevator serviceman at the complex. "They just send a family member to describe their condition and collect medicine."

It's a hard day's work for Razak when he is operating the elevator. "The smell of my sweat mixes with the smell of at least 20 other people who crowd into the lift." It gets less sweaty to the extent there are more wheelchairs.

Razak has been doing his job for the last ten years, the first five of them quite happy ones. "We used to have a special elevator just for doctors and professors," he says. "But by now most have left, and some have been killed. I know three doctors who have been killed."

Past the elevators and up the stairs, it gets worse.

"There is no air-conditioning in the building, when temperatures can be 48C, almost no qualified staff to serve patients, no antibiotics, and sometimes not even basic material for intravenous treatment," says Dr. Samir Abdul Zahra, who treats patients while also doing his medical studies.

There are no senior doctors around. "Most of them left because of the situation in the city, the lack of security," Dr. Zahra says. And that affects teaching as much as treatment. "We are educating ourselves now. This means also that young doctors are taking on complex cases they are simply not qualified to deal with."

This dilemma is particularly acute at Baghdad Medical City because it is the largest medical complex in Iraq, and the most serious cases are usually taken to this hospital.

At this complex now, it is not even safe to drink tap water any more. Sometimes doctors cannot find water even to wash their hands. Equipment is often not sterilized.

And the prescriptions they write can mean little. "Most of the medicines we have here are out of date, and we lack almost all basic antibiotics," says Dr. Saad Abu Al-Noor, a pharmacist at the supply warehouse at Baghdad Medical City. "We cannot get medicines from the stores because of lack of security, and because there is just too much corruption all over."

Patients in need or their family members are sent out to the shops to buy catheters, disposable syringes and essential medicines, Dr. Noor said. "If the patient is lucky, he can find the items on the black market. And then the question is if they can afford these things. The price is ten to 20 times higher than it should be."

And finally, when all is at hand for the very few, and a doctor of some kind is available, electricity is often lacking for serious treatment. The hospital gets about two hours of electricity a day. It has some generators, but these have to be cut out frequently.

The Medical City, located in central Baghdad, includes the Baghdad University College of Medicine. The largest hospital in the complex is the Surgical Specialties Hospital built in 1980. The second largest is the Baghdad Teaching Hospital, built in the early 1970s, which contains the out patient clinics and the emergency department. The complex has over a thousand beds for patients.

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