Gorilla’s Guides

Vulnerable groups:

It is extremely difficult for the population to get health care provisions in an environment that is short on supplies and limited when it comes to facilities because of buildings that are too old. The problem is even more acute for vulnerable groups such as children, pregnant women and injured persons. For a pregnant woman to pass a checkpoint on her way to deliver a baby is not obvious as there is a risk of being shot or kidnapped. 

On the shooting of pregnant women see for example Gorilla’s Guides (old site): What Was That We’re All Meant To Be “Pro” Again? and Gorilla’s Guides (old site) : What Was That We’re All Meant To Be “Pro” Again? Part 2 in particular see the notes numbered 4 and 5 on Solatia payments in part 2.

Note 4:

A particular point to note is no money is paid to Iraqi’s killed by insurgents. This was, to me at any rate one of the first indisputable indications that a cover up in Haditha had been attempted by the local commanders. The payments are made solely as a result of US actions and are made at the discretion of the local commander. In Haditha the US army first claimed that the 24 in Haditha had been killed by insurgents and then paid them. Clearly a HUGE discrepency between policy and what was done. The question immediately arose in my mind as to why the money was paid. The only reasonable explanation is as “hush money.”

Note 5:

Readers should also note that given that the payment for a death is US$2,500.00 payments in the order of US$19 million implies a massive number of civilian deaths many thousands of civilians deaths. Yet the admitted total of civilian deaths is considerably less than 1,000 - in the order of 600.

As Richard of This Old Brit remarked in his comments on Solatia payments on Mark’s personal blog (now defunct)

Those compensation figure mathematics have just floored me. I wonder if the enormous [and horrendous] implications of this revelation is sinking in as it should? 

The answer to that question was then and is now. “No”

Mass Casualties:

The main focus for us today is to respond to mass casualties. We help the health system cope with the influx of wounded by distributing war wounded kits comprised of medical and surgical items necessary for the treatment and recovery of an injured person. Each kit allows hospitals to treat more than 100 injured persons, thus reducing the number of deaths during hospitalization.

With reference to mass casualties or indeed any casualties the situation is far worse than M. Olle’s comments would suggest. There is now considerable experience in Irak of treating bomb casualties. The problem is not stabilising a critically wounded patient. That can be and is often done with considerable success. The problems are:

• Coping with the volume of wounded:

  During the aftermath of a major incident a patient will at most get 2 hours in surgery due to the volume of cases needing urgent surgical treatment.

• Fatal post-surgical infections:

  Patients are of course sent home before they are recovered as there are not enough beds or staff and new patients need to be treated.

  Worse than that there are not the antibiotics needed to treat infections and staff lack such basic supplies as gloves and surgical spirit to disinfect their hands. A high level of cross-infection is the inevitable result.

  Additionally many post-operative patients wounds become infected at home due to the poor hygiene inevitable when the only water available is heavily contaminated. Again there are not the antibiotics to treat them without recourse to the black market and even if the patient’s family can afford these black market products there is no guarantee that the antibiotics they have bought are not useless as black market medicines are often re-labelled as current years after they have in fact expired. Add to that the fact that in a country where many cannot afford food disinfectants are prohibitively expensive and the results are clear.

  Post-operative deaths due to such complications are not included in the statistics of violence related deaths supplied by the health authorities or by the Americans. The consensus amongst my colleagues is that at a conservative estimate approximately half of the patients they treat for wounds following a bombing or any traumatic incident die within three weeks of release as a result of infections.

Maryam.

ICRC | Iraq: dire state of health system must take priority

After years of sanctions and recurrent wars, and more significantly since 2003, the Iraqi health system has steadily deteriorated. Pascal Olle, the ICRC’s health programme coordinator for Iraq, explains the state of the health system and what the current needs are.

BAGHDAD, 26 February 2008 (IRIN) - With scores of doctors killed over the past few years, an exodus of medical personnel, poor medical infrastructure and shortages of medicines, Iraq’s health sector is under great pressure, a senior Health Ministry official said on 26 February.

“We are experiencing a big shortage of everything. We don’t have enough specialist doctors and medicines, and most of the medical equipment is outdated,” said the official who preferred anonymity.

“We used to get many spinal and head injures but were unable to do anything as we didn’t have enough specialists and medicines. Intravenous fluid, which is a simple thing, is not available all the time,” the official said.

“We have no neurosurgeons in Baghdad which has about five million people. Even with the security gains of the past few months, it is still dangerous for doctors and their families to step out of their houses,” he said.

He said no new hospitals had been built since 1986, at the height of the Iran-Iraq war.

Since the US-led invasion in 2003, 618 medical employees, including 132 doctors, as well as medics and other health care workers, have been killed nationwide, according to figures from the Iraqi Health Ministry released earlier this year.

Hundreds, possibly thousands, of other medical personnel are believed to have fled to Iraq’s northern semi-autonomous Kurdistan region or neighbouring countries.

Shortage of medicines

On 22 February the health minister highlighted the shortage of medicines: “The Iraqi Health Ministry is suffering from an acute shortage of medicines… We have decided to import medicines immediately to meet the needs,” Minister Salih al-Hassnawi told a press conference in the northern city of Arbil.

Al-Hassnawi blamed what he called an “obvious blemish” in the government’s 2008 budget with regard to the import of drugs for medicinal purposes.

He said the 2008 budget meant total expenditure on medicines, medical equipment and ambulances would amount to only US$22 per citizen.

Expired medicines

Al-Hassnawi also blamed corrupt individuals for importing expired or counterfeit medicines and circumventing ministry testing procedures.
“Only a small amount of the imported medicines find their way to the ministry’s labs,” he said.

In the past few days a factory in Kadhimiyah (northern Baghdad) had been found sticking fake expiry dates on already expired imported medicines, he said.
sm/at/cb

IRIN Middle East | Middle East | Iraq | IRAQ: Iraq’s health sector under pressure | Early Warning Health & Nutrition | News Item