Poor security was identified as the most serious impediment to the delivery of aid and health care in Baghdad at a meeting of the Red Cross and Red Crescent last week. “The three most urgent problems for health in Iraq today are security, security, and security,” said Dr Ghulam Popal, the World Health Organization's representative in Baghdad.
Figure 1.
A young man takes water from a broken water pipe in Basra
AP PHOTO/ADAM BUTLER
Several hospitals have been offered “protection” by armed gangs. Oxfam's media officer in Baghdad, Alex Renton, said one survey had found that more than half of 56 hospitals have been taken over by militias that take their orders from local mosques. Posters on hospital walls warn female staff to wear the hejab.
The lack of security was vividly illustrated by the murder in his home last week of the neurosurgeon Dr Jaafar Al-Nakeeb. Dr Al-Nakeeb, who was a fellow of the Royal College of Surgeons of Glasgow, was shot in his garden by an armed gang. His wife, Faiza, was also shot but escaped over a fence.
Dr Al-Nakeeb, who worked during the 1970s in Preston, England, was one of only six highly qualified neurosurgeons in Iraq.
Iraq's medical profession did, however, flex its political muscles successfully for the first time last week. Doctors' protests forced US administrators to remove the newly appointed health minister, Dr Ali Shnan al-Janabi, formerly a senior Ba'ath party member.
Meanwhile, in the British held city of Basra, an outbreak of cholera, which had been long predicted by aid agencies in southern Iraq, has been confirmed. The national public health laboratory in Kuwait has confirmed four cases from stool samples. Another 18 cases have been clinically confirmed by three hospitals in Basra.
WHO has set up a task force in conjunction with local doctors to monitor and contain the epidemic but says that its work has been hampered by the looting of the city's central laboratory, requiring samples to be sent to Kuwait for analysis.
Basra has seen cholera, which typically peaks in the summer months, every year since 1989. The number of cases confirmed so far is not out of line with previous years, but aid agencies and local doctors believe they represent the tip of an iceberg.
The city's water treatment facilities were largely destroyed in the war and by the subsequent looting, although WHO says it has helped to restore the water supply almost to prewar levels. Although the water is chlorinated before pumping, tests at several outlets have shown that adequate chlorination is not reaching the whole system.
WHO representatives also believe that the supply has been contaminated at several points by people tapping water illegally. Farmers have been shooting holes into an aqueduct that feeds the city.
Unicef is delivering water daily to Basra, but private operators are also selling water of unregulated quality.