Don't get ill in Iraq. the main focus of the article is on health sector in Iraqi Kurdistan.



By Judit Neurink

Getting ill - don't do it in Iraq. The Iraqi physicians that once were welcomed all over the world for their knowledge and skills are no longer available. Either they left the country and did not return, or they have retired. And they are badly missed: healthcare in today's Iraq is a disaster.

A Dutch friend who is specialized in internal medicine already brought the message home, a couple of years ago. She saw the books that medical students at

the universities in Kurdistan are using. "Those books are years old, they mention medicines as being developed that have been in the market for ages," she told me. She went to a meeting with Kurdish specialists who watched on a big screen an operation that was taking place elsewhere in the same building. The surgeon who was conducting the operation joined them for a while. When he went back into the operating theater to finish the job, he did so without scrubbing again or changing his clothes.

What is wrong with the medical profession in Iraq? It's not only outdated education. It is also the fact that doctors here think they know it all, once they finish their study. Keeping up with the developments outside by reading about them - as doctors do elsewhere in the world - hardly is done. The education system is to blame: young people who score well in high school are allowed to become medical doctors. It is the points they have scored that count, not their state of mind - if they care about and want to heal people.

The result is clear and rather disastrous: medical doctors who cannot make a secure diagnosis, patients who shop around because they do not trust their doctors. At the same time, Kurdistan does not have family doctors. Patients who need care, go to the first aid post in the hospital. Hospitals are old and dirty, and do not offer much in care: there are hardly enough nurses and family members have to take care of patients.

Yet medical doctors who had their education abroad and return have problems finding a job. Or they have problems doing the work for which they were educated. Because the older doctors who did not update their knowledge eye them with contempt. The newcomer knows more, is better educated, and if given the chance might badly dent their status. Instead of thinking of how patients can profit, it is all about keeping their position and making sure these clever newcomers cannot become a threat.

Patients are discharged even though treatment has not been finished. Every so often you will meet people who still have the tube for a drip in their hand - sent out, sometimes even back to work. Driving their taxi, washing dishes - not realizing that the tube can be the cause of an infection. I have seen people pushed around in wheelchairs and into aeroplanes who were too ill to move - who should not be out of their sickbed. Often their family members got so disgusted with the bad care that they decided to take the patient to a hospital in Iran, Jordan or Turkey, where they know the care is better.

In Sulaymaniya the biggest businessman in town is in the process of building a professional hospital, with care on an European level. Because of the low level of education in Kurdistan, part of the plan is to train all the staff in Europe before the hospital will be opened.

Bad healthcare can be deadly. In only a few weeks time a number of my staff members were confronted with that tragic fact. Two of their family members involved died after a stroke that did not get the care it deserved. Mistake was followed by mistake. They mourn the loss of a beloved one, knowing that he/she could have been saved, if only good healthcare was available.

Yet medical staff in Iraq hardly gets punished for their mistakes. Kurds know why - and even if it is not true the fact that they speak about this so openly shows how bad the situation is. They say that the special medical council which has to decide about punishment for doctors making mistakes hardly ever does so, because colleagues are keeping each other out of the wind. 'If you wash my hands now, I'll wash yours later', is the concept.

One of the problems in medical care in Iraq is that not enough hands get washed. That too many doctors care more about their income and status than about their patients. That the government does not have a good policy to make sure healthcare is up to standard. But then: what can you expect in a country where the president and other high politicians go abroad when they need medical treatment?

Judit Neurink is an independent Dutch journalist residing in Sulaimaniyah, Iraqi Kurdistan.