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A Doctor’s Day in Baghdad

Baghdad.

I have a big family. My eldest two are already dentists and both abroad. I have one daughter just married one month ago. so I am not yet a grandpa. Although I have perfect job satisfaction, Full Professor, with MRCP, FRCP and a couple more degrees from London and France, things are so unhappy here in Baghdad, there is no quality of life at all. There are no services: we are loaded with garbage, as it is not collected more than once every so many weeks, the garbage collectors are also afraid of being killed. We have almost no electricity, no fuel, bad water supply, and what’s more you could get killed whether you are Shiite or Sunnite, if you fall in the wrong hands. I nearly got killed on several occasions, I cannot count the sheep sacrified for my safety till now.

As for our colleagues, nearly none is with me from our medical class, all have left the country, the last one two months ago, to Oman. The only one left with me is XXXXX, he is a physician in the department of Medicine

It is not a miserable life. If there is a grade more than miserable, then it will be ours!

We work no more than three days a week in the university, medical city, the one which was elegant and beautiful is now surrounded by garbage and barbwires and concrete blocks from all directions. We don’t spend more than three hours maximum at work, so that totals to nine hours a week. This is the maximum that anyone is working. In the afternoons most of my colleagues say that they have completely stopped going to their private clinics, for fear of death or abduction. I do no more than one and a half hours in the afternoon, I have to feed my big family. I come back rushing to my house after that, we lock our doors and do not leave at all.

What about shopping? What shopping? You must be joking! It is called Marathon Buying, for I try to spend no more than ten minutes getting all the needed vegetables, fruits and food items–this is on my way back from university, ie three times a week. I also spend another ten minutes in the afternoon on my way back from clinic buying gas (benzine, car fuel) for my home electric generator. It is all black market reaching four to five times the official price. If I need to get it legally, I have to spend overnight in line in front of the gas station, people bring their blankets, water, food, and sleep in the street in front of the gas stations. Of course sometimes I speak nicely to the guard of the gas station, presenting my ID and my buisness card and ask them if I could fill my car off-line. Sometimes they kick me out, othertimes I would get lucky and the guard has some rheumatic complaints, back pain or knees pains and bingo! I can fill my car off-line, with a promise to bring him medicines. Of course without any physical exam or investigations, if I was too lucky, and the stars where on my side that day, then I may even be allowed to get an extra 20 litres of gas for my generator.

A month ago, there were militia men with their guns, storming the dormitories of resident doctors in the medical city. They were particularly looking for doctors from Mosul or Anbar. There was a big fuss, and target doctors went into hidings, none was caught. Next day, two of them — rheumatology post-graduates under my supervision — asked me to give them leave to go to their hometowns and not be back except for their exams, and that even their training and teaching be taken there. I agreed, because they were leaving anyway. They would have been killed if they were caught, not because they have done any crime, but just because they are Sunni from Mosul and Anbar.

I believe that many doctors from southern parts of Iraq, who were Shiites, also left the dormitory on that day, because they feared that they are not safe anymore, and that next time it will be their turn, when maybe Sunni militia gunmen will come. So everyone left. Actually in that week I had prepared a lecture for post-grad doctors in the medical city. No one appeared, as all resident doctors had left. Of course many have come back again, but are terrified. Yet life has to go on.

The same applies for other hospitals, services are almost non-existant now. I was in Yarmouk hospital two days ago. The resident doctor whom I was visiting was living in a place in the hospital with broken, dusty furniture, wood and metal scattered all over, doors and windows broken. It looked like an animal barn. I was requesting a death certificate for a colleague. I went with him to the morgue where he kept the death registry. Outside the morgue there were the bodies of two young men, both shot in the head, laid on stretchers in the open air. The hospital was barricaded behind huge cement walls– the hospital itself had been targeted several times by car bombs. A few months ago, doctors in this hospital declared a one day strike because they were being regularly beaten and wounded by officers of the National Guard. The hospitals are frequently raided by militia men who pull the wounded out of their hospital beds and drag them to where they will be executed.

Attendance of patients to hospitals has dropped tremendously. We used to see an avrerage of 100 one hundred patients in our consultation clinic at Rheumatology every single day prior to 2003. We don’t see more than twenty these days. Don’t ask me where did the patients disappear to? Many are scared to leave their homes and go to the hospitals. The hospital used to provide medicines for the chronically ill, for diseases like rheumatoid arthritis. We used to have a monthly blood check followed by a month supply of DMRDs. These supplies are now so infrequent, blood checking is not done. Because services are so irregular, most patients got fed up and decided it is no more worth it to attend hospitals. Even simple NSAIDs most of the times are not available to patients coming for acute complaints. Many who used to come from towns and cities away from Baghdad, for better treatment in the capital city, now think it is too risky and dangerous to travel to Baghdad for follow ups. Instead, patients stop their therapy altogether, or depend on local facilities and whatever simple resources they get where they are, regardless of whether it is efficient or not. The financial situation of most families in Baghdad has gone so much down, that many find it is a luxury to treat chronic illnesses. The priority is for food, fuel and staying alive.

This is a small summary of what and how we are living.