Necropolis Now: The U.S. Assault on Iraqi Healthcare

Image Source: Location of the Ibn al-Khatib hospital in Baghdad, Iraq

The recent Baghdad hospital fire, Western reporters told Iraq, is a “you” problem. The Washington Post blamed the country’s “endemic corruption” for the 82 deaths. The New York Times denounced its “mismanagement” and “legacy of decrepit infrastructure.” And the Wall Street Journal, quoting Iraqi Prime Minister Mustafa al-Kadhimi, cited “negligence.”

But Iraqi healthcare wasn’t always broken. The WHO once called its facilities “first-class.” In the 1980s, according to the UN, Iraq was “fast approaching [social development] standards comparable to those of developed countries.” Its system was the “jewel of the Arab World.”

Then Washington attacked. Operation Desert Storm killed tens of thousands of Iraqis, wrecking “bridges, roads, power and water stations.” When it ended, the UN’s Martti Ahtisaari led a mission to Baghdad. Its members were “fully conversant with media reports regarding the situation in Iraq.” But they soon realized “nothing that [they] had seen or read had quite prepared [them] for the particular form of devastation”—“near-apocalyptic”—Washington had visited. The bombing condemned Iraq “to a pre-industrial age,” and shattered the jewel.

Destruction of the electrical grids alone incapacitated the medical system,” making hospital visits a sudden luxury. Bombing the water purification and distribution systems “led to death and suffering.” But all this only previewed the coming nightmare: the sanctions.

The New York Times calls them “international sanctions against Saddam Hussein.” They were UN in name—but “at every turn shaped by the United States,” whose “consistent policy” was “to inflict the most extreme economic damage possible on Iraq.” On its people, more precisely.

What Iraqis call al-hisar—the siege—“prohibited oil sales—Iraq’s main export—and banned imports of goods,” to the point where “food and medicine imports declined by 85-90%.” The blockade also barred Iraq “from importing material to fix its broken infrastructure.”

Some 576,000 children, by the UN’s reckoning, died as a direct result. Madeleine Albright believed this mass death “worth it,” but two successive UN Humanitarian Coordinators in Iraq disagreed. Denis Halliday concluded the sanctions were “genocidal.” And their “conscious violation of human rights and humanitarian law” repulsed Hans von Sponeck.

Omar Dewachi was equally disgusted. He started his residency at al-Madina, “Iraq’s largest teaching hospital,” in 1997. The facility was once the national “epicenter for specialized medical care,” lauded “as one of the most advanced medical monuments in the Middle East” at its 1972 opening.

But when Dewachi arrived, the building “was unrecognizable due to the lack of maintenance, the cannibalization of its physical structures, and the absence of spare parts for its outdated medical equipment.” Its physicians repurposed “nasal tubes to empty bladders,” were forced to save “sterilized disposable gloves and the remains of surgical sutures so they could be used on the next patient.” The monument, crumbling, became a necropolis: “Empty coffins went into the hospital’s morgue to come out full, accompanied with shrieking screams of mourning.”

Gruesome scenes were the norm nationwide. The siege deprived facilities of “proper illumination, hygiene, water supplies, [and] waste disposal.” Winter patients endured the “lack of heaters, heating fuel, and blankets,” while one Baghdad infirmary “got so hot in summer that ‘any child who [arrived]…without a fever end[ed] up with one.’” Nurses “reuse[d] intravenous disposable equipment,” and “postoperative care and pain management in some hospitals was limited to aspirin.” Operating theaters “provided only hand soap” for disinfectant; clinics “were cleaned only with water.” Ambulances vanished from hospital bays, leaving patients “to rely on poorly maintained taxis or coaches.”

Even cancer grew more terrible. A WHO expert, visiting Iraq in 1999, was appalled: “A cancer center without a single analgesic; a radiotherapy unit where each patient needs one hour under the machine because the radiation source is so old”; wards where “the availability of chemotherapy is essentially a lottery.”

A lottery children lost with increasing frequency. At one hospital, because of a dearth of chemotherapy drugs, “disease-free survival rates [fell] to 25 per cent [by 2002] compared to 60 per cent in 1988.” Joining them in early death, as the new millennium dawned, were “thousands of Iraqis” perishing “from malnutrition, infectious diseases,” and “shortages or unavailability of essential drugs.”

But the sanctions, like Desert Storm, just foreshadowed future horrors. Washington’s 2003 invasion—Iraq’s “biggest cultural disaster since the descendants of Genghis Khan destroyed Baghdad in 1258”—brought more ruin to medical institutions.

“Around 7% of hospitals were damaged during [2003] combat,” and U.S. forces leveled Fallujah’s Nazzal Emergency Hospital in November 2004. Paul Hunt, a top UN official, also accused Fallujah’s occupiers of “blocking civilians from entering the main hospital; preventing staff from working there or redeploying medical supplies to an improvised health facility; and firing at ambulances which they suspected were being used to transport insurgents.”

Soon infant death, cancer, and birth defects—paraplegia; a two-headed newborn—plagued Fallujah’s residents at rates above “those reported by survivors of the atomic bombs” in Hiroshima and Nagasaki.

As U.S. soldiers damned Iraqis to illness and premature demise, Washington further unraveled the country’s health system. Paul Bremer’s first task, as Coalition Provisional Authority administrator, was “to fire some 500,000 state workers,” including medical staff.

Little wonder “18,000 doctors, representing over half of those who remained in the country, left Iraq” in the occupation’s first five years. Intensifying sectarian conflict—a direct consequence of Washington’s “divide-and-rule policy”—put doctors in the crosshairs. Hundreds were kidnapped and killed.

And hundreds of millions of dollars—funds meant to rebuild health centers—disappeared. The Special Inspector General for Iraq Reconstruction found, in 2006, that USAID had mismanaged two contracts. One, for $243 million, was for scores of new clinics. Few were finished. The second was for the Basra Children’s Hospital. Its construction costs tripled inexplicably, from $50 million to $150 million. But for the U.S. press, Iraq’s “endemic corruption” is the issue.

Resource-starved facilities witnessed more grisly scenes. In June 2006, a power outage at a mortuary stopped its refrigerators. “The corpses rotted because of the lack of electricity,” their “foul smell permeat[ing] through the college building” next door, into a lecture hall filled with students.

For other Iraqis, a student’s settled lifestyle was inconceivable. Some “2.7 million people were internally displaced” in the war’s first half-decade; more, years later, fled that product of the U.S. invasion: ISIS. The shelterless had little security, their new rootless lives precarious as their healthcare.

Over 2 million Iraqis, by a March 2020 count, remain displaced. Scattered among refugee camps countrywide, haunted by PTSD, depression, and anxiety, they may never be treated. Northern Iraq, for instance, has 28 psychiatrists, and 26 psychotherapists, for 6 million people.

Not our problem, reporters tell us. But history suggests otherwise.

Nick Alexandrov lives in Tulsa, Oklahoma.  He can be reached at: nicholas.alexandrov@gmail.com

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