Iraq Blog II

A Health Life-line from the American People
Written October 17, 2008

Upon arrival inside the Baghdad Green Zone, I was given a situational overview by a group of U.S. Embassy personnel, and then proceeded to a series of meetings with the Health Minister and different groups of doctors. Those meetings were held at the al-Rasheed Hotel, a famous landmark in Baghdad. During the 1991 war with Iraq, CNN broadcast live from one of the upper floors of the hotel.

Mid-afternoon, I left the hotel for a thirty-minute meeting with U.S. Ambassador Ryan Crocker and General Raymond T. Odierno, the Commanding General of Multi-National Force- Iraq. Both of them are impressive and highly experienced men dealing with enormously difficult tasks.

Most of our discussion related to the Status of Forces Agreement (SOFA) and the Strategic Framework Agreement, currently being negotiated between the United States and the Iraqi Governments. These are complex agreements that will define the nature of our interaction after December 31, 2008, which is when the United Nations Resolutions expire.

Secretary Leavitt meeting with U.S. Ambassador Ryan Crocker and General Raymond T. Odierno.

Following my meeting at the Ambassador’s office, we drove back to the al-Rasheed to continue a succession of meetings and conversations with the leadership of the Health Ministry and doctors from around Iraq.

The Minister of Health, Dr. Salih Al-Hasnawi, is a psychiatrist by training. He has a steady, calm demeanor that engenders trust. He speaks English well enough that we can communicate without problems. Most of all, he seems genuinely committed to improving the health of the Iraqi people.

Dr. Salih works in a very difficult and somewhat dangerous atmosphere. Previous Ministers have been subject to assassination attempts. He must have massive amounts of security for that reason.

Dr Salih’s security concerns are emblematic of the primary reason the health-care system in Iraq is so desperately in need of help. Insurgents have strategically and systematically targeted doctors, hospitals, and health workers. They have kidnapped or wounded thousands of them, murdered hundreds, and threatened their families. This follows 25 years of deprivation and abusive practices under Saddam Hussein.

Throughout the day, I sat with doctor after doctor who related stories of being shot, kidnapped, threatened and tormented by the thought that they or their families could be next. One told me privately of e-mails, notes and phone calls in the night threatening him and his family because he treats members of the Iraqi Army.

Others described how hard it is to get staff to come to work when health clinics are bombed. They feel intimidated and scared. One person described the health community as suffering wounds upon wounds, never fully able to recover.

These are tactics right out of the insurrectionist’s handbook. If you disrupt the capacity of the government to provide essential services, it discredits the government, and creates a fertile ground to foment terrorist ideology.

There is nothing essentially more personal than health care. That is the reason insurgents and terrorists focus so intensely on it. Not just in Iraq, but all over the world. The pattern is the same.

Regrettably, the tactic has worked in Iraq. Out of 34,000 doctors registered in Iraq in 1990, at least 20,000 have left the country. Since 2003, 8,000 doctors have stopped practicing medicine; more than 2,200 Iraqi doctors and nurses have been killed, and over 250 kidnapped. The doctor’s flight further crippled health institutions in Iraq, because without them corruption and mismanagement became the rule. Iraq probably needs around 100,000 doctors to meet the needs of its population, but has at present only 15,000.

The doctors who remain spoke to me of the hunger they have for professional improvement. They have had no capacity to interact with doctors in other countries who can teach them updated techniques.

In one of my meetings, I sat with a group of mental-health practitioners who had just returned from the United States on a program sponsored by my Department. We arranged for about thirty of them to spend time with their counterparts in the United States. These people were energized and appreciative. Every one of them reported continued conversations by phone and e-mail with mental-health professionals in the United States who have become friends, confidants and mentors. One can only imagine the mental-health toll the last thirty years have created in Iraq.

Tomorrow, I will talk about Minister Salih’s plans to begin rebuilding the health-care system in Iraq.

Comments

Wow - how horrible if there is not vacume to fill - create one"

Thanks for the perspective that does not make the news. To understand the culture is important.

Good luck with your next job after HHS. A few are scared the next person will not take pandemic flu nor blogging like you do.

Kobie

Posted by: Kobie | October 31, 2008 at 09:34 AM

Good morning Secretary Leavitt!

I wanted to send this email to thank you for your faithful devotion and work in allowing freedom for those in America in the medical profession who do hold life as a precious gift of God to be able to work in their profession and honor their conscience with the bill you are working on that allows them to stand for life. It is my understanding that this bill would allow them to personally say no to performing any type of abortion, whether it comes from the procedure itself, or the pill. How wonderful it is to see it honored in leadership in Washington, and despite the battle sometimes in regards to the issue of life every step we take we are taking back ground that is so precious to our God! I thank God for the leadership we have in Washington DC, and I am a praying American who is praying for you and your family today. Thanks so much for your stand, even though there are many "pro-lifers" out here that are quiet, we are many and have been praying for things like we see coming to light today. Do not lose heart, and thanks again for all you do!

God Bless America!!!!!
-Terri Wardlaw

Posted by: Terri Wardlaw | November 20, 2008 at 09:46 AM