U.S. Contributions to Public Health and Healthcare in Diwaniyah Province Has Major Impact

Diwaniyah | January 27, 2010

An inspection of the Al-Jomhoury Primary Health Clinic by Sam Watson, PRT Public Health Advisor

On a 2009 November afternoon, the Diwaniyah Provincial Reconstruction Team’s (PRT) Public Health Advisor visited the site of the newly built the Al-Noor Primary Health Clinic in the rural community of Sumer.  

About 30 kilometers from downtown Diwaniyah, this village is so remote that it is seldom visited by the locals, except to sell their crops.  The visit attracted the attention of the local populace, and soon the team was surrounded by young and old including some of the area’s tribal leaders many claiming to have never seen a U.S. soldier.   It was a warm welcome and the opinion by all was that this well-constructed facility, built with PRT backing and Army Corp of Engineer, design, and management, would soon be a cornerstone in the community.

Residents were eager to voice their thoughts on what the clinic would mean to the community.  At the top of the list is the ability to access pre- and post- natal care for the mothers.  It is estimated that over twenty-five percent of the women of the area were giving birth at home.  Now with this facility, it will mean better outreach and less concern about being able to access qualified medical staff.  This clinic will provide the community with a “state-of-the-art” healthcare facility that will include doctor’s offices, examination, and dental rooms, as well and maternity and childcare facilities.  It will serve a population of 30,000.  

But this story has been told at least eight times already in the province with at least seven other primary health centers being built by the U.S. government.  It was calculated that these centers serve at least one-half of the estimated one million population of the province.   Those who know the story in the province say that the impact in the field of health care delivery has been enormous.   

This legacy was also examined by a recent visit to an urban primary health center which the PRT opened in March 2009.  Medical personnel and residents alike attest to the significant difference the Al-Jumhoury Primary Health Center is making in the lives of the 45,000 residents of this poor, beleaguered section of the city.   Opening this new clinic relieved the pressure of a much larger population at a neighboring clinic by halving its patient load.   The Central Hospital about two kilometers away and it was hard to find a pharmacy.  The area has been a haven for militias.  One resident told us “with the building of this Center by the U.S. it meant that the militias would never be welcomed back in this neighborhood.”

On this particular morning the waiting room full of patients seeking help for a variety of conditions.  Some were small children needing immunizations.  Welcoming the PRT staff was the Center’s director.   She was enthusiastic about the Center as she had been a rural health care practitioner for twelve years.   She demonstrated that she was fully in charge and seemed to have respect of her entire staff.  She proudly showed off examination and treatment rooms, doctors’ offices, an x-ray room, laboratory, and a well-stocked pharmacy all in good order.        
As we left she thanked the Public Health Advisor for the PRT’s contributions and for making the facility a reality. 

Building on the success of these Clinics this year will be a newly created Public Health Care Training Center that will provide instructions for all medical personnel in this newly recognized field.   This Center will also  reach out to the hundreds  of midwives working in isolated areas to give them skills needed when a women is unable to get to reach a medical facility such as the Maternity and Children’s Hospital.  This facility also received a major renovation by the U.S.   The PRT-provided Training Center will enable increased “trainers of trainers” in areas of rural health, midwifery, paramedics, sexually transmitted diseases, and pandemics.

Dr.  Yahyah Nageeb, the head of Diwaniyah Hospital, participated in an International Visitor Leadership Program last year.  He frequently comments on the new ideas in medical techniques and western medical concepts he learned while in the U.S. 

The PRT counts as a key contact the Provincial Council’s Chairman of Health, Dr. Thamir Naji.  As a young doctor, Thamir Naji is looking for new approaches and western management techniques to improve health in Diwaniyah Province. He is so excited about these new directions that he has enthusiastically applied for a Fulbright opportunity in Public Health.

Diwaniyah’s Director General of Health Dr. Abdulameer Leelo is pursing positive changes in the providing of medical services.  When he and  the Team Leader for the PRT  opened the Al-Jumoury Clinic it was said that  “building this  and  the other clinics  took cooperation, courage and resolve, especially on the part of those Americans and Iraqis who helped design the project, oversaw  its  construction and  did the hard work of building it.”  Dr. Abdulameer and Dr. Thamir met weekly with the PRT and its Public Health Advisor to coordinate ongoing projects involving training young medical practitioners, strategic healthcare, and public health planning.

In early December 2009, the PRT participated in a mobile rural clinic near Afak in an area selected by a U.S. medical team. This area has no clinic and residents must travel over seven kilometers to the nearest facility.  Hundreds of men, women and children lined up for exams, minor treatments, medications, and referrals.  The local pre-eminent sheik was present for the entire clinic.  The PRT is looking at building a program of rural mobile clinics to provide training in western medicine and public health to new graduates of the Province’s medical and nursing schools.

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