Whenever someone hears about our kids or reads about our work they almost always arrive at the same question: “How did Iraq get this way?” “What caused this?” “Who’s to blame?”
Well, after 4 years of working throughout this country we believe we can provide you with a concise answer to that incredibly complex question. This isn’t about guilting anyone or pointing the finger (there’s already too much of that going around), but it is a hard look at the answer to your question.
Based on Iraq’s history, here are 5 ways to destroy a nation’s healthcare system:
1. Limit a country’s ability to operate politically and economically
In 1990 the UN Security Council passed Resolution 661, which imposed broad, restrictive regulations upon Iraq. In a nutshell, these regulations stipulated that no country in the UN could import or receive any goods from the country.
Unfortunately, the sanctions did more than impede the political and military action of the Iraqi aggressors. The Iraqi economy, that had been so dependent upon oil exports and foreign trade, crashed as a direct result of the Resolution 661.
In 1989 Iraq’s gross domestic profit was over $66 billion. Just seven years later it was estimated as being $10.8 billion. In 1989, annual income per household was $3,510, and by 1996 had fallen to less than $500. Before the sanctions, 93% of the population had ready access to healthcare institutions, which were staffed primarily by physicians who had been trained in Europe or the United States.
This economic collapse primed the country for the health crisis it is in today, a health crisis that has lead to the death of inestimable millions over the last two decades.
2. Slash governmental healthcare funding
In the 1990′s Saddam Hussein cut spending on healthcare by 90%. Continued education, supplies of necessary equipment, and valuable public health programs all suffered without adequate funding research.
Without funding and governmental support, the healthcare system deteriorated.
3. Reduce the number of medical professionals in the country
In some areas, insurgents made it a practice of targeting medical professionals. Although many doctors were not individually targeted, they were still in danger. Ambulances were frequently robbed of their medical supplies, and it was not uncommon for gunmen to enter hospitals and force doctors to care for their injured family members or comrades.
Another blow was dealt to the stability of Iraq’s healthcare when many doctors and nurses, who were lucky enough to escape death, fled the country in a mass exodus, further damaging the quality of the Iraqi healthcare system.
The murder and exodus of Iraqi healthcare professionals is tragic. It has left many families broken and many patients without the care that they need. But the negative effects extend beyond their families and the patients they left behind. Without their mentor-ship, expertise, and knowledge, generations of students from universities and teaching hospitals will continue to have insubstantial educations.
4. Destroy physical healthcare infrastructure
In 2003 American and Coalition forces destroyed two primary public health laboratories and an estimated 12% of hospitals. While speaking about the state of the nation’s healthcare infrastructure, former Minister of Health of Iraq, Khudair Abbas, explained that of the remaining primary care centers, “15% have been looted. Even though 80% remain intact, 40% need extensive repairs…13% do not have clean water and one third are staffed primarily by paramedics rather than physicians”.
During the Gulf War, American and coalition forces destroyed key elements of Iraq’s infrastructure. “Bridges, communications, electricity supplies, water and sewage systems, weapons factories, healthcare facilities, administrative centers, warehouses” and homes were destroyed. While this may have been a strategy aimed at ceasing Iraq’s ability to make war, this strategy did far more than defeat the Iraqi military.
5. Overburden the healthcare system by creating too many patients
The above contributing factors deal primarily with political, structural, organizational, or educational deficits. Ultimately, however, it is the population of patients that compose the largest component of any healthcare system. And, regrettably, there is a vast population of patients in Iraq.
The demolition of water and sewage treatment plants lead to outbreaks of typhoid and cholera. In 1989, there were no cases of cholera per 100,000 people; just 5 years later there were 1,344 cases per 100,000 people.
According to studies, by 1996 31% of children under five were chronically malnourished. Just a year later, there were a million children under the age of five who were malnourished, and a year after that 70% of women were suffering from anemia. Another study, consistent with the information on malnutrition, found widespread, chronic stunting in school children as an indication of long-term malnutrition.
Poverty’s wide-spread negatively affects the livelihood of the Iraqi people. Low socioeconomic status is associated with lower levels of education, poorer nutritional intake, and higher risk of congenital heart defects.
Research shows that poor diet contributes to far more negative effects than weight loss, anemia, nutritional deficiency, and compromised immune system. Without the funds to afford healthier food, mothers with higher intake of saturated fats and lower intake of nicotinamide (vitamin B3) have increased risk of giving birth to children with congenital heart defects. 5, 8 Furthermore, low dietary intake levels of folic acid (vitamin B9) around the time of conception have been linked to higher risk of neural tube disorders.
But nutrition and education are not the sole arbiters of death and ill health. Many parts of the country still suffer from the chemical and biological attacks perpetrated by Saddam Hussein. Not only are individuals suffering from primary exposure, but research supports that children of those who were exposed suffer secondary effects in the form of birth defects.
The list of health problems and their contributing factors continues ad nauseam, and the patient-load continues to overwhelm doctors.
The evidence shows that the state of Iraq’s healthcare system has been nearly two decades in the making. The downward spiral began with sanctions in the 1990’s by making the nation more susceptible to economic collapse. It continued with a multitude of factors including military action by the US and Coalition forces, violence wrought by religious extremists, and a vast backlog of patients.
The question remains, is it too late for Iraqis to rebuild their healthcare system?
Is Iraq too far gone?
Of course not! The restoration of Iraq’s medical infrastructure is happening now!
This November 5th will be our biggest surgical mission yet–lives will be saved, doctors will be trained and Iraq will be one big step closer to restoring what was broken!
September 13, 2010 by Jeremy · Comments Off
Deeya is alive and doing well at home today because of the surgery you provided for her in Iraq!
Wow! What a phenomenal trip it has been these last few weeks as you have brought a new remedy to the children of Iraq through the surgical and nursing team of Dr. William Novick. It’s high time we update your impact to help Iraqis make a better future for themselves and their children.
The total expense for our first Remedy Mission was approximately $90,000. This amount was further subsidized by the Director of Health in our city and the Kurdish Regional Government in Washington D.C., and the International Children’s Heart Foundation. The balance was underwritten by you!
This family was not yet chosen for surgery… they are still waiting for our next Remedy Mission.
Locally, Remedy Mission was a great success. We ended the week at dinner with the governor and the health director where they invited us to start our next Remedy Mission as quickly as possible. When we suggested May 2010 as a next date, all the surgeons and the health director rallied together to urge us to begin again in February instead.
Our current proposal is a five year plan comprising four trips per year to make the Sulaymaniyah Cardiac Center a premier facility in the region that is able to perform 12-14 surgeries per week without foreign assistance. We estimate that this will cost $1.5m and we are currently talking with the local authorities in hopes that they will choose to shoulder the majority of that expense.
During Remedy Mission ICHF and local surgeons performed 25 corrective cardiac procedures. Put differently, we helped more kids in 12 days than we have in any 12 month period to date… at a massive savings compared to our work in Iraq… with hands-on training for Iraqi doctors and nurses! A typical all-inclusive surgery in Istanbul costs us $10,000 (after subsidies). That expense is usually shared among the family of the child, local and international donors. The typical PLC international donor portion of a surgery in Turkey is $3-5k.
Cody Fisher reviews the list of kids who received surgery and kids still in line for February 2011.
The numbers for Remedy Mission look much different. Not only are we able to work in partnership with others more during Remedy Missions, but every surgery represents a local development and training opportunity. The all-inclusive price for all partners was approximately $3,600 per child (compared to $10k in Istanbul and much more in the States or Europe).
Remedy Mission has taught us a lot about being fiscally and developmentally responsible. Therefore, in an effort to redouble our commitment to long-term local solutions, we will be increasing our Remedy Mission funding in hopes of facilitating four Remedy Missions in our current city in 2011.
The following families are still waiting in line for our help…. Will you be the remedy? Donate the amount of your choice below to get our next Remedy Mission off to a strong start!
Remedy Missions are international pediatric heart surgery teams that we bring to Iraq to to perform lifesaving heart surgeries and develop the infrastructure for the future. If you’re on Twitter this week be sure to use the #Remedy or #RemedyMission hashtag to describe all the good news coming out of Iraq this week via @preemptivelove and @babyheart_org. If you’re on Facebook, “Share” this story with the button below.
From the day I first met her in our office, what I remember most are her eyes. In the land of dark skin and eyes to match, Nivar and her hopeful, green eyes separate themselves from the rest.
Nivar is a young girl who feels the effects of her heart defects, a girl who is reminded daily of her need for surgery. Unlike some of our kids, who can live lives without many outward signs of their inward battle, the results of her defect is evident.
I went to visit Nivar and her family in the volatile Iraqi city of Chamchamal and was again reminded how I hate seeing the innocent suffer. While some stayed inside to talk, I was outside with Nivar and her brother, playing with their futbol, as has become the norm.
We started to kick it around, allowing the futbol to distract us from the pain of this situation. We forgot about thoughts of her failing heart; that she was different from me and her brother. We forgot this until Nivar walked away from us and lied down on their swing.
At first, I wasn’t sure what to make of this. Did she just not like futbol? Did she not like me?! What was it? I asked her to come back and play with us, and she quietly replied, “Natwanim, helakim” (I can’t. I’m tired).
Then it hit me. She really couldn’t keep playing. Her heart couldn’t handle it. She had no choice but to sit and rest.
And this is when I again started to grieve. What did Nivar do wrong? I long for restoration, when bodies no longer fail; when children no longer fear their hearts; when all is made right. I look into Nivar’s strikingly green, innocent eyes and need someone to blame.
This isn’t fair; it isn’t right. I am weary of child after child being brought to us by hopeful parents, praying to God we can save their son or daughter. Today, I just need someone to blame.
Is this Saddam’s fault, like so many claim? The chemical attacks, the gassing of thousands, the testing of primitive nerve gas agents on abducted Kurds − is this all his fault?
Those bombs he dropped; those slow-falling bombs filled with chemicals designed to savagely destroy all things living − what about those? Can I blame them? Are they the root of these issues? Did those weapons ever realize their deadly poison would be seeping their way into the heart of a little girl named Nivar years later?
Could Saddam have looked into these green eyes and continued to follow through with his attacks?
Many say it’s his fault. There’s no way to say it conclusively. Today, needing someone to blame, I blame Saddam. But even this is not complete.
No, we must go further than Saddam. For even he was driven by something. I can blame only sin. As a follower of GOD, I grieve the effects of our rebellion. I acknowledge these things also break GOD’s heart, and I long for things to be restored. I come to GOD hopeful, believing his promises that he loves his children, like Nivar, far more than I am ever able to.
And so, I hope.
SEND NIVAR TO SURGERY! Nivar has a four-fold set of heart defects known as Tetralogy of Fallot. At eight years old her growth has been stunted by lack of oxygen in her blood and subsequent lack of energy, activity, etc. But a total corrective surgery can still free her up for on-time development as she moves into her ninth birthday in September. Her father has gathered $3,500 from savings, friends, and family to help send Nivar to surgery! We need less than $2,000 to send her in July! Donate the amount of your choice below to get her on her way!
July 14, 2008 by Jeremy · Comments Off
Thanks to a series of summer fundraising events in the States, the friends of PLC have raised at least $12,500 for heart surgeries to go to Iraqi children. Money is still coming in, but we’ve applied the first round to the sweet kids below who will now be able to travel next week to heart surgery outside of Iraq thanks to the kind kids and their parents who gave this summer so that others could live!
Shkar, 6 years old
Shkar’s case is very urgent and has recently caused him a great deal of difficulty breathing. His surgery is long-overdue, but doctors believe that he can still have a normal life. We plan for Shkar to be in surgery July 2008.
Hevi, 12 years old
Hevi has a condition called Tetralogy of Fallot, a combination of four anatomical abnormalities. Thankfully, doctors believe she can be fully healed and lead a ‘new life.’ We plan for her to be in surgery July 2008.
Shanaw, 12 years old
Shanaw’s case is very urgent. Though it’s difficult to see under the face-painting you see in the picture, Shanaw’s skin is very blue due to a severe valvular obstruction in her heart. Doctors believe she can be cured through surgery and go on to a healthy, normal life. Shanaw has received all her funding now and we plan for her to be in surgery July 2008.
Kale, 8 years old
Kale’s family keeps calling to remind our partnering organization that their little girl still needs help. Her favorite subject in second grade is English… We’re eager to follow up with her when she returns from her surgery. You can write notes to Kale in simple English here. Kale has received all her funding now and we plan for her to be in surgery July 2008.
Sarah, 8 years old
The cardiologist at the March 2008 screening found that the heart of this frail little girl can be fully restored through surgery. Her internal organs are all on the wrong side (situs inversus) – sometimes surgeons will use a mirror to operate in this case! We hope to have her in surgery in July.