Title: Healthcare in Iraq Pre and Immediately Post Operation Iraqi Freedom
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2Healthcare in Iraq Pre and Immediately Post
Operation Iraqi Freedom
- Michael J. Keller, MBA, FACHE
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4- Geography
- Medical indicators
- Health care professionals
- Ministry of Health
- Private sector
5Geography
6Land Mass Comparison -
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9Babyl Province
Population Est. 1.2 million
Principle City Al Hillah (Babylon)
Hospitals 400 Bed General Hospital 250 Maternity/Childrens Hospital
Healthcare staff 470 Physicians (420/50) 1100 Staff
10Medical Indicators
Iraq United States
Population 23.6 million 284 million
Hospital Beds 14/10,000 37/10,000
Physicians 4/10,000 27/10,000
Infant Mortality Rate 92 deaths/1k live births 7 deaths/1k live births
Life Expectancy at Birth 59 years 77 years
11Al Hilla Maternal/Child Hospital
12Medical Supply Missions
13Absence of Equipment
14Sole Incubator
15Sanitation Standards
16Al Hillah Hospital Today
17Physician Training
- All conducted in English (British)
- 4 year medical school, standard residency
training programs - Iraqi developed and administered final exams
since 1981 - Little or no professional contact outside Iraq
during Saddams regeime - No new textbooks or journals gt10 years
18Nursing
- Estimated 250 formally trained professional
nurses (RNs) - No nursing schools operating
- No resources
- Care provided by Aides Orderlies
- No appropriate work uniforms
- Lack of basic care training
19Allied Health Personnel
- Medical Laboratory Technician trained in
Baghdad MOH - PT, OT, Speech, Respiratory, Medical Records
not to be found - Bio-Med - None
- Management/Administration
20Ministry of Health
- Baghdad centric
- Assigned staff upon completion of training
- Handed down operating budget
- Salaries controlled and regionalized
- Directed treatment protocols
21MoH Elections
22Office of Public Health
Year Diagnosed Carriers Deaths
Cholera 2000 6 4 0
2001 0 3 0
2002 3 2 0
2003 0 0 0
Malaria 2000 16 7
2001 19 6
2002 14 4
2003 17 8
Dr. Hazim Al Nassiry, May 17, 2003
23Medical Supply System
- Kamidi
- Central purchasing and distribution system
- Provincial warehouse cold chain storage
- Former régime requirement for testing of all
pharmaceuticals and reagents - Ban on U.S. produced Rxs reagents
- Oversaw Iraq Rx manufacturing
- Endemic corruption and graft
- Administration clung to Kamidia until finally
realizing that it was beyond rehabilitation.
24Private Sector
- Operated throughout the time of the former régime
in all provinces - Obstetric Ophthalmology
- Forced to black market for supplies
- Global fee - negotiated between physician
patient
25Closing comments -
- Dedicated and ethical providers
- Desperately wanting to return to US/European
standards of care - Appropriate spending investment and removing
corruption are key - Exportation of knowledge and learning materials
is the way ahead - MoH was among first ministry to be returned to
Iraqi sovereignty
26Questions Comments
A Portion of the Presidential Palace, Tikrit, Iraq