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Healthcare in Iraq Pre and Immediately Post Operation Iraqi Freedom

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Title: Healthcare in Iraq Pre and Immediately Post Operation Iraqi Freedom


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Healthcare in Iraq Pre and Immediately Post
Operation Iraqi Freedom
  • Michael J. Keller, MBA, FACHE

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  • Geography
  • Medical indicators
  • Health care professionals
  • Ministry of Health
  • Private sector

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Geography
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Land Mass Comparison -
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Babyl 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
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Medical 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
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Al Hilla Maternal/Child Hospital
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Medical Supply Missions
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Absence of Equipment
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Sole Incubator
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Sanitation Standards
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Al Hillah Hospital Today
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Physician 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

18
Nursing
  • 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

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Allied Health Personnel
  • Medical Laboratory Technician trained in
    Baghdad MOH
  • PT, OT, Speech, Respiratory, Medical Records
    not to be found
  • Bio-Med - None
  • Management/Administration

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Ministry of Health
  • Baghdad centric
  • Assigned staff upon completion of training
  • Handed down operating budget
  • Salaries controlled and regionalized
  • Directed treatment protocols

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MoH Elections
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Office 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
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Medical 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.

24
Private 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

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Closing 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

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Questions Comments
A Portion of the Presidential Palace, Tikrit, Iraq
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