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Iraq healthcare in disarray, report says

Report by Medact

16/1/2008 Iraq's healthcare is in disarray with doctors and nurses fleeing abroad and child death rates soaring, according to a report on Wednesday. Up to 75 percent of Iraq's doctors, pharmacists and nurses have left their jobs since the U.S.-led invasion in 2003. More than half of those have emigrated, the report by health organisation Medact said.

"The health system is in disarray, not only because of the underlying security, but owing to the lack of an institutional framework, huge staff shortages, intermittent electricity, unsafe water supply and frequent violations of medical neutrality," the report, "Rehabilitation Under Fire", said.

Iraq has only around 9,000 doctors, giving a ratio of six doctors to every 10,000 people. By comparison, the ratio in Britain is 23 to every 10,000.

"Repeated failures to recognise the special status of health services and personnel in times of conflict have created an environment in which violations of the Geneva Conventions are common," Medact said.

It levelled particular criticism at the U.S. Defense Department which administered Iraq immediately after the invasion. It had pursued its own agenda on rebuilding the health sector, ignoring international practices, Medact said.

Of more than $18 billion assigned to Iraq's reconstruction, just 4 percent was set aside for healthcare.

While per capita health expenditure rose from $23 in 2003 to $58 in 2004, Medact said bureaucracy and inefficiency meant some of the healthcare budget was still not being spent.

"Large health sector reconstruction contracts were awarded with great haste and little consultation," the report said.

"Rapid results and highly visible 'deliverables' such as new buildings, while politically attractive, absorbed important resources inefficiently and failed to lay long-term foundations."

Because of a U.S. desire for privatisation, a decision was also taken to rewrite the national formulary, the list of drugs supplied by the Iraqi Health Ministry.

This was a costly and inefficient process that delivered nothing to patients, Medact said.

Death rates among children under five are now nearing those in sub-Saharan Africa, despite Iraq being a relatively wealthy, well-resourced and educated country. Eight million Iraqis are in need of emergency aid, the report said.

Medact said Iraqis -- political leaders, health experts and society -- should be given a greater say in developing its health system.

It also wanted a renewed focus on mental health, an area of medicine that has traditionally received little attention in Iraq.

"There are significant mental health problems," Medact said. "Many people receive little or no mental health care, and stigma is associated with several mental disorders." (Editing by Kate Kelland and Robert Woodward)



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