Iraqis' medical treatment ranges from poor to none

BAGHDAD - Already a troubled system, Iraqi medical care has fallen to the brink of collapse since the U.S.-led invasion five years ago.

Scores of doctors have been slain, cancer patients have to hunt down their own drugs - even IV fluid is in short supply.

Specialists are hard to find. At one point, Baghdad - a city of more than five million - had no neurosurgeon, said Hussein al-Hilli, a physician who is director of the Ibn Albitar Hospital in Baghdad.

"This was something that was horrible because we had many head injuries, many spinal injuries," Hilli said. He described "big shortages of drugs, big shortages of everything."

Like so many areas of life in Iraq, the health-care crisis is vast and complex, and there is no quick solution to improve conditions for doctors and patients.

According to figures from the Iraqi Health Ministry released earlier this year, 618 medical employees, including 132 doctors, as well as medics and other health-care workers, have been killed nationwide since 2003, among the professionals from many fields caught up in Iraq's sectarian violence.

Hundreds, possibly thousands, of other medical personnel are believed to have fled to Iraq's northern semiautonomous Kurdistan region and neighboring countries.

Even with the security gains of the last several months across Iraq, it is still dangerous for doctors and their families if they dare step out of heavily guarded hospital compounds.

Drug supplies are so low that Iraqis hospitalized for illnesses as serious as cancer are asked to track down their own medicine.

"When we need medicine, we go directly to private pharmacies," said Ahmed Khalil, 38, the owner of an auto repair shop in Fallujah. "We know we're not going to get any from Fallujah hospital."

And when pharmacy shelves are bare, Iraqis turn to the black market.

"Before the invasion, we got our share of medicine through government-owned medicine depots," said a Baghdad pharmacist, who spoke on condition of anonymity because he feared reprisal. He said hospitals and clinics received some drugs from the medical depots, but it was rarely enough for the number of people in need.

"Sometimes we get medicine stolen by employees who work at the depots or at hospitals," he said.

At worst, the black-market drugs are dubious knockoffs, according to patients, doctors and pharmacists.

The war has taken a special toll on hospitals.

Fallujah, site of one of the deadliest battles between U.S. troops and militants west of Baghdad, is slowly rebuilding as violence declines, but memories of the danger are acute at the city's main hospital.

"Doctors would concentrate most of the time on treating people wounded in U.S. bombings or clashes between insurgents and U.S. forces. Other patients got little attention," said one doctor at the hospital, who also declined to be identified because he feared for his safety. "We were beaten by gunmen if we failed to save their wounded fellows."

Jassim Naseef, 52, took his pregnant wife to a private clinic three months ago, paying 20 times what the public hospital would have charged for the birth of their son: $247 compared with $12. The hospital wards, he complained, are dirty and lack electricity.

The American military and nongovernmental organizations such as the Iraqi Red Crescent do a great deal to help, Hilli and others said, by bringing in supplies and advisers and helping train medical staff still versed in 1970s-style medicine.

Hilli also has been buoyed by the Iraqi government announcing a plan to build more hospitals. He said no hospitals had been built since 1986, at the height of the Iran-Iraq war, more than two decades ago.

Yet there are still major problems. Iraq's Health Ministry has been in almost constant flux since the war started. Each minister has stayed "eight months or seven months or 11 months," Hilli said.

An early version of a British

dossier of prewar intelligence on Iraq did not include a key claim about weapons of mass destruction that was vital to then Prime Minister Tony Blair's case for war, the newly published document shows.

The 2002 document

said Saddam Hussein's regime had acquired uranium and had equipment necessary for chemical weapons, but did not contain a claim that Iraq could launch WMD's within 45 minutes - a claim crucial to Blair's push to back the 2003 U.S.-led invasion.

Antiwar campaigners allege

that the alarming claim was inserted into later versions of the document by Blair's press advisers, who were seeking to strengthen the case for invasion - an allegation his government denied.

Foreign Secretary

David Miliband released the document in response to a Freedom of Information request.

- Associated Press