CONFLICT IN IRAQ

Health crisis acute in Iraqi province

Al Anbar's alienation from Baghdad makes the national problem even worse there.

By Tony Perry
Times Staff Writer

May 24, 2007

ABU FLEISS, IRAQ — The Americans gave 10-year-old Ayai Emad a Barbie doll wrapped with pink ribbon. Her brother Mohammed, 7, got a Hot Wheels truck.

But what they really need they may never get: adequate medical care.

On this day, the U.S. military and the Iraqi army were conducting a health clinic for the people of a farming area and village near Habbaniya in Al Anbar province.

To avoid tipping off insurgents to such a "soft" target, the location was kept secret until minutes before the clinic opened.

Still, word spread rapidly, and soon a line of men and a line of women stretched down the dusty block as villagers arrived at the elementary school, seeking treatment for ailments ranging from the mild to the life-threatening.

U.S. and Iraqi medical personnel say it was a typical turnout. The adults looked older than their years, the children younger — in both cases, the result of poor diet and a lack of healthcare.

The problems of Iraq's medical system since the 2003 toppling of Saddam Hussein are well-documented: doctors fleeing the country, graft, supply shortages, and civilians dying for lack of care or because their hospital came under attack.

The International Committee of the Red Cross this month issued its most dire assessment yet about the foundering system. The report concludes that Iraqi healthcare has all but collapsed and that deaths and suffering, already widespread, are increasing.

In Al Anbar, military and health officials say, the deep-rooted alienation between the Sunni Arab population and the Shiite Muslim-led government in Baghdad has made the problem even more acute.

Wounded Iraqi soldiers and police officers tremble at the prospect of being sent to a Baghdad hospital, where they fear they'll be killed.

"I've had some of them almost get off the operating table and try to run away rather than go to Baghdad," said Navy Cmdr. George Dyer, a senior nurse at the trauma hospital at Taqaddum air base.

The same is true at the hospital at the U.S. base at Al Asad. At both facilities, about 60% of the patients are Iraqis, many of them security personnel injured by roadside bombs. Once a patient's condition is stable, the goal is to get him or her to an Iraqi facility.

"We try to get them to a place where Sunnis are accepted," said Army Maj. Kenneth Grundy, a critical-care nurse at Al Asad. "Sometimes we just can't and we end up holding on to them."

After the clinic in Abu Fleiss, a tribal sheik and an Iraqi general pleaded with three visiting Marine generals to do something about the Baghdad government's alleged indifference.

U.S. officials, military and civilian, are concerned that the government's estrangement from Al Anbar could make it easier for foreign insurgents to recruit there.

Sheik Ali Hatem Suleimann Dulaymi said he feared that Islamic fundamentalists, opposed to the alliance between the tribal sheiks and the U.S. military, could gain political power in Al Anbar if the Baghdad government isn't responsive to health needs and other issues. Provincial elections are set for this fall.

Iraqi Gen. Tark Abed-Alwab Jassim said that though "enemy activity is decreasing day after day," there could be a resurgence of violence "if we do not keep our promises to the people."

Chief among those promises was the rebuilding of the healthcare system, ravaged in the decades of Hussein's rule and during the U.S.-led invasion and ensuing Sunni-led insurgency.

But promises have been difficult to keep amid the violence. Building projects have been abandoned or scaled back. Doctors Without Borders, an international aid group, left the country because of security concerns. Iraqi doctors have been killed or intimidated, including a female physician in Haditha whose hands were chopped off by insurgents.

An internal U.S. document says that coalition forces remain "the only source" for food, clothing, and school and medical supplies in much of Al Anbar. Hospitals in the cities of Ramadi and Fallouja have reopened but are swamped with patients.

"Our people have so many problems — epilepsy, diabetes, heart, tumors, eye diseases, everything," said Ibrahim Khalidy, a doctor and colonel in the army.

Flanked by dozens of Iraqi soldiers, who were themselves backed by Marines, Khalidy tried to give each of the patients at the clinic a few minutes' attention. Though other doctors have fled Iraq, Khalidy has decided to stay.

"I love my country too much to run," he said.

Along with a quick medical checkup, the adults received anti-insurgency fliers. "This aid is made possible through the efforts of the Iraqi security forces," said one.

The U.S. military and the Iraqi army try to hold a clinic in the region at least one day a week.

Only female corpsmen and nurses are allowed to interact with female patients. Children stand in the women's line, sometimes for hours.

Youngsters Ayai and Moham med both have chest pains and are wheezing. They are small for their age, possibly a sign of what doctors call a "failure to thrive."

"These people are really hurtin'," Navy corpsman Tiffany Sharkey said. "It's a tough life in Iraq."

*

*