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Lawlessness, lack of electricity endanger Iraq's fragile medical system

BASRA, Iraq—When looters plundered Baghdad's hospitals, they may have stolen Afram Fahmi's hope to save his left leg.

The 68-year-old pensioner was told that removing a blood clot in his leg would have been a minor operation—if thieves hadn't snatched the equipment and scared off the surgeons in the orgy of looting that took place after U.S. troops entered the city and supporters of Saddam Hussein fled.

So Fahmi hobbled off on his crutches, and stepped on a bus for a 12-hour ride to Basra in search of a hospital that could help him. But he found the situation no better in Iraq's second largest city.

"They stole everything," said Fahmi, as he waited outside a U.S.-British military base because he had heard there was a doctor inside.

As Iraq teeters into the post-Saddam Hussein era, a lack of security, water, and electricity, as well as shattered local governments and police, are tearing apart the nation's already weak medical system.

Sparse hospital staffs are inundated by a growing number of victims of crimes and road accidents due to the absence of police patrols. The doctors who haven't fled have not been paid in two months.

Hospital wards have become disease magnets because there's no water to clean them. Surgeries cannot be performed because there's spotty or no electricity to run medical equipment. Surgeons cannot even wash their hands before and after an operation.

The spiraling medical system has become a lightning rod for anti-American anger at a time when the United States is trying to create a stable post-war administration.

"The Americans take our money, they take our oil," said Dr. Nagham Saeed, 26, as she treated patients at Basra General Hospital. "And they give Iraqis small biscuits and a bottle of water. And then they go on television and act like they're helping us."

Western aid officials say that most of Iraq's hospitals have access to enough medicines and facilities to function properly.

"We don't think it's a crisis of medicine, we thinks it's a crisis of governance," said Andres Kruesi, the southern Iraq head of the International Committee for the Red Cross. "Security has to be restored very soon. And we have to make the existing infrastructure work."

At the British-built Basra General Hospital, Dr. Alessa Hussein and Dr. Salam Hadi were taking turns Wednesday stitching up the bloodied face of a frail, young woman who had been slashed by a knife.

She was sitting in a dentist's chair. The doctors are actually dentists.

"We do this work just to help out," said Hadi, 25, who wore neither a surgical mask nor gown.

Next to them was an orange bucket containing impure water from a river nearby. It was intended for the doctors to clean their hands, but they preferred to wear plastic gloves rather then contaminate their patient. Two fuzzy X-rays were posted on a wall.

Before the war, there were 120 doctors at the hospital. Now there are 70. Many left because they were worried about the lawlessness or because they weren't getting paid, said Dr. Nadeem Rahim, a senior medical officer.

Others quit because they simply couldn't do their jobs properly, he added. Many had to conduct operations with flashlights. Electricity returned to the hospital last week, but there are still minor blackouts, said doctors.

Even before the war, the hospital was in a sad state thanks to neglect by the government and 12 years of United Nations' sanctions. Medical equipment was out-dated. Lab test readings were routinely wrong, said Hussein, 29.

"Now, it's even worse," said Hadi.

Basra General Hospital was one of the rare hospitals that wasn't looted after British troops took control nearly two weeks ago. Today, British soldiers guard the compound.

Still, most non-emergency cases are sent home these days. And there's a shortage of oxygen and general anesthesia for operations. Relatives—not nurses or other medical staff—wheel patients on mobile stretchers around the hospital.

Many patients have died of septicemia because bacteria from a lack of clean water had poisoned the blood, said Rahim. Others have died of renal failure because there's no water for dialysis.

Meanwhile, the number of patients is rising due to lawlessness. Doctors say they are treating more bullet wounds from feuds between neighbors. Injuries from the mad scramble for goods during looting sprees are also on the rise. And victims from car accidents are rising as drivers zoom recklessly through un-policed intersections.

"Everyday we're seeing people come here because of the lack of security," said Saeed, adding that she now works for the "sake of God"

As she walked through her overcrowded ward, men groaned in their beds. Flies swarm around bloodied wounds; there's a shortage of fresh gauze wrapping. Doctors are so swamped that they limit treatment to stopping bleeding—the bare minimum in medical treatment—and move on to the next patient.

There's no time or facilities for surgery.

In the parking lot outside the U.S. coalition military base, Afram Fahmi patiently waits for a soldier to come out and talk to him. But his hope—and his dignity—is at a shattering point. He sees some Westerners. He picks up his crutches and hobbles. He tells them of his plight.

"Maybe you can send me to Kuwait to make this operation," he begs, breaking down in tears. "Please I need your help. I'm an old man. I've no family here."


(c) 2003, Knight Ridder/Tribune Information Services.

PHOTOS (from KRT Photo Service, 202-383-6099): USIRAQ-HOSPITALS