photo: Eddy van Wessel


Friday, August 10, 2012

Don't get ill in Iraq, revisited

The hospital wanted 5000 dollars. As a guaranty, just in case. Even though the staff of the private clinic in Erbil was not sure yet if their surgeon would be able to help the patient who had just cut off two of his fingers, the guaranty had to be paid.

I was witness of the frantic phone calls to get the money arranged. A young worker had been wounded during his work. Of course you want him to have the best treatment, but this is Iraq - where you should not get ill. ,,Will they be able to sew the fingers back on?'' I asked full of doubt. A couple of phone calls did nothing to take my doubt away: this operation that gets done in the West almost on a regular base, rarely is conducted in Iraqi Kurdistan.

Then the surgeon arrived at the hospital, and declared he could do the operation. He predicted a thirty percent chance of success. You do not want someone to spend the rest of his life without two main fingers, so of course, let's give it a try. A long operation started, which was interrupted late at night, around 11 PM, for a phone call. More money was to be delivered, otherwise the surgery would be stopped and the patient stitched up.

Is this about health, or about money? I cannot help but doubt, even though the outcome at the moment of writing is promising. The fingers are back on, the blood is flowing through them. The big question now is if the muscles will heal and if the nerves will grow back.

Healthcare should not be about money. It should be about caring for sick people. Yet in Iraq, it is booming business. Who will teach doctors and patients that not every illness needs a pill, that the body can look after itself in principle, and that all those antibiotics for sure will lead to immunity? That you are still a good doctor if you do not prescribe a bag full of medicine to your patients? That more expensive care does not have to mean better care - as the doctor is often the same, in the mornings at the government hospital, in the afternoon in his own clinic?

This picture (with thanks to Rudaw) shows a Kurdish child with heart disease that is operated on outside the country. Some foreign organisations pay for foreign doctors to come into Kurdistan and conduct operations, like this one: a heart operation for a child. But do local doctors learn from this and can they conduct these operations themselves afterwards?

As at the same time people flee outside the country for their healthcare. Like the mother of a friend of mine. She was all set for her spinal operation, but when she reported to the private hospital in Erbil for the operation, she was sent home again because she did not bring blood for her transfusion. While the doctor had said when the appointment for the operation was made that the hospital would provide that. She has decided she does not trust the doctors and wants to go to Iran for the operation.

My earlier weblog about this subject had an unexpected, indirect result. It made some people in the right places aware that something needs to be done soon. That all those new private hospitals and clinics are only taking people's money but not really adding anything to the level of the care. At a high level it was decided to send Kurdish medical doctors to Australia, to learn and work and return as more experienced and more knowledgeable medical practitioners.

While a contract was signed for that, the Ministry of Higher Education also contacted two universities in Britain, and as one of the advisers to the Minister reported on his Facebook page:

,,I have great news for our young medical doctors. We had a good discussion with Buckingham University (medical school), they will design specific Clinical MD program for HCDP funded doctors, Buckingham will give them FULL GMC registration with perfect hands on training, they will also provide 4 years ( specialty training) for our candidates as well). Buckingham University will also provide one year diploma training for Kurdistani Board students.''

So even though I am told that there might be some problems with the arrangement above (as Buckingham is a private university that does not seem to be able to offer what is mentioned here), at least something is done. The arrangement with some Australian universities holds a promise of some better qualified doctors, although it will take a couple of years until we see the result in the Kurdish hospitals. And in the mean time, how about the education at the medical faculties in Kurdistan? What is done to improve that? Or am I asking too much at the same time..?

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