A simple but ambitious plan: $20 million to jump start the Iraqi Health System
Geneva/Baghdad , 2 May 2003 - The damage done to the Iraqi health system by years of underinvestment, economic sanctions and most acutely by weeks of conflict is clear to see. Now, the World Health Organization is working to assist in the long process of putting the system back on its feet.
The first and most urgently needed step is to "jump start" hospitals and health centres across the country with a small amount of funding to prevent the damage from getting worse and most importantly to safeguard Iraq's committed and hard-working medical staff.
"In the past days and weeks, we have seen the commitment of Iraqi health workers to public health. They have continued to work under some very difficult conditions,” said Dr Gro Harlem Brundtland, Director General of the World Health Organization. "Now we must ensure that their dedication and bravery is not wasted. Iraq's health system must not collapse for want of finance and support."
The idea behind the "jump start" programme is to build on existing Iraqi health facilities and their highly committed staff. In the first place, that means making sure the very basics are in place - that floors are cleaned, patients fed and waste removed; that staff are given a daily allowance until a system is worked out to again pay their salaries; that basic maintenance work can be done, generators can operate and the most essential medicines can be supplied.
WHO estimates that just an additional few thousand of US dollars per month is all that is needed to make sure that each one of the key hospitals in the country can continue to provide basic health services for the people who depend on it.
The cost of not doing this could be much greater: without basic cleaning and maintenance, disease outbreaks are almost certain; without food, patients cannot recover; and without an allowance to enable them to feed themselves and their families, health workers and other hospital staff will have to look for work elsewhere.
For the whole country, WHO estimates that US$20 million per month is all that is needed to keep the health system functioning. Without this small initial investment, much more will be needed to repair the damage that will inevitably result.
Iraq's hospitals and health providers were shamefully targeted by looters hoping to gain from the chaos that followed the collapse of the government. Vital medicines and medical supplies were stolen and health facilities were damaged in many towns and cities across the country. Now, a few thousand dollars a month is all that is needed to make sure each facility can continue to operate.
At the same time, from south to north, there were many tales of heroic defence by health staff. Some took up positions in front of their hospitals, refusing to allow the looters in. Others took medical records and computer discs home to protect health and patient records. Many more continued to work when it was difficult and dangerous to do so, risking their own safety to protect their patients.
Iraq had an advanced health system in 1990. Although it deteriorated over the next 10 years, it was still serving the Iraqi people at the beginning of this year. Now, WHO is working to ensure that people can access the essential health care they need under the current difficult conditions.
Specific planning for emergency support to Iraq's health services has been developed by WHO's staff over the past two weeks. The good news is that this plan can now begin to be implemented because the WHO Representative in Iraq, Dr Ghulam Popal, was able to return to Baghdad on Thursday, 1 May, along with colleagues from several other key United Nations agencies.
"I am so pleased to return back to my team of dedicated national WHO staff, who have worked extremely hard in the worst imaginable circumstances," said Dr Popal. "As soon as it was safe, and often when it wasn't, our Iraqi colleagues came back to work. I am proud to be able to join them once again."