At the CARE office briefing we learned that CARE has been in Iraq since 1991 and in Baghdad since 1995. Their assignments have been to make water treatment plants and hospitals operational. CARE has gathered almost 10 years of data about facilities and equipment and a historical record of the deterioration of the infrastructure and society. It was clear that they know many local engineers and mechanics, where to locate the limited spare parts and how to get them. They have unique knowledge and are able to involve local experts, which is making their work more effective, particularly in the areas of water and sanitation.

This was our busiest day in terms of visiting actual relief sites. Our first stop was to Sheikh Omar Healthcare Training Centre. This hospital had been badly looted with vandals ripping out and carting away sinks, air conditioners and refrigerators, stealing all the supplies from the laboratories, and destroying the elaborate filing system which kept records of every child in the area. A sewer leak resulted in the flooding of the basement and that has compromised the water quality. CARE’s role here was emergency repair so that doctors had clean water to wash their own hands between patients, and windows and doors for basic privacy and security. The one small refrigerator in the hospital was bare and the supply of vaccines and basic medications was completely depleted. All of this raises mounting concerns about a possible onset of epidemics such as cholera and other diseases.

The 800-bed Al Yarmuk Hospital had no electricity. CARE has been trying to procure a major generator from Jordan that they plan to install and service. Without electricity, doctors cannot conduct surgeries and clothes and sheets cannot be washed. CARE was also in the process of installing refrigerators so that the cold chain necessary for maintaining the potency of the medication can be restored.

It has been virtually impossible for medicines to be distributed to local hospitals in Baghdad. For instance, a delivery of 25 trucks of medicine and supplies from Saudi Arabia was intercepted and could not get into Baghdad. Even if it had, the breakdown in the civil administration and the firing of all senior level officials in all the ministries, including the Ministry of Health because of membership in the Baath party, has resulted in the absence of any authority or system to monitor and facilitate the distribution of goods to the hospitals in the health system. There is also fear, as Iraqis who are perceived to be collaborating with the occupying authority are often threatened and attacked.

The next stop, The National Centre of Haematology Clinic, had less visible damage than other healthcare facilities. Many felt that its proximity to one of Saddam Hussein’s palaces protected it from the severe looting prevalent throughout the country. CARE has a long history of working with this clinic and previous efforts have involved linking doctors with universities outside of Iraq for training and education in advanced medical procedures, such as bone-marrow transplants.

This clinic serves 3,000 people with blood disorders,
primarily leukemia. It was very disturbing to hear from doctors that they had observed a spike in the number of cases caused by radioactivity. They attributed this to the usage of big yellow chemical drums that people had stolen from a nearby chemical facility. Needing containers


to store the intermittent supply of water for bathing and cooking, the population had inadvertently placed themselves and their children in harms way. The doctor, Ali Muslim, told us about six new patients whose recent diagnoses were traced to the looted chemical drums.

We were very impressed with Dr. Muslim’s dedication and expertise. He helped create this Haematology Clinic while a lecturer and consultant physician at Al-Yarmuk Teaching Hospital. Dr. Muslim has persuaded top haemotology specialists in Iraq, who were previously retired, to work there twice a week. Before the present crisis, he was trying to advance the work of the center, despite the sanctions prevailing at that time, and as the centre was not subject to routine Ministry of Health restrictions, CARE had decided to assist him in this goal.

CARE is helping this clinic by attempting to target and source the specialized drugs. With the normal channels interrupted, the patients of this facility, all of whom have some form of cancer, are unable to obtain the medicines that they need to survive.

When we arrived at Doura, New/Old Qadissiyeh, the sewage station, it was 120°F. Not unusual here. The sewage system has been backed up and CARE engineers have been working around-the-clock to restore sanitary drinking water.

After observing the humanitarian need throughout Baghdad, there are several apparent needs from the global relief and donor communities. Most of all, the need is for money, telecommunications and rebuilding services. The Iraqi people have many experts in sanitation, engineering, construction, and they need external assistance with supplies and tools and spare parts.

As we’ve reviewed the operations practices, it is clear that little money is available for the humanitarian community to conduct emergency infrastructure repair, as food and water supplies are the top priority. There is little institutional knowledge from prior humanitarian crises around the world available to share with the rebuilding teams, and the lack of data storage using technology means that relief operations continue to be dependent on old–fashioned information sharing to disseminate information across organizations involved in the relief effort. This effort goes far beyond the normal emergency relief of housing and food. It is ongoing and indefinite and, overall, is rather awesome.

This night, like others, we heard bomb blasts every few hours and automatic rifle fire through the night.

Lynn Fritz

Anisya Thomas

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