Health Care in Iraq Was Better Under Saddam Hussein

By Pratap Chatterjee, CorpWatch. Posted January 19, 2007.

The convoy of flat-bed trucks picked up its cargo at Baghdad International Airport last spring and sped north-west, stacked-high with crates of expensive medical equipment. From bilirubinmeters and hematology analyzers to infant incubators and dental appliances, the equipment had been ordered to help Iraq shore up a disintegrating health care system. But instead of being delivered to 150 brand-new Primary Health Care centers (PHCs) as originally planned, the Eagle Global Logistics vehicles were directed to drop them off at a storage warehouse in Abu Ghraib.

Not only did some of the equipment arrive damaged at the warehouse owned by PWC of Kuwait, one in 14 crates was missing, according to the delivery documents. The shipment was fairly typical: Military auditors would later calculate that roughly 46 percent of some $70 million in medical equipment deliveries made to the Abu Ghraib warehouse last spring had missing or damaged crates or contained boxes that were mislabeled or not labeled at all.

Not that it really mattered. Just over three weeks before the April 27th delivery, the U.S. Army Corps of Engineers had canceled the construction of 130 of the 150 PHCs for which the materiel was intended. As a result, the equipment that could help diagnose and treat Iraqi illness (and escalating bomb or gun injuries) now sits idle waiting for someone to figure out what to do with it.

Even if the equipment finally makes it through the bureaucratic logjam, lack of trained personnel to operate it, especially outside major cities, will severely limit its utility. The Army Corps had written a 15-day training plan into the contract, but over time, this had been whittled it down to ten and then to just three days. Iraqi Ministry of Health officials have given up hope that any training at all will accompany the sophisticated equipment.

But if Iraqis have failed to benefit from the idle PHCs, the $70 million contract to supply them has been a shot in the arm for Parsons Global. The Pasadena, California-based engineering company reaped a $3.3 million profit according to an audit report issued by the Special Inspector General for Iraq Reconstruction (SIGIR), an independent U.S. government agency. And that is in addition to the $186 million that U.S. taxpayers shelled out to Parsons to build dozens of clinics that have yet to dispense a single aspirin.

While the new buildings remain uncompleted and millions of dollars worth of expensive equipment are stored under lock and key, a dwindling number of doctors at existing hospitals perform operations without basic supplies of disinfectant and anaesthesia. A severe shortage of nurses further imperils patient care.

This failed planning and wasted money has been a hallmark of the last three years of healthcare in Iraq. Today the country faces a medical crisis that many say exceeds conditions under sanctions. Compounding this crisis is the violence that creates a steady flow of seriously injured victims.

What we asked for, we did not get

Days before the equipment arrived in Abu Ghraib, Dr Lezgin Ahmed, general director of planning at the Kurdish health ministry offices, just below the ancient hilltop city of Erbil, northern Iraq, proclaimed his frustration with the U.S. plan to fix the Iraqi healthcare system to this reporter.

"They told us that they had money for seven PHCs in Erbil, three in Dohuk. We were asked where they should build them, that's all," said Dr Ahmed. "We didn't approve it but we accepted it without interference because it was part of the plan for all of Iraq. They simply asked us for the numbers and locations. What we asked for, we did not get," he said, noting that the ministry would have preferred repair of existing facilities.

Six of the 150 PHCs were slated for the western Kurdish region of northern Iraq. In the Brayati neighborhood of Erbil, just five miles from Ahmed's office, a partially constructed grey building topped with red water tanks, appeared abandoned. The windows and doors were sealed with cinder blocks to prevent intruders after work halted in late March. No construction workers or security guards were to be found. In other cities across northern Iraq, such as Koya and Sulamanya the story was the same: buildings, most lacking even paint, stood abandoned. In Halabja Taza, close to the eastern border with Iran, a security guard at an empty Parsons PHC agreed to talk. Nawshin Shakir Qasim explained that the contractors did a really bad job and the roof was leaking. "The Americans soldiers fired the contractor. Now there is no more money so all the work has stopped," he said.

Indeed, just two months before my visit, SIGIR inspectors traveled to five PHCs in Kirkuk, northern Iraq, and came to similar conclusions about the quality of the work. The auditors snapped pictures of poorly placed roof beams, honey-combed concrete, walls made of brick fragments held together with plaster, and staircases crumbling into dust even before they were finished.

The SIGIR auditors also questioned Parsons' progress reports. One building, declared 56 percent complete, was a shell of uneven bricks. Another floor that was balanced on wooden sticks was listed as half complete, according to the SIGIR report.

If health care is in short supply, blame is plentiful. The SIGIR report concludes that a wide range of factors contributed to the failures, ranging from disputes among Iraqi construction companies, poor quality of local materials, and lax oversight by the Army Corps, which conducted "windshield surveys" - hasty drive-by inspections.

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Pratap Chatterjee is managing editor of CorpWatch and the author of 'Iraq Inc.' (Seven Stories Press, September 2004).

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