Because of the numerous surgeries he underwent; Dhiaa Abdullah still has a hard time speaking. The young boy travelled to India where he received treatment after a malignant tumor in his head was discovered by Iraqi oncologists. The doctors recommended that Dhia’s surgery be performed abroad, as they lack capacity to ensure the adequate treatment here.
Diaa was permanently disfigured due to his chemotherapy treatment. “For seven years, Dhiaa has been fighting cancer and struggling in pain while [we] face equipment and medicine shortages.” Dhiaa’s father explained. “But the Corona pandemic made matters even worse as it paralyzed the country and hospitals. Dhiaa’s hospital was particularly affected.” he claimed. Due to the shortages in public hospitals, Iraqi patients are still burdened with providing the necessary medications to themselves. Some are also forced to buy medications from private pharmacies or from the black market which are both expensive.
On February 24, 2020, the first case of Coronavirus infection was recorded in Iraq in the city of Najaf, where Iranian religious students were tested positive, which was followed by other infection cases. In Basra, the local government imposed different phases of partial and full curfew that continued between mid-April until the end of October, after the number of cases of the pandemic increased.
Additional preventive measures imposed by Iraq’s Crisis Response Committee, a task force set up to face the Coronavirus crisis, stripped hundreds of thousands daily workers of their jobs. The committee took several measures to try contain the pandemic, including suspending work hours in schools and universities, closing departments, public markets and parks, as well as closing the entrances and exits of cities, with the exception of critical cases. Additionally, the economic crisis related to low oil prices and travel restrictions all led to an unbearable situation in the country.
No treatment at home, unaffordable treatment abroad
The patients’ families’ suffering increased during the pandemic. Already crippling spendings soon became impossible to afford. Every two weeks, Abd al-Hussein Azhar, needs to bring his cancer-affected child to take a chemotherapy dose in Basra’s children hospital. According to Mr. Azhar, doctors are forced to request medication from other countries due to the lack of support from the government and send their patients abroad for surgery: “Iraqi doctors cannot treat some diseases which must then be treated abroad, especially children diseases like spinal cord cancer. But us, this is simply not affordable”, he bitterly admitted.
As another example, Nidal Musa’s child suffers from a malignant tumor in her bladder. Nidal spoke about how she went to every possible door asking for help, to no avail. She mentioned that many of the scanner machines in Basra’s scanning department are dysfunctional. She tried to get scans from other public hospitals but was referred back to the cancer hospital due to administrative issues. Moussa added that the scans cannot be made in private hospitals because they are unaffordable. This delayed her sick child’s scanner operation for a whole month.
Many patients at the Children Cancer Hospital in Basrah started chemotherapy, which is usually too expensive outside public hospitals. Athraa, a cancer patient who came with her mother to Basra for treatment, stayed in the hospital for a whole month. Medicine shortages brought additional complications to her medical condition. “The COVID-19 epidemic caused a great shortage of medicine for children, which affected my psychological condition and the process of my treatment,” explained Athraa, in an interview with the Red Line.
Government Failure
Sixty-year-old Umm Ali from Dhi Qar governorate needs to pay for her sick daughter’s travel and treatment expenses to Basrah on a weekly basis. She claimed that the hospital staff is negligent and not taking good care of her daughter: “My daughter needs appropriate treatment, as all the other children affected by cancer. There also needs to be a hospital built in Dhi Qar province to avoid all these transportation costs.” she stated.
Umm Ali also narrated what she described as a “tragic night”, when medical staff told her that the hospital ran out of the medicine her daughter needed. “It was tragic and disturbing to see my daughter suffering, while the nurses ran here and there in search of a dose of the required medicine.” she recalls. What happened to Umm Ali is not an isolated case; many patients and their relatives shared very similar stories to The Red Line.
The systemic failure of Iraq’s health facilities is mostly the result of a lack of government allocations to the health sector in the government budget, compared to what is allocated to the Ministry of Defense. As of 2021, the iraqi sate allocated 2,6 billions to the health sector which amounts to 161 US dollars per iraqi, while the average in the world is above 1000 US dollars.
The city of Basra suffers from a large shortage of doctors and nursing staff, and what exacerbated the situation was the spread of Corona, which caused a crisis at the medical and therapeutic level. Furthermore, huge numbers of graduates were waiting for the opportunity to be appointed to the cadres of the Ministry of Health, the financial crisis prevented their employment due to the lack of adequate job openings by the Iraqi government.
Affected Children
Basra’s Cancer Hospital for Children has a capacity of 120 beds, of which 60 are designated for cancerous diseases, while another 60 remain available for surgical treatments, intensive care, and consultations, explained Ali Al-Eidani, the hospital’s former director. But the medical staff only covers forty percent of the hospital’s needs. There are insufficient nurses and oncology specialists compared to the numbers of patients.
Mr. Al-Eidani explained the large number of patients is mostly due to the successive wars as well as the pollution related to oil and petrochemical industries in the area of Basra. “Up to sixty percent of children who visit the hospital get cured, while around three percent remain incurable” Assistant director of Basra Specialized Cancer Hospital for Children, Sadiq Hassan, also spoke to the Red Line, stressing that the crisis is not specific to Basra, but to all of Iraq because of the lack of deficient medicines approved by the Ministry of Health.
According to the director of the office of The High Commissioner for Human Rights in Basra, Mahdi Al-Tamimi, five percent of cancer cases in Basrah province affect children, in comparison to average rates between 0.5 and 1% around the world. Through the High Commissioner, Mr. Al-Tamimi sent a message to the legislative and executive authorities, saying: “Pay attention to Basra and the level of cancerous cases in it, restore Iraq’s obligations to the agreement and enforce laws that will accelerate the recovery of these children.” After insisting upon the Minister of Health, the High Commissioner was able to allocate new sums of money to the cancer hospital. However, these funds still havent’ been spent on the relevant programmes until now, Mr. Tamimi declared.
The security and health conditions prevented a large number of children from attending their therapeutic sessions, as explained by civil activist Safaa Al-Dahi: ” October 2019 protests brought a lot of roadblocks, which were soon followed by the spread of Covid 19 around February 2020. This had a negative impact on many patients, including the children by complicating access to their medicine, treatment and medical sessions.”
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According to Mr. Ali Yousef, the Head of Information of the Basra Governorate office, the local government of Basra tried to provide the necessary funds to cover the costs of medicines and medical equipment: “The government did support the Specialized Children’s Cancer Hospital with money and medical equipment, but was partly unsuccessful due to the security and general health situation that had an impact on all State institutions, not just the hospital.”, he regretted.
Tank Graveyard and remains of war
While many factors can explain the high cancer rates in Iraq, some are still noticeable in the sands of Basra’s province. The dry soil of the Western desert covers many army vehicles of the Baath regime which were bombed during the Gulf war by the international coalition forces which used depleted uranium coated missiles. The effects of depleted uranium on the lives of people in Iraq is significant, as cancer rates increased dramatically right after the war.
A local source within the medical community in Iraq which requested anonymity stated that tons of radioactive scrap metal from former Iraqi army equipment in Al-Zubair district are still being collected by scrap metal workers.” The radiation levels are variable, but they are way above normal” claimed the source.
The source also stated that there are many contaminated sites like Jabal Sanam, west of Basra Governorate, near the Saudi and Kuwaiti borders with Iraq. Another site is called Greshan and is located in central Basra. The anonymous source also pointed out that while most contaminated equipment had been removed from inhabitant areas, a lot of contaminated soil was still present in urban areas, and should be transported to designated sites under the supervision of the Ministry of Environment.
The enormous task of cleaning up the polluting remnants of the Gulf war is a major challenge for Iraq. Unless the waste is being treated and taken away from populated areas, it will continue to harm and cause diseases.
Oil is killing people
On top of radioactive waste, oil industries also have a devastating effect on the health of Basrawis. The flares from the giant Nahran Omar oil field can be seen from Basra city. Even Though the plants and oil treatment facilities of the oil field are a source of revenues for the province, they can also kill in silence. The head of Al-Dair district, Adnan Hussein confirmed that several deaths were proven to be related to gas and smoke pollutants from these fields.
Mr. Hussein said that he sent official appeals to the provincial office and the Basra Oil Company, calling on them to find solutions to the problem of these gas emissions and to save people from the diseases caused by these oil extracts. But so far, the government hasn’t taken any concrete measures to protect the population from pollution.
The director of the Department of Environmental Protection and Improvement in the South, Walid Al-Mousawi, confirmed to The Red Line that future generations are at greater risk due to pollutants and their presence in cities: “According to our statistics, more than two thousand cancer cases are registered annually in Basra”, he claimed. Basra is the largest oil exporter in Iraq, at a rate of about two and a half million barrels per day from the southern ports.
The situation of cancer affected children in Basra is highly worrisome. This tragic issue is a result of the government’s failure to provide the most basic health facilities. The accumulated negligence of the government was even further exacerbated by the Corona pandemic that came to reveal how dysfunctional the crisis management really was.