Collaborating to confront Covid 19
Today, the halls of Al-Shaab international stadium no longer receive athletes. Rather, it has turned into a quarantine area for people infected with Coronavirus after government hospitals were overwhelmed. Assistant director general of Rusafa health department in East Baghdad, Hassanein Al-Mousawi said that 11 sports halls in Al-Shaab Stadium were used for quarantine in coordination with the Ministry of Youth and Sports. The health authorities also decided to use the complex of the “Baghdad International Fair”, which is located in the capital’s city centre, as a quarantine centre.
The sports infrastructures also received support from other ministries. Deputy Director General of the Oil Products Distribution Company, Hussein Talib, said that the Ministry of Oil undertook several initiatives: “In order to support the efforts to fight the epidemic, our Ministry provided the halls of al-Shaab Stadium with the equipment required by medical teams”, he explained. Talib added that the ministry allocated about two million dollars to each governorate in the south Iraq (Basrah, Maysan, Thi Qar governorates) and 200 thousand dollars for each governorate in the rest of the country (not including the Kurdish provinces of Duhok, Erbil and Sulaymaniyah). Baghdad also allocated one million dollars to support its health institutions, which allowed it to better equip the quarantine rooms in order to support the medical staff in curbing the deadly epidemic.
Despite all these investments, the epidemic at its peak had completely exhausted Iraq’s health infrastructures, which received hundreds of thousands of patients in a few months. Health institutions were already in a deplorable situation as a result of the lack of maintenance and neglect causing shortages in medical equipment in the past years in addition to unmatched levels of corruption.
As fears of a new large-scale outbreak of the “Covid-19” due to mutations of the virus increased in Iraq, the government has been forced to increase its efforts to confront it. The measures included a full day curfew later downgraded to partial, but also suspending flights and studies in universities and schools.
Dr. Reda Al-Zuhairi, who works in one of the quarantine centers in Baghdad, said that the Ministry of Health prepared and equipped these centres in anticipation of a possible second wave. The halls of the five square kilometres exhibition complex were invested to reduce the pressure on public hospitals and will be again if needed. The initiative will also allow other services to function efficiently in providing services to other patients while providing an orderly reception of suspected cases as well. Mr Al-Zuhairi also explained that the exhibition center has been equipped with a specialized laboratory for coronavirus tests, while providing housing for the health team on site.
The Ministry of Higher Education and Scientific Research also collaborated by handing over some students’ dormitories at the request of the Crisis Response Committee. The committee was established to face the coronavirus outbreak. It is run by the Prime minister and includes all relevant ministries and authorities to address the issue amid the emergency. Dr. Anmar Al Ghafil, a scholar at Dhi Qar University explained that converting the universities dormitories into quarantine centres provided hundreds of hospital beds. However, he added, this had negative repercussions on students who came from different governorates as they lost their beds on the university’s campus. Nonetheless, during the 2020-2021 academic year, courses are mostly given online, which solved the lodging issue. The dorms have since been vacated by patients but remain available in case of a second wave of epidemic.
Hospitals’ capacity expand
In defense of the Iraqi health institutions, the director of […] hospital in Baghdad and former spokesperson of the Ministry of Health, Dr. Ahmed Al-Rudainy , told The Red Line that “[d]espite the financial crisis, the health institutions succeeded in absorbing the increasing numbers of people infected by the COVID-19 and have been able to provide oxygen, medical supplies and others. Dr. Al-Rudainy also added that the country’s health institutions benefited from the epidemic in gaining experience in how to deal with crises and epidemics and develop Iraqi medical expertise and absorptive capacity.”
Dr. Al-Rudaini assessed that “[currently], the total number of cases in hospitals does not exceed 8% of the total bed capacity in hospitals. However, as case numbers increased during the winter season, the bed capacity was used up to 98% of its numbers. In order to increase this capacity, a special cooperation with the religious shrines in Karbala took place. The religious institutions provided buildings which were transformed into quarantine centres.”
Exhausted medical staff
Nonetheless, anger kept growing within the medical community in Iraq. Doctors and staff working in the health sector went out and demonstrated in the past few months after an exhausting year managing the epidemic. Dr. Mohammed Amer, a Baghdadi doctor, explained that the reasons for the strike are cumulative, but what precipitated it was the delay in appointing the 2019 graduates in hospital jobs. Some 2,500 doctors were initially supposed to supply the health institutions but failed to be appointed by the Ministry of Health. This increased the burden on the current medical staff facing the epidemic.
Doctor Rana Al-Amiri explained that Iraqi law does not allow for more than eight hours of continuous work, “but the medical staff worked beyond their capacity, sometimes up to 12 continuous hours several days in a row. But these exhausting shifts were not registered by the Ministry of Health as working hours in their wages.”, the doctor added.
Assaulting the doctors
Distress and anger caused by the inefficiency of the medical institutions eventually led to cases of violence against medical staff. In the absence of any law enforcement forces in hospitals, these attacks continued throughout the pandemic and had a huge impact on the medical staff’s morale. Dr. Alaa Al-Mousawi shared some insight on the matter with The Red Line: “the hospitals lack of medicines and supplies filled the families of patients with anger which was eventually directed toward the most exposed target: the medical staff. Some relatives of the victims held the doctors responsible for the situation even though it is well beyond their control.”, the doctor explained.
Doctors in Iraq are forced to work in unsuitable environments while being on the first line to face the deteriorating health situation. Doctor Wafa Abbas shared her analysis on the matter, “Doctors suffer from the lack of a suitable environment for work. With the emergency and the lack of medicines, they are often forced to send the patient’s family to buy essential medicines from outside pharmacies”. This quixotic situation explains why the medical staff is verbally and physically assaulted. “They are the guinea pig, made responsible for all the shortages.”, the doctor explained
Several doctors received death threats in Iraq due to the catastrophic impact of covid-19 on communities. When doctors fight back and file complaints against their assaulters, they often end up being threatened by their tribes, pushing for the complaints to be dropped. During their demonstrations, doctors demanded that the government take all necessary measures to ensure the safety of the medical staff as well as enforcing the rule of law and a fair judicial system in case they would be assaulted.
The high pressure and threats that the medical community in Iraq has been subject to is symptomatic of the many dysfunctionalities Iraq is facing. As explained, the collaboration between the different state departments managed to alleviate part of the burden on hospitals amid the peak of the epidemics’ wave in 2020, but it was far from sufficient.
To cope with this shortfall, Iraqis often took matters in their own hands. Dozens of initiatives have been carried out to provide human aid. These volunteers provided oxygen bottles to the poor patients. Ahmed, a young volunteer, shared his story, stating that many families cannot buy these life-saving materials. “It’s not available in sufficient numbers in the hospitals, so we need to provide it especially to patients who were put to home quarantine.”
Mortada Al-Khalidi who works in a volunteer team called Hope of Life that consists of 22 people collects donations from the well-off to buy food baskets and present them to poor families during the hard Corona period.
Without a complete restructuring of the medical institutions and ministries, the tragedies which occurred during the pandemic are doomed to repeat themselves. The creation of a crisis committee overlapping different sectors and actors of the government was a positive and necessary move, but far from enough to cope with the extent of the catastrophe. As many countries are facing second or even third waves of infections with Covid variants, will Iraq’s government remain passive and rely on the hope that the population will remain spared from a new surge?