The U.S. troops which were in Iraq are now gone. More than 30 million Iraqis in Iraq, and many more across the world, celebrated "Iraq Day," or the "Day of Defeating the Occupier," Dec. 31. But with the end to the U.S. presence in Iraq comes a tremendous burden: that of rebuilding a country which has been transformed by almost a decade of war and nearly 24 years of rule by a vicious dictator. In a media climate dominated by politics, both domestic and foreign, health care in Iraq is not often brought up as a top issue of discussion in the mainstream media.
The Iraqi government's ability to spend money on health care has been affected significantly by many years of war and economic sanctions. With war came destruction of infrastructure, including health centers, shortages in medical supplies and basic necessities, such as water and electricity, as well as a surge in the number of internally displaced citizens.
About 23 percent of Iraqis live on under $2.20 a day, which is well below the poverty line. It is not even safe to walk outside in certain areas of Iraq because of the tense political climate, random acts of violence and improvised explosive devices which remain buried in the ground, ready to detonate and kill or maim an unknowing passerby.
However, a positive side to this war is that the United Nations World Health Organization has had a significantly stronger role working with Iraq's Ministry of Health since the war began in 2003. Since the U.S. invasion, studies on hepatitis, measles, maternal and fetal care and well-being, HIV/AIDS, child malnutrition and much more have been carried out, and plans for the improvement of health care throughout the nation have been developed.
In 2009, the Iraq Ministry of Health, with the support of the WHO, developed the Basic Health Services Package for Iraq, outlining some plans to improve access to essential health care services to the underserved population, primarily women and children in the rural setting. The report includes descriptions of the many services they hope to deliver through Primary Health Centers. Pilot programs for such PHCs are being initiated in Baghdad, Kirkuk, Missan and Erbil. Pre-existing PHCs have already begun initiating some of the changes mentioned in the report, including increasing childhood immunizations, educating citizens about family planning and reproductive health, and combating violence against women.
Despite Iraq's recent successes, one has to realize that this is a country which has taken many steps backward before moving forward; it is a country which will be fighting an uphill battle for years, especially with respect to health care. Electrical power supply in Iraq only meets the needs of about 50 percent of the population. In rural areas, water is supplied to less than 48 percent of the population, and to only 70 percent of those in major cities. Poor sanitation has led to outbreaks of cholera. Violence continues to erupt. Refugees and internally displaced people abound.
All of these aspects of life indirectly and directly affect health care. Lengthy periods of political instability in a 'reborn' Iraq will not make changes easier. For the sake of the Iraqi people, who have spent more than 40 years suffering, one can only hope that the health care situation will not get any worse before it begins to get better.
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