As war often does, the war in Iraq polarized the emotions of Americans, most of whom never saw the conflict first-hand. Recently I spent three weeks in Iraq as part of an international medical effort. It was hard to leave, and some day I hope to return. My work in Iraq began when Dr. Jeff Colyer, a physician with a longstanding association with the International Medical Board (IMB), asked if I would go to Iraq to perform reconstructive surgeries as part of a humanitarian effort. I had always known about the IMB, and there’s no better example of why someone should go to medical school than to respond to a need like the one we have in Iraq. I went to medical school to acquire the knowledge and skills to help people, and when Jeff called there wasn’t any question as to whether I would go. By the time I returned his call Jeff was already in southern Iraq, and we planned to meet in Baghdad.
There were only two ways to enter Iraq at that time: through Amman, Jordan, or through Kuwait. Because there are no flights into Baghdad, we had to drive. After a briefing at the IMB office in Amman, we entered Iraq from Kuwait, driving through southern Iraq, through Al-Nasiriah, and on to Baghdad. It was a 12-hour drive, and we traveled with a large group of vehicles. The first 10 hours were across desert where we didn’t expect to encounter much of anything. The last two hours, however, were potentially dangerous because of bandits. Fortunately we arrived unscathed.
The destruction wasn’t the first thing we noticed when we arrived in Baghdad — it was the trash everywhere. There was no electricity, the water wasn’t good, there was little fuel for cars, and little security. We had very specific security protocols and we followed all of them. We were told that after 7:00 p.m. we had to be in for the night because of the gunfire in the streets. The gunfire went on all night.
Most of the hospitals in Iraq were looted to varying degrees before we arrived. Reception areas invariably became emergency rooms to treat the large numbers of trauma victims. We worked in Al-Karama, a hospital that served the indigent people of Baghdad, so it was in a bad neighborhood. An open-air gun market was located just across the street from the hospital. During the war, people from the neighborhood protected the hospital, and this group was primarily criminals who had been released by Saddam Hussein’s regime just prior to the war. Supplies of equipment, oxygen, and anesthetic often were limited. There were some types of microsurgical procedures that we couldn’t do because we didn’t have the supplies. It was frustrating to have to put in peritoneal dialysis catheters without Xylocaine to numb the area. Sometimes we had enough equipment to be able to operate and sometimes we didn’t. That was due partly to the looting and partly due to the United Nations sanctions. There is a terrible shortage of nurses, so family members performed a lot of the nursing while we were there.
There were three primary types of injuries: gunshot wounds, from criminals robbing people; burns from gasoline explosions, suffered primarily by people smoking cigarettes while selling gasoline on the black market; and people hurt by such previously unexploded ordinance as land mines planted by the old regime and cluster bombs. We took care of kids who picked up things that exploded in their hands, and of Iraqis who were in cars that drove over land mines planted by their own people.
There were many things we needed that weren’t available because of the UN sanctions. Diabetics could not have their diabetic retinopathy treated by a laser because the lens needed for the laser was classified as being dual use — meaning it could be used for a weapon as well as for medicine. People were going blind for lack of a laser, and that is something that should never be allowed to happen. Children with end-stage kidney disease caused by infections from kidney stones could have been treated by a lithotriptor, but the igniter for the lithotriptor could not be brought into Iraq because of the UN sanctions. Because of the war there were many people who couldn’t see their doctors. This included patients who needed chemotherapy or insulin. The hardest part was seeing the Baathists, because the Baathists had to know how much the people had been suffering.
The connections we were able to make with the Iraqi people and the Iraqi doctors were amazing. The Iraqi people have suffered so much, and these surgeons have sacrificed so much, that it was hard to leave. Iraqi physicians are highly qualified, but most of them have been out of touch with the rest of the medical community for 15 years or longer because they have not been allowed to travel. Few have received any recent medical education, and most textbooks and journals they have date from the mid-1980s. They are desperate to interact with the worldwide medical community, and my primary focus now that I’m back in the United States is to enable physicians in the Iraqi medical community to engage with their counterparts in their respective specialties in the United States.
The first step would be for Iraqi physicians to come to annual meetings related to their various special-ties, and to have organizations or physicians sponsor leading Iraqi physicians and to pay their way. Although sponsorships would likely not be available for all Iraqi physicians, everyone should be invited. What I envision would be for Iraqi physicians to spend a week here in the United States at a meeting, where they can make a lot of contacts and bring their techniques up to date; then perhaps spend another week visiting physicians with the same specialty, observing their practices and the available technology; and then take that knowledge with them back to Iraq.
I worked at the same hospital as Dr. Quraish Al-Kasser, president of the Iraqi Society of Surgeons. We connected him via satellite phone to Dr. Tom Russell, the Executive Director of the American College of Surgeons, who assured Dr. Al-Kasser that he would do all he could to encourage the American surgical community to assist the Iraqi surgical community in reintegrating and reuniting with their colleagues elsewhere in the world. I had chills just watching the phone call. That was the beginning, and the dialogue is continuing.
We’re contacting the American Medical Association about the program in the hope that physicians in various specialties here will contact their counterparts in Iraq and invite them to visit the United States, to help sponsor visits, and to work with the US Department of State to help Iraqis obtain the necessary visas. Everything that we can do to engage these physicians, to introduce them to current techniques and to life in the United States, will help to facilitate the cause of democracy, which is something that Iraqi physicians say they want. There is much to be gained by introducing them to modern techniques as soon as possible.
There are a lot of ideas, and now it is time to raise funds to help make it all possible, to talk to hotel companies regarding donating rooms for Iraqi physicians, and to solicit publishing companies to donate textbooks that can be used to build libraries. Anyone who would like to help can contact the International Medical Corps by calling 310-826-7800 or by visiting them on the Web at www.imcworldwide.org.
I left Iraq having learned a number of lessons. I learned that the regime was much more brutal than we thought. I also learned that the United Nations sanctions had a more profound effect on Iraqis than I had ever considered. Before going to Iraq my feelings about the war were conflicted. I certainly don’t like war, and I didn’t feel that I knew enough about the facts to have an informed opinion. However, two and a half weeks after I had been there someone mentioned weapons of mass destruction, something I had completely forgotten about because I had been immersed in treating patients — seeing on a daily basis how horribly this regime had treated the Iraqi people and how good it was that the old regime was gone. It bothers me sometimes when I see political commentators make grandiose statements that I now know are baseless, because I saw the truth, measured in human suffering.
