Medical situation in Iraq

[MASON]

The air and other coalition ambulance crews typically offer care and transport for eval but sometimes people do not accept for multiple reasons scared of US , scared of New Iraqi Army or repercussions from insurgents.

My understanding is if we did not cause the injury or it is a regular health issue then we are not obligated to help (life or limb only etc). This unfortunately leaves the insurgent targeted civilians to seek care in as above is noted to be a onerously burdened system. In the end we must find ways to protect the population if possible in and out of hospitals and clinics or better yet to help them protect themselves.

The much bigger bang for support and impact on hearts and minds are in treating the not so badly injured too. That task would likely require a mixed medical team of Iraqi staff and American or other coalition staff. What we are attempting to do is honorable but given our own restraints as to who we will care for and how-- our personal risk is minimized but so is our effect on the greater situation.

[Jedburgh]

USIP: Public Health and Conflict in Iraq: Rebuilding a Nation’s Health

On March 22, 2007, the U.S. Institute of Peace (USIP) and Johns Hopkins Bloomberg School of Public Health (JHSPH) Task Force on Public Health and Conflict held its third symposium, Iraq: Rebuilding a Nation’s Health. The Task Force is committed to raising the profile of conflict analysis and resolution in the field of public health education. The speakers at this event included Dr. Robert Lawrence, professor of Environmental Sciences and professor of Health Policy and Management at JHPSH; Dr. Gilbert Burnham, professor and co-director of the Center for Refugee and Disaster Response at JHSPH; Jeff Helsing, deputy director of the Education Program at USIP; His Excellency Ambassador Feisal Al Istrabadi, Iraq’s deputy permanent representative to the United Nations; His Royal Highness Prince Zeid Ra’ad Zeid Al Hussein, Jordan’s ambassador to the United States; Dr. Sarmad S. Khunda, dean of the University of Baghdad School of Medicine; Commander David Tarantino, director of Medical Stability Operations and International Health Affairs at the Office of the Secretary of Defense; Dr. A. Hadi Khalili, Former head of the Iraqi Board of Neurosurgery; and Dr. Abdullah Salem, a current student at JHSPH who studied medicine in Baghdad. This USIPeace Briefing summarizes the symposium’s discussion on public health and conflict in Iraq.....

[tequila]

Deadly cholera outbreak in northern Iraq - LATIMES, 1 Sep.

A cholera outbreak in northern Iraq, where thousands of people have sought refuge from sectarian violence, is overwhelming hospitals and has killed as many as 10 people, health officials said Friday.

The outbreak in Sulaymaniya and Kirkuk is seen as the latest example of the displacement and deterioration of living conditions caused by the Iraqi conflict.

The water-borne disease has struck more than 80 people in the two cities, which are about 100 miles apart, said Claire Hajaj of the U.N. Children's Fund, or Unicef. She said cholera had been confirmed as the cause of five deaths and was suspected in five others.

Local officials said more than 2,000 people had been affected.

Aid agencies had warned of the possibility of a cholera outbreak as blazing summer heat settled in Iraq, where the infrastructure is shattered by war and neglect. The disease tends to appear in the summer because, as the temperature rises, Iraq's chronic electricity shortages make it difficult to operate pumps at sewage and drinking-water treatment plants, which leaves many people without clean water ...

[Rob Thornton]

Its important to consider that "security" extends beyond the physical sense, and how that translates to how a populace perceives itself. I'd also suggest that we don't always consider the relationship between critical infrastructure and the people required to provide critical services - those professionals who make the medical, legal, political, and economic systems respond to the needs of the populace.

The AIF I think has understood it from the beginning. The reasons we might not have understood as well could be:

-where we perceived our focus to be
-where we preferred our focus to be
-the fact that our critical infrastructure was on the FOBs

I think during the last year or two we have made some great gains in understanding how the infrastructure problems bear on security and instability, but we still have a problem securing the means and ways to fix (and to help the Iraqis fix) these problems given the scope of the problems and the many other related problems brought on by instability.