Iraq 2007: Hell on Earth where not even the hospitals are safe

Attending Doctor Said Al-Hashimi's mental health clinic near Baghdad's Yarmouk hospital is a life-threatening exercise, not least for the psychiatrist.

Dozens of his colleagues have left the country, no longer willing to put up with the deprivation and the danger. Others have been killed.

The Iraqi Medical Association estimates as many as 12,000 of the 34,000 doctors registered before the US-led invasion in March 2003 have left the country in the past three years. The IMA says assailants have murdered at least another 2,000 Iraqi physicians, and kidnapped roughly 250 others during that period.

"This may be the first time in history people are afraid to be admitted to a hospital because they're afraid of being killed," said Dr Hashimi.

And things are getting worse rather than better.

Yesterday, the International Committee of the Red Cross gave an unrelentingly dark picture of the "disastrous" security situation in Iraq.

In its report, Civilians Without Protection, the charity warns that violence has forced hundreds of thousands of people from their homes. And the humanitarian crisis facing the population is worsening.

It estimates 106,000 families have been displaced inside the country since February 2006, when violence escalated in the wake of the bombing of the sacred Shiite shrine of Samarra.

Daily life in Iraq is driven by fear. Families, particularly in the capital, are often too afraid to leave their homes, go to work or send their children to school because of random violence and kidnappings for ransom.

Power shortages are increasing, while the destructive legacy of previous conflicts and years of international sanctions imposed on Iraq are exacerbating the crisis.

One third of Iraqis live in poverty, with 5 per cent of the population classified as grappling with extreme poverty.

"The conflict in Iraq is inflicting immense suffering on the entire population," the report said.

"Civilians bear the brunt of the relentless violence and the extremely poor security conditions that are disrupting the lives and livelihoods of millions.

"Unemployment and poverty levels are rising and many families continue to rely on government food distribution to cover their immediate needs.

"Much of Iraq's vital infrastructure is in a poor state of repair, owing to lack of maintenance and because security constraints have impeded repair work on electrical power grids, water and sanitation systems, medical facilities and other essential facilities."

Half of Iraq's doctors had fled the country at a time when hospitals were grappling with an influx of casualties from the daily bombings and attacks, it added.

Healthcare is "stretched to the limit" because of the escalating violence, and food shortages have led to an increase in malnutrition.

Most hospitals and primary care centres are relying on back-up generators which often fail because of overuse.

Infrastructure is in a poor state as repairs had been impeded by the security situation while saboteurs were also carrying out attacks on power plants.

Devastating accounts were given in the report from Iraqis.

Saad, a young humanitarian worker in Baghdad, said: "Once I was called to an explosion site. There I saw a four year-old boy sitting beside his mother's body which had been decapitated by the explosion.

"He was talking to her, asking her what had happened. He had been taken out shopping by his mum." Raad, a shopkeeper in the Adhmaia area of the capital described a shooting near a mosque between police and an armed group.

"A young man passing by was hit by stray bullets and lay badly wounded and crying out for help. Because of the gunfire, nobody could get close to him to drag him out. He bled to death right in front of us."

The campus where Dr Hashimi teaches, at Mustansiriya University Medical School in the Yarmouk section of the Iraqi capital, is often nearly empty due to both students' and professors' fear of attacks. Despite the violence, the 54-year-old psychiatrist refuses to stop at simply satisfying his university class loads.

He continues to push ahead with workshops training teachers to identify symptoms of trauma in schoolchildren and adolescents to better help them cope with their young charges and possibly recommend professional help to the families. He has also conducted two small-scale studies regarding post traumatic stress disorder.

"People think nothing can be done here but we're still working and we need help," Dr Hashimi said, referring to funding and technical support.

But on some days, nothing is done.

Frequent power cuts and network failures leave professionals like Dr Hashimi without the use of a computer, e-mail, or phones. And spontaneous road closures and security cordons often prevent him from reaching his school or clinic.

Before Iraqi security forces and masked gunmen usurped control of Baghdad, Dr Hashimi kept normal office hours. Today, anyone seeking his counsel must make an appointment. Still, he keeps a secretary in his office in case any potential new patients, who are unaware of his policy, travel from outside of Baghdad to see him.

One of Dr Hashimi's greatest fears is that the trauma suffered by Iraqi children today, which often goes untreated, will haunt the country later.

"Some of these children are time bombs waiting to explode," Dr Hashimi said. "They may think it's better to martyr themselves for religion or country."

• UNEMPLOYMENT and poverty levels are rising and many families continue to rely on government food distribution to cover needs. An estimated one-third of the population lives in poverty while more than 5 per cent live in extreme poverty. Food shortages have been reported in several areas while malnutrition has increased over the past year.

• THOUSANDS of Iraqi families have been forced out of their homes because of the ongoing military operations.

The outlook is especially bleak in the capital, Baghdad, where the situation is expected to deteriorate even further.

Most displaced people have taken refuge with host families, who struggle to cope with the extra burden.

Humanitarian aid is desperately needed by a wide range of vulnerable civilians.

• SHOOTINGS, bombings, abductions, military operations and other violence plague the lives of ordinary Iraqis, forcing thousands to flee their homes. In some regions, particularly in Baghdad, families are too scared to leave their homes to go to work, shop or send their children to school because of the threat of kidnapping for ransom. Many aid organisations and medical workers feel it is not safe enough to operate there. Sabotage against power stations are exacerbating power shortages. Violence has escalated since the bombing of the sacred Shiite shrine of Samarra in February 2006.

• THE quantity and quality of drinking water are insufficient, despite limited improvements in the south. Water is often contaminated due to the poor repair of water-supply networks and the discharge of sewage into the rivers, the main source of drinking water. Poor infrastructure means there is no reliable supply of clean drinking water. The ICRC has been trucking water daily to displaced people.

• MEDICAL professionals are fleeing the country following the murder or abduction of colleagues. More than half the doctors have left, according to the Iraqi ministry of health. A mass daily influx of casualties has put the health system under huge strain.

Many hospitals are also having to rely on back-up power generators, which frequently break down due to overuse.

Medical staff are often threatened or targeted, while the injured sometimes feel it is too dangerous to risk going to hospital.

• MUCH of Iraq's vital infra-structure is in a poor state due to a lack of maintenance and security constraints which have impeded repair work.

Electrical power grids, water and sanitation systems are all in poor shape. Power shortages are growing worse across the country. Fuel shortages are affecting power stations. The poor state of repair is also due to previous conflicts and years of international sanctions.