By Kathy Kelly

In 1996 Dr. Raad Towalha gave up his career as a surgeon to become director of Ibn Sina hospital in Mosul. Looking at his handsome and dignified figure, I quickly jot “could double for Omar Sharif” in my notepad. Like its director, Ibn Sina looks pretty good. Walking into the Cardiac Care Unit, I was surprised to see at least some machinery hooked up and blinking.

Then the litany: there are 14 beds in the unit, but only two monitors and there is no central control station. Who gets the two monitors? “I have no other choice,” says Dr. Hamid Zacharia, the chief resident on the CCU. “I choose the most critical.” In the event of an emergency, they make a change-it sounds like a bizarre game of musical chairs-remove the monitor from the patient formerly deemed most critical and hook it up to serve the newly arrived patient.

An electrocardiogram machine was delivered, but alas, no paper.

They have a kidney dialysis unit, but lack filters.

Since 1996, when our first delegation visited hospitals in Iraq, we’ve heard the wretched litany of NA-Not Available-over and over as frustrated doctors point to the missing items without which they can’t heal their patients.

Dr. Zacharia has never been able to work in a fully equipped unit. His education has been inferior because of what he terms “scientific sanctions;” lacking journals and textbooks, he has learned much of what he knows about cardiac care through oral tradition. Older doctors describe what a “real” cardiac care unit would be like. Now he passes on this knowledge to younger resident doctors.

U.S. State Department officials have repeatedly told us that Iraqi doctors lack needed equipment and medicines because the government of Iraq refuses to order sufficient quantities of needed goods and fails to distribute what goods do arrive. Yet last week we heard a different account from Dr. Ghulam Popal, director of the UN World Health Organization in Iraq. He emphasized that WHO monitors are very satisfied with Iraq’s distribution of needed items. Dr. Popal showed us a recent study indicating that 85% - 87% of goods that arrive in the country reach the “end user” destination. The remaining 13% - 15% of goods are held up in Iraq for purposes of quality control and for storage as buffer stock in the event of a national emergency (both policies recommended by the WHO).

He also showed us the list of items needed for health care that have recently been placed on hold through the UN Sanctions Committee. However, even out of the approved contracts, from Phase 1 of the Oil-for-Food program, which began in 1997, to Phase 10 which ended last year, only 57% of approved items have reached Iraq. Some contracts that were approved in Phase 2 are just entering the country today, after a three-year delay.

“Under these conditions,” says Dr. Popal, “you must expect shortages.”

Yet, Dr. Towalha and Dr. Zacharia believe that their biggest problems are emotional and psychological. Both are frightened and uncertain of the future. “If we lose the patient, we continuously blame ourselves,” says Dr. Zacharia. “Yet, we need ‘weapons’ to fight disease. We are soldiers in the front without weapons.”

They both express feelings of helplessness and frustration. “We rebuild our country. It is very difficult to see it attacked again. But if they plan to attack us again, what can we do?”

Dr. Towalha speaks of his personal future as a doctor. “We lose a generation of doctors. They become out of date. In two years if you are not in contact with the outside, you are out of date.” He points to himself, and says quietly, “One of them is me.”

Dr. Towalha’s hands are covered with thick, scaly scabs - the most severe case of psoriasis that I have ever seen. His condition forced him to stop practicing surgery. He mentions he also has a duodenal ulcer. Looking at his red and raw hands, he tells us that the methyltrexate needed to cure his condition is in short supply and very expensive. He shrugs slightly, “Stress can be a major cause of this disease.”

Back in his office he orders a round of tea. Eventually, conversation leads toward his past. Since 1982, Dr. Towalha’s younger brother, also a doctor, has been missing in Iran. He was last heard from on 20 March 1982.

“I lost two brothers, one in Iran, the other, my twin, during the Gulf War. This brother, my twin, has two daughters and one son.” Dr. Towalha’s eyes well up with tears and he quickly excuses himself. We make our goodbyes and quietly leave the hospital.

Enroute to Mosul, I’d read a report from the Washington Institute for Near East Policy, an American-Israeli think tank, about usage of psychological weapons to wear down the morale of Iraq’s people. In it, Michael Eisenstadt, the report’s author writes, “Such efforts could keep Saddam on the defensive and create an atmosphere of crisis and tension.” I wonder if Mr. Eisenstadt knows that more than one person lives in Iraq, and if he would regard Dr. Towalha’s hands as a battle trophy?
Do this kind doctor’s feelings of guilt, anxiety, frustration, fear, helplessness, humiliation, uncertainty, and a penetrating, overwhelming sense of loss signal victorious gains for U.S. strategists?

Unfortunately, that answer is not available.