Iraqi doctors under siege as they battle surge in COVID-19 cases

Doctors complain that they have been suffering violence and abuse from some families who blame medical personnel for patients' COVID-19 deaths.

al-monitor A medical worker wearing personal protective equipment adjusts her headgear as she prepares to take swabs from subjects being tested for COVID-19 in the 5-Miles area of Basra, Iraq, on June 2, 2020. Photo by Photo by HUSSEIN FALEH/AFP via Getty Images.

Jul 25, 2020

After the coronavirus hit this country of 39 million, doctors began receiving a torrent of abuse from families of COVID-19 patients, escalating the already high scale of violence in Iraq.

The pandemic has further revealed the fragility of Iraq's health system.

Health authorities announced the first coronavirus case in February, in a patient who traveled from Iran to study in Iraq's holy city of Najaf.

It quickly spread across the country.

Inadequate measures from the government, corruption and a lack of medicines added to the struggle of health care workers seeking to deal with the virus.

“Violence against us is not a new challenge, but when COVID-19 virally spread across the country, violence doubled,” said Dr. Saif al-Madhloom, 28, who works at the Al-Dayer primary health care center in Basra province.

Many people, particularly those who are living in conservative and religious areas, believe that the virus is a political game or a hoax and they ignored World Health Organization advice for social distancing, hand washing, the wearing of face masks and the avoidance of gatherings.

“About 90% of patients who visited hospitals and health care centers denied the existence of COVID-19 and assumed that it was a political conspiracy. Therefore, lots of patients refused to be tested for COVID-19, claiming that they had acquired a cold,” Madhloom added. “Our hospitals lack any kind of safety measures; there are shortages of medications and medical appliances.” 

Many videos circulated on social media platforms showing local residents attacking medical workers who were trying to do tests for the coronavirus. Observers in Baghdad and Basra told Al-Monitor that the government did not take any tangible measures to help health care workers in such situations, which meant that medical personnel had to fend for themselves.

“We are subjected to verbal and physical abuse on a daily basis. When we announce the death of a patient, the patient's relatives are going to destroy needed and scarce medical devices, such as the mechanical ventilator," Madhloom told Al-Monitor.

Abdulameer Mohsin Hussein, the head of Iraqi Medical Association told Al-Monitor, “We tried to pressure the government to take security measures to stop the verbal and physical attacks on doctors and medical personnel, however, and the prime minister and the head of the Supreme Judicial Council issued some instructions to prevent such attacks but they were ink in paper, nothing has seen on the ground”

“Many doctors are subjected to tribal threats that compel them to waive their personal rights and close cases and complaints in the courts. The attacks increased dramatically with the spread of corona, and it is happening on a daily basis, especially in the governorates of  Thi Qar, Basra, and Baghdad.” He added.

Several doctors in Basra city who asked not to be named told Al-Monitor that they decided to leave the country after receiving threats, saying seeking a better and safe life abroad is the best choice for them.

“There is a great desire among a large number of doctors to flee home and to stop them from escaping the country, the government did not give them their graduation documents and any document proving that they are doctors,” Said Hussein. “We currently have more than 20 000 documented doctors living outside Iraq, like Britain, America, Sweden, Australia, Denmark, UAE, Qatar, Turkey and many other countries,” Hussein added.

Madhloom said abuse came not only from local residents but from police who were supposed to provide security to medical staff.

“The Iraqi Health Ministry failed to manage the pandemic,” he said. “Although the Health Ministry is following WHO guidelines and protocols, that was only ink in paper and it is a media show. In fact, the picture is quite different. There are few hospitals to contain the growing number of patients and there is a scarcity of diagnostic tools and therapeutic devices.”

He said that when he asked his medical director for essential protective equipment, the response was, “You are an emergency room doctor, so you do not need that equipment.”

Madhloom said, “Since March, I have spent a third of my monthly salary to buy face masks, sterilizers, gloves and other personal protective equipment.”

In part as a result of this lack of equipment, 592 doctors had gotten COVID-19 up to June 19, and more than 30 died, he said. The infections of doctors continue at an alarming rate, he added.

He said it is very difficult to tell or convince patients or their families that the patients have COVID-19 or are suspected of having it. He said that he recently received the body of an old woman whose case record showed she had had a temperature of 40 Celsius (104 Fahrenheit) "and I refused to issue her a death certificate until I reported the case to the health authorities to take a sample. But her family threatened to kill me if I reported it to the health authorities.” He said, “However, the security team of our emergency department protected me until the local police force reached the building to investigate the incident.”

Iraq’s total coronavirus cases from Feb. 24 to July 24 number 104,711, with 71,268 recoveries and 4,212 deaths, according to the Health Ministry.

Working in tribes-majority areas, mostly in the southern part of Iraq, multiplied challenges for doctors, and many have faced verbal and physical abuse. This has come on top of negative depictions of doctors in the media, which makes them a scapegoat for Iraq's health care troubles.

Dr. Haneen Mustafa Mahdi, 27, who is from Baghdad but works in Qurna Public Hospital in the north of Basra province, was the victim of a tribal threat.

She said: “A woman accompanying a patient hit and insulted just because I asked her to give me the patient’s full name to document that the patient refused to be tested, arguing that the test is expensive; in fact that was not true, medical service in Iraq mostly is free in charge." Mahdi said: "She left bruises and scratches on my entire body.”

“After the incident, I departed the hospital to avoid suffering more violence.” She said, “I filed charges against her and police arrested her, but she was then released as the city has no specific prison for women.”

The tribal power in southern provinces, particularly in Basra city, prevents the government from holding many perpetrators accountable, and prevents security forces from enforcing the law.

“The patient's clan asked me to pass on the complaint; otherwise, my family and I will be under the threat of death,” Mahdi said. “In order to save my life, I asked health authorities to transfer my paperwork from Basra to my city, Baghdad, and I am waiting for their response.”

She also said, “In particular, the shortage in medical supplies continues to hamper patients' needs, giving us the challenge of treating patients with very limited care.” 

Legislator Ali al-Ghanimi, a member of the parliamentary crisis cell, told local media outlets that hospitals treating coronavirus patients need an additional protection force to prevent violent acts from patients' families or tribes.

Ghanimi added: "The current situation really requires support for hospitals that treat coronavirus patients, with trained security forces to protect frontline workers and prevent any attacks on health personnel."

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