War adds major risks for expectant Iraqi mothers
Safe healthcare hard to find amid poverty, violence
BAGHDAD -- Noor Ibrahim lay shivering underneath two blankets on a bed at Al Jarrah Hospital. Steps away was a red plastic bassinet. It was empty.
A few doors down, her recently born son lay wrapped in a pink blanket. He was a chubby boy of nearly 9 pounds with a big patch of black hair. His eyes were closed, his head cocked to the left, his mouth slightly open. He was in a cardboard box, destined for the morgue.
"Fresh death," Ibrahim's obstetrician said as she reached into the box and lifted the boy's limp right arm.
In war-torn Iraq, giving birth is becoming increasingly risky.
Spontaneous road closures, curfews , and gun battles make even getting to the hospital a challenge for expectant mothers. Once they arrive, the women have no guarantee they will receive adequate health care from a qualified physician.
"It's spiraling downward. It's getting worse each day," said Annees Sadik, an anesthesiologist at Al Jarrah.
Iraq once had a premier health care system. But the trade embargo of the 1990s and now the exodus of medical professionals have made it no better than a Third World system, doctors say. Hospitals lack the equipment, drugs , and medical expertise to make labor easier or to handle complications.
Women are forgoing prenatal visits to doctors as a result. Fearful of going into labor during the nighttime curfew, they are having elective caesarean sections. Others are relying on midwives in their neighborhoods.
Doctors, especially women, have been targeted by unknown groups for kidnapping and murder. The kidnappers often appear to be motivated by money, seizing professionals because they are among the wealthiest people in Iraq. But many Iraqis also say insurgents are waging a campaign to eliminate the people with the skills most needed to rebuild Iraq.
As is often the case in Iraq, where bombs usually kill civilians rather than their intended targets, the death of Ibrahim's son was a matter of bad timing. Her mother-in-law, Amira Saeed, told their story as Ibrahim recovered at Al Jarrah. Ibrahim would later confirm the details.
Ibrahim felt labor pains at 9 p.m. Dec. 23 at her home in Madain, a town 15 miles south of Baghdad that has become a flash point for tension between Sunni and Shi'ite Muslims. Few ambulance crews are willing to pick up patients at night for fear of encountering death squads . Few doctors are willing to work at hospitals at that time for fear of being kidnapped .
Ibrahim decided to bear the pain until morning . At 3 a.m., her water broke. Once the sun rose, she, her husband and her mother-in-law drove to the public hospital in Madain.
When they arrived, there was no obstetrician and no anesthesiologist, Saeed recalled. A surgeon had just been kidnapped and the doctors refused to go to work. That left the nurses to deliver Ibrahim's baby.
For several hours, Ibrahim pushed. But her baby was big and she got tired. The nurses used forceps to try to pull him out. When that didn't work, they told her to go to another hospital, Saeed said.
The family decided to go to Al Jarrah, a private hospital in Baghdad. The ambulance driver refused to take them into the capital, even after they offered to pay him, Saeed said.
Ibrahim, her husband and Saeed got back into their own car and drove for 30 minutes as Ibrahim's baby languished.
One of Al Jarrah's most experienced obstetricians carries a pistol to work.
She has received three death threats. Her ultrasound machine has been stolen. She agreed to speak to a reporter only if her name were not used because, she said, she feared for her life.
"I came here to serve my people," said the Iraqi-born and London-educated doctor, who wears a purple hijab, or head covering, and green scrubs when delivering babies.
According to a December 2006 report by the Washington-based Brookings Institution, 34,000 physicians were registered in Iraq before the 2003 U S -led invasion. Since then, about 12,000 have fled and 2,000 have been killed, it said.
At Al Jarrah, two doctors have been kidnapped and killed. Two were kidnapped and released. Three have left Baghdad. Thirteen remain on staff.
"It's a campaign to drain the country," said Aviad Najeed, a surgeon at Al Jarrah. "A very, very well-organized one. We don't know who's behind it."
Sitting in their windowless lounge, four doctors at Al Jarrah talked about the hope they had after the invasion. They thought the Americans would bring the best technology and medicines.
The Iraqi health care system was once considered one of the best in the Middle East, with the most up-to-date equipment and well-educated doctors. Iraqis could get basic health care free, and each town had at least one hospital. That changed when the U N Security Council imposed an embargo after Iraq invaded Kuwait, leading to the 1991 Persian Gulf War.
Medical instruments and drugs used to be shipped from Germany, France, Japan , and Switzerland. Now, hospitals buy cheaper supplies from Egypt, Jordan , and India, the doctors said.
At Al Jarrah, staff members do not have fetal monitors, the doctors said. The delivery room has a chair with rusted metal footrests and an examining table with a hole in the leather cushion.
Many private hospitals have closed, and the public hospitals are overwhelmed by victims of car bombings and mortar attacks that happen across the city each day, the doctors said.
"I don't know why this is happening," said Najeed, a former military doctor . "Is this a punishment?" 