The Complexity of Iraqi Health Care

I took part in a DoDLive Bloggers Roundtable with Dr. Adel Hanson, linguist/medical advisor, USF-I Health Affairs, Iraq Training and Advisory Mission (ITAM); Col. Bernard DeKoning, ITAM and medical advisor, and Col. Andrew Kosmowski, CJTF-76 Surgery Cell, today. The discussion explored the work being done by the Iraqis to restore their health care system, especially the emergency response side of the equation.

Col. Kosmowski told us that the Iraqis have three separate medical care systems. The Ministry of Health operates the civilian side. The Ministry of the Interior operates a system for the police and their families. The Ministry of Defense runs the health care system for members of the military and their families.

Each of the systems are at differing levels of capability. The civilian system, run by the MoH, is the most robust and the MoI system for the police the least, at this time.

Col. DeKoning said that when he was first deployed to Iraq, they were able to use Iraqi hospitals, including a very modern one in Talil. As the security situation changed, that became no longer possible.

Dr. Hanson described the situation in Iraq in 2003-2005 for us. Terrorists targeted medical professionals, forcing many to leave the country. Just wearing a lab coat could get you assassinated, according to Hanson. Doctors and other health professionals fled, to Jordan and other nations.

Many of these professionals are now returning. The MoH is paying the highest salaries and the MoI the least, which has created a recruiting issue for the MoI and the MoD.

The Iraqi Air Force currently has six helicopters in operation. While there are no dedicated air ambulances, the Air Force is able to provide some medical evacuation capability, primarily for the police and the military. Col. DeKoning told us that the military medic school in Taji turns out about 60 trained medics every six weeks, filling the various needs of the growing Iraqi military. As with other aspects of the draw down of Coalition forces, the Iraqis are assuming control of this training.

Kosmowski discussed the hope that by the coming elections the Air Force's helicopters could be placed in a state of readiness to actively assist with any medical evacuation needs.

All three participants were enthusiastic about the progress being made by the Iraqis. Iraq was considered to have the best health care in the Middle East at one time. Dr. Hanson expressed his belief that the work being done could lead to Iraq resuming that status and perhaps doing even better.