International Community Works to Rebuild Iraqi Health System
By Kathleen T. Rhem
American Forces Press Service
WASHINGTON, Aug. 11, 2004 -- When the United States and international aid
organizations began to look closely at Iraq's health-care network, they found a
system in ruins after decades of neglect and misuse, the man now responsible
for that health-care system said here today.
Dr. Alaadin Alwan, health minister for Iraq's interim government, explained
that in the 1970s and '80s, Iraq's health care was among the best in the Middle
East, then went into a rapid decline.
"Following more than two decades of major wars, disastrous military adventures
and irrational policies, the health system went into a steady decline driven by
a combination of negligence, poor management, severe lack of resources and more
than 12 years of sanctions," he said, during a symposium at the U.S. National
Academies' Keck Center.
"The result is an almost collapse of the health system, with health indicators
becoming one of the worst in the region, in less than 10 years," said Alwan,
who is a Baghdad native and has held several high-level positions with the
World Health Organization.
"Health care was used as a tool to manipulate the will of the Iraqi people by
the ruling party. Basic medical needs went unmet," Dr. William Winkenwerder,
assistant secretary of defense for health affairs, said at the symposium.
"The physical medical infrastructure was crumbling from years of neglect.
Medical equipment was inoperative, outdated by any modern standard.
Distribution of needed drugs was wracked by corruption and inefficiency."
Of particular concern, Alwan said, were the mortality rate for mothers, infants
and children, which tripled between 1990 and 2000, and the deteriorating
physical infrastructure of primary health centers and hospitals "to the degree
that they are now incapable of delivering basic health services of acceptable
standards."
Today, improving health care for the Iraqi people is a major goal of the United
States and several international organizations. "There is no doubt that
security, transition to democracy, and economic recovery emerge today as
crucial challenges," Alwan said. "But we cannot make any long-lasting progress
in meeting these challenges without addressing health and education, the two
major prerequisites to sustainable development."
Winkenwerder said the need for quality health care is universal. "The
international health community is committed to improving the health-care
situation of those in need, regardless of national interests," he said.
"Improving health care transcends geopolitical borders; it really is a powerful
force for bringing people together to do good things and for common goals."
Winkenwerder, DoD's top health expert and the man tasked to jump-start the
reconstruction process for Iraq's health-care system, explained the process
through which experts have been working to resolve some of Iraq's medical woes.
In June 2003, Winkenwerder sent a team of health experts from across
disciplines and across agencies to Iraq to assist the country's fledgling
health ministry. Jim Haveman, a former director of Michigan's Health
Department, led the team of 30 to 35 experts from across the Defense
Department, U.S. Agency for International Development and the Department of
Health and Human Services.
An immediate priority was to ensure there was no pending public-health disaster
following the fighting there. "They found that the stabilization efforts that
were under way at that time, led by the U.S. and coalition forces and the
international community and the nongovernmental agencies around the world … had
stabilized the situation," Winkenwerder said.
He offered high praise for the dedication of the Iraqi doctors and other
health-care professionals who were working under arduous conditions. "What our
team found when they arrived in Baghdad was a proud and strong Iraq health-care
community absolutely dedicated to improving their situation for their people,"
Winkenwerder said. "It was evident that those serving in the Ministry of Health
as well as Iraqi doctors and hospital staff were steadfast in this commitment,
at many times serving at great personal peril."
After addressing immediate concerns, the international team set out to assess
needs and plan long-term solutions. "Using the intellectual power of this
group, … (they) assisted the Iraq minister of health in setting the strategic
course for Iraq's future," Winkenwerder said. "A strategic plan was developed.
The organization was aligned for improved governance, which was an issue, and
attention to strengthening the areas of preventive medicine, community health
and maternal-child care."
Winkenwerder's staff in Washington worked closely with the U.S. Agency for
International Development and other international organizations to ensure the
team in Baghdad was getting all the support it needed.
Today, significant planning for rebuilding Iraq's medical system has been
accomplished. "For Iraq, this is a new beginning, a rebirth if you will,"
Winkenwerder said. "The people of Iraq are now able to choose their future
without the yoke of a brutal dictatorship but with the knowledge that wise and
responsible decisions need to be made on behalf of all of the people of Iraq."
Biography:
Assistant Secretary of Defense for Health
Affairs Dr. William Winkenwerder
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