Most of them were subjected to violence in hospitals

Doctors of Iraq..Work under threat or emigrate abroad

• The work environment in Iraqi hospitals has become unacceptable.

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• Iraqi female doctors have continued to work despite the challenges.

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• Doctors work in a tense atmosphere.

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• Receiving patients in emergency is a nightmare for doctors.

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A recent opinion poll showed the suffering experienced by the medical staff in Iraq.

In Baghdad, 87% of doctors said they had experienced violence on the job, and some were threatened with firearms, in most cases, at the hands of patients' relatives.

Dr. Maryam Ali had just come out of the neurosurgery room when a man grabbed her and pushed her to the ground with a knife in her back.

Immediately, hospital security guards closed the facility and arrested the man.

Fortunately, the surveillance cameras, covering the pavilion, were working.

“I thought I was going to die,” the doctor said, adding, “I was in complete shock, I hated the day I became a doctor.”

Maryam Ali, 27, was in the second year of her medical training, after graduation at Ghazi Hariri Hospital, Baghdad, when the attack occurred, in January 2021. Her attacker was arrested and imprisoned;

But she, like many Iraqi doctors, has since been considering leaving the country.

A recent survey of Baghdad doctors showed that 87% had experienced violence in the past six months.

The majority said violence had increased since the beginning of the epidemic, and that three-quarters of the attacks were perpetrated by patients and their families.

Authorities say the man who attacked the doctor was a thief, who often steals from the hospital.

This is an example of the insecurity that increases the suffering of Iraqi doctors.

Maryam Ali and her colleagues complained about the destruction of the communication room, on several occasions, but no one repaired it.

In Iraq, it is usual for a patient to receive support from friends and family, sometimes up to 15 people, when he enters the hospital.

When a doctor is unable to treat a dying patient, or is believed to have made a mistake, tensions can spill over into violence.

Difficulty handling

In this, Riyad Lafta, professor of epidemiology at Al-Mustansiriya University in Baghdad, says: “When patients go to the hospital while they are already in a state of stress and anxiety, doctors have difficulty dealing with them.

Then the patients get angry and attack.”

Lax security means that these attacks can involve weapons, as about 20% of civilians in Iraq own firearms.

"People are worried, they are armed, and there are problems in the health care system," said Lafta, explaining, "All these factors contribute to the escalation of violence."

Lafta personally mentions two incidents in which doctors were killed.

In 2005 a group of 10 doctors were killed in Karbala governorate, south of Baghdad.

He says the clans, operating under the Iraqi tribal system, have developed a new method of extortion.

They threaten doctors and their families for committing mistakes, real or fabricated, and demand "tribal punishment."

He asserts that the penalty is up to 145 million Iraqi dinars ($100,000).

Other doctors claim they have seen penalties of up to $200,000.

"Unfortunately in Iraq, most people know that they can get away with it," says Lafta. "When there is no punishment, you can do anything you want."

Cardiac surgeon, Othman Qutaiba, says that such problems have prompted doctors to indulge in “business” and carry out useless medical interventions on patients just to satisfy family members.

“When you are in front of a dead body and 10 people are standing next to you, they will kill you if you say he died,” says Qutaiba, 28, explaining, “So, you give him an electric shock, maybe two, three times, four times, maybe 10 times, and you know It is wrong, but what should you do in such a situation?”

precautionary measures

Qutaiba says his colleagues do it daily;

They also take precautionary measures, calling in security guards when they anticipate the death of a patient.

The violence prompted doctors to leave the country in droves.

A 2017 study found that 77% of junior doctors are considering emigration.

In 2019, an Iraqi health ministry spokesman said 20,000 had already done so, with violence a major cause.

“It is not only the person in question who is subjected to violence, but also his colleagues, family, friends or relatives,” he says, adding, “In the past, we had a problem with (brain drain), some countries were receiving our medical specialists.

Now the phenomenon has changed to (brain push), we push our minds out of Iraq because of the violence.”

Tribal sanctions and threats also push doctors to avoid complex surgeries.

Recent medical graduates avoid high-risk career paths, such as neurosurgery and emergency medicine.

Qutaiba says: “In my specialty - heart surgery - the death rate is high.

Nobody will do such operations, and if they do that and the patient dies, he will have problems.”

fight the problem

Graduates wishing to pursue high-risk majors can now follow the fast-track, through two-year postgraduate studies, as the government seeks to address the shortage.

Having chosen heart surgery as a specialty, Qutaiba began paying higher monthly payments to his clan to support him in the event of an attack or attempted extortion.

Meanwhile, the Iraqi government tried to combat the problem by passing the Doctors Protection Law in 2010, which allowed doctors to carry handguns to work.

This gesture is considered absurd, as he believes that expanding firearm ownership is behind the violence in the first place.

"When the attackers go to the hospital, they have automatic rifles, and there are four or five, and the doctor cannot protect himself with a small firearm, and he cannot be as fast as those gangs," he says.

Lafta adds that only comprehensive security will help "when people respect the law and are afraid of it, then I think this violence will vanish on its own."

A medical student at Al-Mustansiriya University, Zahra Asdan, wants to change the status quo, saying: “I want to help people, and I want to change anything in Iraq.

I want it from my heart.”

On the other hand, Doctor Maryam Ali lost confidence, after the clan of her attacker visited her home at night to pressure her to withdraw her case.

She returned to work, but is considering emigrating.

"I'm very attached to my family, and I don't think it's worth living away from them, and that's the only thing stopping me (from emigrating)," she says.

• The Iraqi government tried to combat the problem by passing the Doctors Protection Law in 2010, which allowed doctors to carry handguns to work.

• 77% of junior doctors in Iraq are considering emigrating, according to a 2017 study.

• 20,000 doctors have emigrated due to violence, according to the Iraqi Ministry of Health.

• Tribal sanctions and threats prompted doctors to avoid complex surgeries.

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