Medical doctors, a disappearing profession in Iraq

Revenge attacks targeting doctors from grieving families, powerful tribes and militia leaders resulted in a massive brain drain.
Sunday 31/03/2019
Doctors and patients at a Baghdad hospital. (AFP)
Tough profession. Doctors and patients at a Baghdad hospital. (AFP)

BAGHDAD - Hoda Janabi, 26, a recent graduate from a prestigious medical school in Baghdad, is thinking about migrating to Europe or the United States because of physical harassment, life threats and poor remuneration facing medical professionals in Iraq.

“Physicians in Iraq are being blamed for everything from the shortages in medicine, the lack of vaccines that the Ministry of Health is supposed to provide, to complications that patients might have and are quite common in the medical field,” Janabi said.

Physicians are frequently harassed by families of patients for as simple a reason as barring them from staying in the hospital after visiting hours, she said.

“During my hospital residency, I have been personally threatened more than once by patients’ relatives,” Janabi said. “Many doctors I know were targeted by tribal revenge in case of the patient’s death, even if the patient was critically ill or arrived almost dead at the hospital.”

Revenge attacks targeting doctors from grieving families, powerful tribes and militia leaders resulted in a massive brain drain across the medical profession in Iraq. This, in addition to poor pay, infrastructure damage and political violence, has left Iraq without physicians needed to care for traumatised populations.

An Iraqi surgeon, who asked to be identified as Dr Saad for safety reasons, said dozens of highly qualified physicians in rare specialities have fled Iraq in the past few years because of kidnapping and assassination threats by militias and armed gangs.

“In one case the family of a cardiac surgeon had to pay more than $100,000 in ransom to have him released. Fearing further attacks and revenge acts, he quietly closed his surgery, packed his things and emigrated with his family to the United States,” Saad said.

“Doctors are suffering the most from chaos and insecurity plaguing Iraq because tribal customs and laws override state laws that are supposed to protect all citizens without exception,” he added.

Approximately 20,000 doctors have emigrated from Iraq in the last 15 years, a study conducted by the International Committee for the Red Cross, the Iraqi Health Ministry and other medical organisations concluded.

It said 70% of Iraqi health personnel said they considered leaving the country out of fear of reprisals, kidnapping or violence.

“Iraq is left facing a vast shortage of doctors,” Health Ministry spokesman Seif al-Badr said. “Poor pay and intimidation, including tribal harassment, are the main reasons pushing doctors to leave. They are subject to daily offences and these include insults, abuses, assassination and threats to their life.”

“Iraqi doctors are known for their skills, which makes them appreciated and welcomed in Arab and foreign countries,” Badr added.

In 2017, there were nine doctors for every 10,000 people in Iraq, three times fewer than in neighbouring Kuwait and two times less that conflict-ridden Libya, the World Health Organisation said.

The massive flight of doctors, combined with poor medical infrastructure ravaged by wars and decades of international sanctions, has led to the deterioration of Iraq’s overall health-care system.

Dr Ali al-Bayati, of the Iraqi High Commission for Human Rights, said authorities should enact laws that protect medical establishments and professionals.

“The doctors and medical staff constitute the safety valve of our country in times of war and peace. Extra effort should be made to protect them in a lawless society where they are repeatedly attacked by terrorism and placed at the mercy of tribal law,” Bayati said.

Law 26, enacted in 2016, and Article 230 of the Iraqi Penal Code stipulate a prison sentence of no less than 1 year for attacking medical staff while they are performing their duty.

Some lawmakers have proposed including crimes against doctors under Iraq's anti-terrorism law, which could bring the death penalty.

“The continuous emigration of medical professionals will have a catastrophic effect on the country’s health system, which will further deteriorate unless the government takes serious steps to safeguard and reward them properly,” Bayati added.

Doctors have taken to the streets to demand a 2013 law allowing health workers to carry weapons in their workplace be activated.

Poor pay is another reason doctors opt to leave Iraq. As a resident doctor who must practice in hospitals in various regions of Iraq before receiving her diploma, Janabi earns $750 per month, a small amount compared to what resident physicians earn abroad.

“The pay does not cover my housing and transportation expenses. It is a very poor remuneration for the time and effort that we spend on the job,” she said.