Iraqi doctors are spending six weeks at Birmingham’s Heartlands Hospital on afact-finding mission to help return the Middle East nation from the ravages of war to an internationally-renowned centre of medicine. Health Correspondent Alison Dayani talks to the visiting consultants.
Being able to take in the day-to-day running and atmosphere of British NHS wards first hand is a feat in itself for the group of gracious 25 senior doctors from war-torn Iraq.
For under the old regime, these dedicated and hard-working souls would never have had the chance to travel abroad to enhance their abilities or exchange valuable information on their areas of expertise.
After years of war, invasions, occupations and civil unrest in Iraq, it has overshadowed and broken down the nation’s once-renowned health services.
“Before the occupation, the health service suffered from embargoes and blockade sanctions,” says paediatrician Dr Aamir Jalal Al Mosawi, aged 42, from Al-Quadisiyyah, in south Iraq.
“Doctors were not allowed to travel abroad to go to conferences, or learn about new techniques and improve their knowledge. None of us would have been allowed to come to England in the past.
“Some doctors were not even allowed to come to the UK to complete their Royal Physician final examinations. I have now been able to go to America and share my research on children’s treatment to specialists worldwide.”
Dr Yaseen Alzubaidi, a 55-year-old heart specialist nods his head in agreement, adding: “People forget that Iraq had one of the best health services in the world in 1977 but circumstances have had a negative impact on it, as well as other areas in life
“No-one was adhering to the rules, but things are changing and the plan is to expand specialised cardiac centres in every region, but that also needs more buildings and many more qualified nurses.
“Ten years ago, the NHS in England was not as good as it is now but things have got better and this is the way with the Iraqi health service. There are changes taking place and it is only a matter of time.”
Shadowing Birmingham doctors in an “observe only” schedule to view operations and appointments in their specialist field has been an eye opener for the foreign medics with pros and cons.
Baghdad surgeon Dr Hayder Gergees explains how there are no taxes in Iraq and the health service is free, apart from the price of a hospital admission ticket.
All outpatients who want to see a doctor, pay 500 Iraqi dinar, the equivalent of 25 pence, and wait to see the medic of their choice. It means most specialist doctors see around 60 patients a day, compared to the ten seen by British consultants.
“In Iraq, people just come in, get a ticket and sit and wait for me in the waiting room for as long as they want,” Dr Gergees explains. “The problem with that is I don’t always see people for my speciality and sometimes get people who have got a headache and I try saying that I am a surgeon.”
“Our casualty departments are the same, but we don’t have the four hour targets or the corresponding units where patients are moved to when the four hours are approaching,” adds Dr Gergees with a wry smile.
“We also treat our patients from beginning to end. My patients won’t close their eyes in the operating theatre until they have seen my face beside them, but in the UK, there are teams of doctors doing surgery.
“There have been junior doctors in surgery who don’t know anything about the patient or background yet all the patient surveys in England are people saying “they want a doctor who cares”.
“I think there are advantages to both countries’ systems that doctors can learn from.”
There are real differences in culture and conditions and one of the most common illnesses in Iraq is rheumatic heart disease, connected to rheumatic fever and tonsillitis that has not been treated quickly, an illness rarely seen in the UK. People over the age of late 60s are rare in Iraq, compared to those in their 80s and 90s in England – but it is still blast injuries, especially burns, that are one of the main injuries.
I am greeted by an initial heavy pause and tense atmosphere when I ask about working through the war and resulting violence since American and British forces invasion of Iraq in 2003.
Troops are only now starting to pull out of the country but there are still bomb threats from insurgents and al-Qaida in Iraq, which was blamed for the truck bombing that killed at least 75 people, destroying a Shi’ite mosque and dozens of mud-brick houses just two weeks ago.
Dr Gergees, the 42-year-old surgery specialist in Baghdad, is the only one willing to relive experiences the carnage.
“It was difficult for doctors, not just because of the numbers of people who were turning up at hospitals and the blast victims, but because we were also targeted for violence,” says Dr Gergees.
“If you want to stop a community getting stronger, you attack the people that are educated and those that are treating the injured and saving lives. If you eradicate those people, then more people will die. Doctors got death threats and had to be extra careful, along with everything else that was going on.
“My hospital is in the centre of Baghdad and when there was a blast, we would be inundated with so many patients. They would just keep coming.
One day, we had worked the whole day constantly treating blast victims and when the nurse finally said there were no more, my senior consultant’s knees buckled and he collapsed to the floor with exhaustion, and relief.
“We dealt with civilians and even the US military. We treated a female American soldier in her late 20s who suffered severe burns in a bomb attack. We rushed over and treated her as we would any patient as we see no difference between people’s lives.”
The Department Of Health is paying for the doctors’ stay and travel as part of the Iraqi Clinical Training and Development Programme, but it is also down to the efforts of Heartlands Hospital gynaecology consultant Shirin Irani, who instigated the Birmingham visit.
“Hearing what the Iraqi doctors have to say about the current health care systems in Iraq, or lack of it, makes us grateful for the NHS,” added Miss Irani.
“But sharing our ideas, experiences and thoughts both ways has been a positive experience.”
Heart specialist Dr Mohamad el-Jashaarmi, aged 53, adds: “The difference between Iraq and the UK is stability.
“We don’t have that as much as in this country. We have to get stability first and then we can improve things more, hopefully we should get there in the next two to three years.”