Stop violations of the right to health care in Iraq

 

Solidarity call with the plight of Iraqi health workers (sign the statement)

Solidarité avec les travailleurs irakiens de la santé (signez la déclaration)

Solidariteit met de Irakese gezondheidswerkers (teken de verklaring)

Solidaridad con los trabajadores y trabajadoras sanitarios

 Further reading

UPDATE 2007:   Four years into the occupation: No health for Iraq (Dr. Bert De Belder, 20 March 2007) - Read also: Dahr Jamail's report: Iraqi Hospitals ailing under occupation

 

To sign this statement, please mail to info@brusselstribunal.org, with the subject heading “health statement”. Please mention your name, function, organisation and country.

 

As large-scale US-led military operations in Iraq continue unabated, the health situation on the ground is at breaking point. The Iraqi health infrastructure, medical doctors and hospital staff are unable to cope with the deepening medical and humanitarian crisis. As they themselves are often targets of harassment and attack, doctors and medical staff find it near impossible to perform their duties as health workers. 

We, health professionals and activists from around the world, cannot remain silent while our colleagues in Iraq are facing the enormous difficulties caused by the ongoing war and occupation of their country. As health workers, we urgently demand that all actions that compromise human health must be stopped at once. 

We therefore:

-          Express our solidarity with the courageous Iraqi health workers who are trying to perform their duty in the most difficult conditions and render medical services to the civilian population in need.

-          Condemn the attacks on medical facilities, and the killing and harassment of health personnel and academics.

-          Call on the US and Iraqi authorities to respect the Geneva Conventions and other relevant instruments of international law regarding the protection of medical personnel and facilities.

-          Ask international and Iraqi health and human rights institutions and agencies to conduct an independent investigation of violations of the right to health care in Iraq.

-          Stress that from a public health point of view, a swift end to occupation, with the withdrawal of all foreign troops, appears to be a major requirement.

Categories and some concrete examples of violations of the right to health care in Iraq 

Initial list of signatories (15 November 2005):

 

Dr. Bert De Belder, coordinator Medical Aid for the Third World, Belgium

Hans von Sponeck, Former UN Assistant Secretary General & Humanitarian Coordinator for Iraq, 1998-2000, Germany

Dr. Dahlia Wasfi, M.D., Global Exchange, USA

Dr. Yasmine Wasfi, M.D., Ph.D., USA

Ellen Catalinotto, midwife, USA

Dr. Geert Van Moorter, Medical Aid for the Third World, Belgium

Dr. Colette Moulaert, Medical Aid for the Third World, Belgium

Prof. Em. François Houtart, World Forum for Alternatives, BRussells Tribunal, Belgium

Prof. Lieven De Cauter, Philosopher, BRussells Tribunal, Belgium

Dirk Adriaensens, BRussells Tribunal and coordinator SOS Iraq, Belgium

Hana Al Bayaty, filmmaker / journalist, BRussells Tribunal- Iraq / Egypt / France

Carlos Varea, Campaña Estatal contra la Ocupación y por la Soberanía de Iraq (CEOSI), Spain

Eman Ahmed Khammas, Former co-director of Occupation Watch - Journalist - translator - Iraq

Corinne Kumar (Secretary General of El Taller International - Tunesia / India)

Abdul Ilah Al-Bayaty, writer,  Iraq/France

Haifa Zangana, novelist, Iraq/UK

Sami Ramadani (Senior lecturer in sociology at London Metropolitan University - Iraq / UK)

Karen Parker, lawyer, Association of Humanitarian Lawyers, USA

Niloufer Bhagwat (Vice President of Indian Lawyers Association - Mumbai / India)

Amy Bartholomew (Law professor - Canada)

Jeffrey Blankfort, BRussells Tribunal, San Francisco, USA

Joachim Guilliard, journalist, anti-war movement, Germany

Sara Flounders, co-coordinator, International Action Center, USA

Gabriele Zamparini, independent filmmaker - Italy/UK

Larry Everest, author Oil, Power & Empire: Iraq and the US Global Agenda, USA

Sigyn Meder (Anti-war movement - Sweden)

Inge Van De Merlen, BRussells Tribunal, Belgium

Prof. Pierre Klein, Professor International Law, U.L. Bruxelles, Belgium

 

* Click here for more complete list

 

To sign this statement, please mail to info@brusselstribunal.org, with the subject heading “health statement”. Please mention your name, function, organisation and country.

 

Categories and some concrete examples of violations of the right to health care in Iraq 

A. Attacks on and military occupation of hospitals and other medical facilities

 

-         The occupation of Fallujah Hospital, on 7 November 2004, is the most prominent example. Not only were the hospital staff and all patients arrested, but the internal central clinic of the hospital was bombed, killing patients and two doctors.[1] 

-          In the course of 2005, hospitals in the cities of Haditha, Al-Qaim, Talafar and Ramadi were occupied and sometimes used as bases for US and Iraqi armed forces, without providing alternative health care facilities to the people of those cities.  

-          In the August 2005 military offensive against Al-Qaim, the electricity supply to Al-Qaim General Hospital was cut off. Doctors were unable to move inside the area because of the ongoing military operation. The manager of the hospital was forced to temporarily close the facility because of the unsafe conditions in the area.[2] 

-          On 4 October 2005, US and Iraqi military forces launched an attack on Haditha, devastating its medical facilities. The main hospital had been severely damaged already by a previous military attack in May, with the medical store of the hospital completely burnt. US/Iraqi forces took over the hospital for seven days.[3] 

-          Early November 2005, during a joint US/Iraqi military operation in Al-Qaim no ambulances were allowed inside the city. The only hospital in the city is desperately lacking medicines.[4] 

These constitute violations of Article 18 of the Fourth Geneva Convention: “Civilian hospitals organized to care to the wounded and sick, infirm and maternity cases, may in no circumstances be the object of attack, but shall at all times be respected and protected”, and of other relevant instruments and principles of human rights and humanitarian law. 

B. The harassment, arrest and maltreatment of health workers

 

-          On 9 November 2004, 20 doctors were killed by a US air strike on a government clinic in the centre of Fallujah.[5] 

-          On 19 July 2005, more than 30 doctors in Baghdad’s Yarmouk Hospital went on strike, demanding that they should be able to treat the patients freely, free from the continuous threat of Iraqi soldiers. The strike was triggered by an incident in which Iraqi soldiers burst into the hospital’s women’s ward. When a young doctor voiced disapproval, soldiers maltreated and threatened him.[6] 

-          On 26 July 2005, members of the Iraqi National Guard destroyed the Intensive Care Unit at Baghdad’s Medical City hospital and threatened medical staff after one of their colleagues died despite the medical attention he had received.[7] 

-          On 10 August 2005, unidentified gunmen ambushed a group of doctors on their way from Karbala to offer assistance at hospitals west of Baghdad, killing 10 of them. Among the victims were Dr Youssef Alewi and two of his assistants from the Karbala health department.[8]  

-          On 5 October 2005, US-led forces arrested two doctors at the main hospital in Haditha. Dr Walid Al-Obeidi, the director of Haditha General Hospital and Dr Jamil Abdul Jabbar, the only surgeon in the Haditha area, were arrested for a week, very badly beaten and threatened.[9]  

-          According to reports from the Word Health Organization, during military operations in Al Anbar province in October 2005, medical doctors were detained and medical facilities occupied by armed forces. According to the UN Assistance Mission in Iraq, “such actions are contrary to international law governing armed conflict and in any event they constitute a denial of the protection of international human rights law”.[10]   

These constitute violations of Article 20 of the Fourth Geneva Convention: “Persons regularly and solely engaged in the operation and administration of civilian hospitals, including the personnel engaged in the search for, removal and transportation of and caring for the wounded and sick civilians, the infirm and maternity cases, shall be respected and protected.”; of Article 55: “Medical personnel of all categories shall be allowed to carry out their duties.”; and of and other relevant instruments and principles of human rights and humanitarian law. 

C. The failure to provide adequate health services and resources, in spite of the increased patient load

 

-          In the Baghdad area, of 11 hospitals surveyed in late 2004, eight to eleven were in critical need of X-ray equipment, ventilators and ambulances, and all of them were only sporadically supplied with medicines and laboratory material.[11] 

-          In mid-October 2005, two days of US air attacks against Ramadi caused heavy casualties among the city’s civilian population. “We have received the bodies of 38 people in our hospital and among them were four children and five women,” Ahmed Al-Kubaissy, a senior doctor at Ramadi hospital said, adding that his hospital had also treated 42 injured people. Dr Al-Kubaissy said he had run out of painkillers, but more casualties kept on arriving.[12] 

-          The UN Assistance Mission in Iraq reports that for the months of September and October 2005, according to figures released by the multinational forces and NGOs, more than 10,000 families have been displaced due to ongoing military operations in Al Anbar and Ninewa provinces. Displaced persons’ access to basic services has been severely hampered.[13]  Thousands of refugee families who fled Al-Qaim arrived in small towns and villages where there were no medical facilities and there was a shortage of health workers.[14] 

-          The October 2005 offensive in Haditha took the Iraqi Red Crescent by surprise at a time when most of its resources were deployed trying to help civilians hurt and displaced by US military operations against Al-Qaim and Talafar. “It is a collapse and we now don’t know where to start or finish”, Red Crescent spokeswoman Ferdous Al-Abadi said.[15] 

These constitute violations of Articles 55 and 56 the Fourth Geneva Convention: “To the fullest extent of the means available to it the Occupying Power has the duty of ensuring the food and medical supplies of the population (… and) of ensuring and maintaining, with the cooperation of national and local authorities, the medical and hospital establishments and services, public health and hygiene in the occupied territory.”; and of and other relevant instruments and principles of human rights and humanitarian law

D. The kidnapping and assassination of health personnel and academics

 

-          Various reports put the estimated figure of assassinated physicians, since the start of the invasion, at anywhere between 30 and 100.[16] 

-          Since the invasion of Iraq, its academe has been hit by a series of killings, including those of a former rector, a dean and several professors of the medical faculties of the University of Baghdad, Al-Mustansiriya University of Baghdad, the University of Basra and the University of Al-Anbar.[17] 

-          Some of the country’s most qualified specialists have been abducted and released in exchange for ransoms ranging between 1,000 and 10,000 dollars. “The kidnapping of doctors has risen, forcing the best practitioners to leave Iraq and settle in neighbouring countries to protect themselves,” declared Health Ministry Public Affairs Officer May Yassin in May 2004.[18] 

-          Iraqi hospitals are having a hard time trying to cope with brain drain — the migration to other countries, because of the troubled situation in Iraq, of trained and talented personnel. “Security is causing so many doctors to leave, as are the kidnappings of doctors,” said Dr Wijdi Jalal, executive manager of the Baghdad Teaching Hospital. Wa’al Jubouri, a pharmacology student at Baghdad University said: “Everyone is asking himself if he’ll go or stay. We just live day by day. We all want to get out because the situation is so bad.”[19] 

Examples of concrete action undertaken against the violation of the right to health care in Iraq 

Further reading:

 

Iraq healers have become targets  (NYT 31 May 2005)

Medics beg for help as Iraqis die needlessly (The Independent, 20 Oct 2006)

Unemployment and violence increase poverty (IRIN, 18 Oct 2006)

The Collapse of Iraq's Health Care Services (Counterpunch, 16 Oct 2006)

Four years into the occupation: No health for Iraq (Dr. Bert De Belder, 20 March 2007)

 


[1] First Periodical Report of the Monitoring Network of Human Rights in Iraq (MHRI), Baghdad, August 2005, http://www.brusselstribunal.org/survey111105.htm#4

[2] Doctors for Iraq, 30 August 2005, http://www.health-now.org/site/article.php?menuId=14&articleId=480

[3] Doctors for Iraq, 10 November 2005, http://www.health-now.org/site/article.php?menuId=14&articleId=506

[4] Doctors for Iraq, 7 November 2005

[5] “Iraq: Medical needs massive in Fallujah - Red Crescent”, IRIN (UN’s humanitarian information unit), 10 November 2004, http://www.irinnews.org/report.asp?ReportID=44075&SelectRegion=Iraq_Crisis&SelectCountry=IRAQ

[6] First Periodical Report of the Monitoring Network of Human Rights in Iraq (MHRI), Baghdad, August 2005, http://www.brusselstribunal.org/survey111105.htm#4

[7] Ibid.

[8] “10 doctors killed in Iraq”, 10 August 2005, http://www.news24.com/News24/World/Iraq/0,,2-10-1460_1751963,00.html

[9] “Iraqi Doctors Beaten and Arrested in Haditha Hospital”, Sabah Ali, 30 October 2005, http://www.brusselstribunal.org/ArticlesIraq2.htm#doctors

[10] UN Assistance Mission in Iraq, Human Rights Report, 1 September-31 October 2005, https://www422.ssldomain.com/uniraq/documents/HR%20Report.Oct.Eng%20final.doc

[11]Iraqi hospitals ailing under occupation”, report by Dahr Jamail, 22 June 2005, http://www.brusselstribunal.org/pdf/HealthcareUnderOccupationDahrJamail.pdf

[12] “Iraq: Women and children killed in US air strikes on Ramadi, doctor says”, IRIN, 18 October 2005, www.irinnews.org/report.asp?ReportID=49611& SelectRegion=Middle_East&SelectCountry=IRAQ 

[13] UN Assistance Mission in Iraq, Human Rights Report, 1 September-31 October 2005, https://www422.ssldomain.com/uniraq/documents/HR%20Report.Oct.Eng%20final.doc

[14] Doctors for Iraq, 9 October 2005, http://www.health-now.org/site/article.php?menuId=14&articleId=489

[15] “Iraq: Thousands flee US military onslaught on Haditha”, IRIN, 6 October 2005, www.irinnews.org/report.asp?ReportID=49396& SelectRegion=Middle_East&SelectCountry=IRAQ

[16] Al-Ahram Weekly, 27 October-2 November 2005, http://weekly.ahram.org.eg/2005/766/re73.htm; and Haifa Zangana in The Guardian, 25 October 2004, http://www.guardian.co.uk/comment/story/0,,1335170,00.html

[17] Lista ampliada de profesores universitarios asesinados en Iraq durante el período de ocupación, Documento de la Campaña Estatal contra la Ocupación y por la Soberanía de Iraq (CEOSI), http://www.nodo50.org/iraq/2004-2005/docs/represion_11-11-05.html

[18] “Iraqi doctors forces into exile”, The Australian, 30 May 2005, http://www.theaustralian.news.com.au/common/story_page/0,5744,9700132%255E1702,00.html

[19] Iraqi hospitals ailing under occupation”, report by Dahr Jamail, 22 June 2005, http://www.brusselstribunal.org/pdf/HealthcareUnderOccupationDahrJamail.pdf


Non à l'atteinte du droit aux soins de santé en Irak

Solidarité avec les travailleurs irakiens de la santé

Alors que les opérations de grandes envergures, menées par l'armée américaine en Irak, se poursuivent sans discontinuer, la situation au niveau de la santé est, dans le pays, totalement catastrophique. Les infrastructures irakiennes, docteurs et personnel hospitalier, ne sont pas de taille à affronter la crise humanitaire et médicale. Les médecins et autres travailleurs de la santé sont d'ailleurs souvent la cible de menaces et d'attaques. Dans ces conditions, il est pour eux quasiment impossible de remplir les devoirs liés à leur fonction.

Nous, travailleurs de la santé et activistes du monde entier, ne pouvons nous taire alors que nos collègues en Irak font face à de telles difficultés, dues à un état de guerre prolongé et à l'occupation de leur pays. En tant que travailleurs de la santé, nous exigeons que toutes les actions qui pourraient compromettre le droit à la santé soient immédiatement arrêtées.

Liste des premier signataires (15 novembre 2005) :

Dr Bert De Belder, Médecine pour le Tiers-Monde, Belgique.
Hans Van Sponeck, ex secrétaire générale et coordinateur humanitaire général des NU pour l'Irak, Allemagne
Dr Dahlia Wasfi, Global Exchange, Etats-Unis.
Dr Yasmine Wasfi, Etats-Unis
Ellen Catalinotto, sage-femme, Etats-Unis
Dr Geert Van Moorter, Médecine pour le Tiers-Monde, Belgique.
Dr Colette Moulaert, Médecine pour le Tiers-Monde, Belgique.

 

Liste complète des signataires : http://www.brusselstribunal.org/healthworkers_signatories.htm

Pour signer cette déclaration, envoyez un mail à info@brusselstribunal.org avec la mention « santé en Irak », en joignant votre nom, métier ou fonction, organisation ou institut.


Stop de schendingen van het recht op gezondheidszorg in Irak

 

Solidariteit met de Irakese gezondheidswerkers

 

Terwijl de grootschalige, door de VS geleide militaire operaties in Irak onverminderd doorgaan, is de gezondheidssituatie in het land catastrofaal. De Irakese gezondheidsinfrastructuur, dokters en ziekenhuispersoneel kunnen de toenemende medische en humanitaire crisis niet aan. Artsen en andere gezondheidswerkers zijn zelf dikwijls het doelwit van bedreigingen en aanvallen. In die omstandigheden is het voor hen bijna onmogelijk om hun plicht als gezondheidswerker te vervullen.

 

Wij, gezondheidswerkers en activisten van heel de wereld, kunnen niet zwijgen terwijl onze collega’s in Irak voor enorme moeilijkheden staan ten gevolge van de voortdurende oorlog en bezetting van hun land. Als gezondheidswerkers eisen we dat alle acties die de menselijke gezondheid in het gedrang brengen, onmiddellijk worden stopgezet.

 

 

Enkele van de ondertekenaars uit België

-        Dr. Bert De Belder, Geneeskunde voor de Derde Wereld

-        Guido Vanham, MD PhD, Head of the HIV and Retrovirology Unit, Institute of Tropical Medicine, Antwerp,  Professor in Tropical Infectious Diseases, University of Antwerp

-        Prof. Em. François Houtart, World Forum for Alternatives, BRussells Tribunal

-        Fred Louckx, sociologist, Vrije Universiteit Brussel

-        Prof. Lieven De Cauter, Philosopher, BRussells Tribunal

-        Prof. Jean Bricmont (scientist, specialist in theoretical physics, U.C. Louvain-La-Neuve

-        Dr. Geert Van Moorter, Geneeskunde voor de Derde Wereld

-        Dr. Colette Moulaert, Geneeskunde voor de Derde Wereld

-        Dr. Dirk Van Duppen, Geneeskunde voor het Volk

-        Ludo De Brabander, Vrede vzw

-        Frank Vercruyssen, acteur

-        Patrick Deboosere, demographer, VUB

 

Enkele van de ondertekenaars internationaal

-        Hans von Sponeck, ex-assistent algemeen-secretaris en humanitair coördinator van de VN voor Irak, Duitsland

-        Dr. Dahlia Wasfi, Global Exchange, VS

-        Dr. M A Khalil, Ex-Dean of the College of Medicine, Univ. of Baghdad

-        Dahr Jamail, independent journalist, USA

-        Dr Salam T. Ismail, Doctors for Iraq, Iraq

-        Karen Parker, lawyer, Association of Humanitarian Lawyers, USA

-        Jan Myrdal, author, Skinnskatteberg, Sweden

 

Volledige lijst van ondertekenaars: http://www.brusselstribunal.org/healthworkers_signatories.htm

 

Om deze verklaring te ondertekenen, mail naar info@brusselstribunal.org met in het onderwerp ‘gezondheid Irak’. Vermeld je naam, functie/beroep, en organisatie/instituut.


 Iraq healers have become targets
By Sabrina Tavernise - The New York Times
TUESDAY, MAY 31, 2005

BAGHDAD The letter came to this city's main cardiac hospital late last month. It was handwritten and unsigned, but its message was clear: It threatened the hospital's top doctors and warned them to leave their jobs immediately.

 

Four of the hospital's top surgeons stopped going to work. So did six senior cardiologists. Some left the country.

 

And it was far from an isolated incident. The director of another hospital, Dr. Abdula Sahab Eunice, was gunned down May 17 on his way to work, officials at the hospital said.  

 

In the past year, about 10 percent of Baghdad's 32,000 registered doctors - Sunnis, Shiites and Christians - have left or been driven from work, according to the Iraqi Medical Association, which licenses practitioners. The exodus has accelerated in recent months, said Akif Khalil al-Alousi, a pathologist at Kindi Teaching Hospital and a senior member of the association. The vast majority of those fleeing, he said, are the most senior doctors.

 

"It represents a very good chunk of the doctors," Alousi said. "They are the people who make the doctors, heads of departments."

 

But insurgents' threats are not the only pressure facing doctors in this health care system, once one of the best in the Middle East. Iraq's lawlessness has reached inside the wards, sometimes turning doctor-patient friction into armed conflicts.

 

Doctors are easy targets for gangs that specialize in kidnapping because doctors move around the city to visit patients and often cannot afford large numbers of guards. Health care providers must also deal with the power failures that plague hospital operating and emergency rooms that are coping with a seemingly constant stream of patients furnished by the insurgency.

 

"It's the worst health care system Iraq has ever known," said Dr. Waleed George, chief surgeon at al-Sadoon Hospital in Baghdad. "Imagine yourself trying to operate on a patient in a two-hour surgery and the power goes out. You pray to God, and you sweat."

 

In the early years of Saddam Hussein, the health care system in Iraq was a showcase, with most Iraqis receiving excellent, inexpensive care.

 

But Saddam let the economic penalties of the 1990s bite deeply into medical care and used the damage to the increasingly worn system to try to persuade the world to ease economic pressure on Iraq.

 

In the chaotic Iraq of today, doctors say that after difficult or unsuccessful operations, they sometimes find themselves confronted by armed, angry relatives. Recently, a surgeon in Mahmudiyah, a restive area south of Baghdad, closed her clinic after threats from a man who said his wife's abdominal tumor had grown back.  

 

One 32-year-old doctor at a medium-sized Baghdad hospital said doctors now routinely exaggerated the risk of complications, hoping that patients would decide against surgery.

 

"We try to avoid complicated operations," said the doctor, who said he was afraid enough for his own safety to insist on being identified only by his first name, Omar. "What if the patient dies? You're face to face with relatives with guns."

 

The Ministry of Interior has responded to the situation by simplifying gun licensing procedures for doctors, allowing them to get licensed weapons faster than other Iraqis.

 

Omar al-Kubaisy, one of the doctors who stopped going to work at the cardiac hospital, Ibn al-Betar, after he was threatened, kept working at his own clinic - watched over by his 23-year-old son, Ali, who stood guard with a large and always visible semi-automatic gun. But two weeks ago, Kubaisy, one of Iraq's top cardiologists, left for France.

 

The simple quest for money, which fuels the country's widespread kidnapping industry, appears to be the biggest motivation for making targets of doctors. Alousi estimated that 250 Iraqi doctors have been kidnapped in the past two years.

 

The exodus of senior doctors has resulted in unpredictable medical service, doctors and hospital officials said. Patients are not sure whether they will find their doctors.

 

Junior doctors fresh out of medical school are performing complicated surgeries that ordinarily would be performed by more experienced doctors. 

 

The more prosaic problems are no less serious. A decade of economic embargo left equipment in poor shape.

 

The state no longer pays for medicine: Iraqis in several clinics visited this month complained of not having access to basic heart and diabetes medications. 

 

George, the surgeon at Al-Sadoon, said shortages of power and medicine had forced the hospital to reduce the number of operations by about half. It briefly solved its power problem by hooking up to the electricity system of the Ministry of Agriculture nearby, but even that has chronic failures now, he said.

 

The workload increases for the doctors who remain. Dr. Hashem Zainy, a psychiatrist and the director of a psychiatric hospital, Ibn Rushud, said the doctors who have stayed must see almost double the daily caseload.

 

"It's ridiculous," he said. "They listen to the patient for a few minutes and write out a prescription and that's it."  

 

Perhaps Alousi, of the Iraqi Medical Association, put it best. "If you get a doctor and you need to be examined and there's an AK-47 under the table, things are very bad."