Hospitals Gutted, Medical Care Takes to Streets

No one in the desperate crowd knew what kind of pills Dr. Salaam Gasam was passing through the coils of razor wire. Everyone wanted some and was willing to fight for a share.

A boy grabbed his throat with both hands and gagged to demonstrate his need. A woman held up an infant with blast burns. A man pointed to his swollen eye and cried: “Please! Please!”

Gasam raised the plastic bottle into the air. It was empty now, the mild, over-the-counter painkillers gone. As frustrated as the crowd, he threw the bottle to the ground and walked away.

With many of Baghdad’s already understocked and crumbling hospitals now gutted by looters, with nurses washing scalpels in dirty water and surgeons operating by the light of lanterns, out-of-work physicians and military medics are teaming up to provide the most basic care. They set up on dirty street corners, the crack of gunfire clattering down alleyways, for a few hours a day to do what they can, often for people who need much more.

The unannounced visits, like this recent one by medics from the Army’s 3rd Infantry Division, 4-64 medical unit along with Gasam and Iraqi medical student Ibraheem Hamoodi, often draw hundreds of people within minutes. Some would-be patients have oozing bullet or shrapnel wounds, wounds both old and new. Some have glaucoma, or diarrhea, or a foot mangled by a mine.

Others appear healthy, but after suffering through years of war, poverty and oppression, they do extraordinary things to secure a few minutes of attention from a caregiver.

They intentionally cut themselves on the razor wire. They seek bandages and ointment for tiny, scabbed-over nicks to a knuckle.

One man in his 20s comes around almost every day in a soccer shirt to get a new elastic wrap on an arm he says aches.

The medics and doctors conduct street-side triage with the help of infantrymen who also provide security, but they cannot possibly treat everyone. It is often difficult to sort out those with medical maladies from those in need of a different sort of attention.

“Oh, tough guy, big man, big stud soccer star wasting our time,” a tired, exasperated mortar operator, Cpl. Richard MacDougal, said to the man in the soccer shirt, who didn’t speak English. “People are dying and we have to treat you. You got your bandage, now get out.”

Iraq, and Baghdad in particular, had a relatively well-functioning health-care system until Saddam Hussein invaded Kuwait in 1990 and the United Nations placed strict sanctions on the country.

The U.N. allowed Iraq to use oil proceeds to buy food and medicine, but since the 1991 Persian Gulf War, the hospitals have fallen into disrepair, and much of the food and medicine went to Hussein’s allies.

Common chemotherapy drugs ran out once, Iraqi physicians say. The X-ray machines worked, but there was little X-ray film.

Kidney dialysis machines operated, but doctors could not get the necessary solutions to use them.

Then came the current war, and the looters. At the 1,000-bed Yarmuk Hospital, looters stole heart monitors, bedpans, stethoscopes, sheets. Baghdad Children’s Hospital, like many others in the city, is all but closed down -- out of medicine and equipment and the money to pay the average doctor’s salary of $20 a month. The Spinal Institute is shuttered.

With humanitarian groups trickling cautiously into the still-dangerous city, military medics are using their own meager battlefield supplies to aid the ailing. They raid the long-awaited care packages from home belonging to willing soldiers, taking aspirin, cough syrup, even extra insulin and asthma inhalers.

Before heading out to their curbside clinic recently, the Army medics, who are living at Hussein’s main palace complex, loaded up at one of the best storehouses in the city: Hussein’s private palace hospital.

“We need everything we can get,” said physician’s assistant Lt. John Frasure, 33. “Everything.”

Greeted by security forces and Gasam and Hamoodi inside the concertina wire surrounding the Rashid Bank, the medics had not even unloaded their few small boxes of supplies before a yelling, crying crowd had gathered on the dusty corner, strewn with trash and shell casings. “Ahhh, ahhh,” a woman groaned, sticking out her tongue and pointing at it. A boy sobbed. A man lifted his leg to show a badly swollen foot.

Soldiers ushered crowd members three or four at a time through the wire -- a woman with a headache, a paraplegic girl in pain, a 3-year-old with a gaping forehead wound, flies getting stuck in the blood.

Suturing the wound might have reduced later scarring, but there was no time for such luxury, and the boy’s father was thrilled with a cleaning and a sterile bandage. “Thank you,” Ahmed Hamza said repeatedly.

MacDougal shouted at a boy of about 10.

“Cutting himself on the wire,” he grumbled.

For every person with a serious problem there were two wanting a bandage for a small scratch or intentional cut, aspirin for a headache, antibiotics for a cough or upset stomach.

“Some of these people were so abused for so long, you give them a Band-Aid and they’re happy,” said Staff Sgt. Charles Weaver, head of the mortar platoon providing security at the site. “And the kids -- I can’t bear seeing hurt kids.”

Aqil Naji appeared to be one of those who needed, more than anything, someone who cared. The 27-year-old rolled up his left pant leg to reveal a quarter-size scab and nothing more. Medic Spc. Morgan Burnham cleaned it quickly and placed a small bandage on the area.

Then Naji rolled up his right pant leg, then lifted his shirt. His body was riddled with small shards of shrapnel and stone.

“Bomb. Boom-boom,” he said. “Thank you.”