By Yasmin Alasady

Having endured three brutal wars in less than thirty years, exacerbated by more than twelve years of UN sanctions, Iraq has witnessed both its physical and civil infrastructure crumble, leaving behind a humanitarian crisis of an unimaginable scale.

The health system

The Iraqi health system did not escape the wrath of the conflict. In addition to the structural damage that health buildings, telecommunications systems and the road networks suffered, the mass looting that ensued as a result of the unstable security situation stripped the few functional health centres of essential resources, leaving entire cities unable to meet even the simplest of health needs.

The difficult circumstances translate deeper within; with a combination of the early ‘de-ba’athification’ of the system, the targeted kidnapping and murder of professionals, and the continued exodus of academics and professionals, the system has been left lacking in the expertise it so desperately needs to re-build itself.

Nonetheless, the tragic history Iraq has had to endure has planted a seed of hope in both hearts and minds, and now, seven years since the invasion, evidence of progress is beginning to materialise. Early building projects are coming to life and resources are slowly making their way to the frontline- but we mustn’t get ahead of ourselves. The needs of the nation are great, and only through effective long-term health strategy can these glimpses of hope be turned into a lasting reality.

Putting things into context

The almost continuous barrage suffered by the country’s infrastructure over the past three decades has left a heart-rending legacy. Whereas they previously provided safe drinking water to over 90% of the population, water and sanitation plants now lie abandoned and the surviving ones are unable to operate due to a long-term lack of maintenance. The pattern of neglect continues with mountains of rubbish lining the streets, and dysfunctional sewage systems that leave a toxic trail in the country’s waterways.

Add to this the poor dietary intake that results from the continued financial insecurity, it is no wonder that the spread of infectious diseases is rampant. Cases of Cholera and Tuberculosis, once unheard of, are becoming increasingly common. Perhaps more worrying, however, is the number of lives being lost to what would otherwise be a simple case of diarrhoea.

In light of these living conditions, the Iraqi health system is in considerable need for the development of an effective public health program capable of facing the worsening incidence of communicable diseases.

Mental health

Despite the steadily improving state of affairs, according to the Global Peace Index of 2009, Iraq remains the most violent and dangerous place on the planet. Violence is a very real threat and security remains at the forefront of concerns.

With most families having experienced the tragic loss of loved ones, homes and livelihoods, superimposed upon a 30-year history of poverty and oppression, the population as a whole is extremely vulnerable to a vast spectrum of mental disorders and psychosocial distress. What’s more – due to the considerable stigma associated with psychological illness, those most in need are considered shameful and are often found neglected and abandoned by their families, who favour traditional interventions. Alongside the development of a much-needed psychiatric health programme, therefore, considerable effort needs to be directed at the primary and public health sectors to address the troublesome health perceptions of this community.

The future of Iraqi health

So, what are the greatest medical situations facing Iraqi citizens? Quite simply, the medical situation itself.

The rehabilitation of the healthcare system requires a coordinated long-term strategy based on reliable up-to-date health information. A nationwide data collection campaign is essential to facilitate an objective needs assessment from which successful policy can be formulated.

Physical infrastructure needs to be restored but cannot stand without a strong civil presence parallel to it. The passage of information needs to be a two way process, mobilising local expertise and addressing the range of lingering health perceptions, in order to begin to establish a greater communal responsibility for the health of the population.

Where do we go from here?

As we enter 2010, we are reminded of all the achievements we have seen over the years, the advancements that have been made, and the progression of mankind. Take time to look a little deeper, however, and you will notice the injustice that continues to reign around the world, the hardship our fellow humans have to endure, all the wrongs that need to be made right.

To the Muslim community, Iraq has been the centre of centuries’ worth of Islamic history and heritage; the wealth of this great nation stretching much deeper than its oil fields.To Britain, Iraq has been both friend and foe throughout its long and complex history. Power shifts and failed coups, the British presence in Iraq has never been taken lightly.

As the Iraq inquiry continues, as mistakes are exposed and lessons are hopefully being learnt, it is quite clear that the question of whether you fall in the pro- or anti-war camp is long since irrelevant. It happened, and now we must deal with the consequences. For those in favour, the responsibility to finish what was started remains; for those against, the need for human rights advocacy, in light of continued suffering, is crucial.

With an ever-increasing global population, there has never been a greater period for us to come together as fellows, to put aside differences and disagreements, in order to nurture our global community. We are by no means perfect, but we can, and should, aspire to be. As the great saying goes, ‘Be the change you want to see in the world’.

Yasmin Alasady is currently in her fourth year of study towards a degree in medicine at Bart’s & The London SMD. Beginning with a BA in Experimental Psychology, she has set about investigating the psychosocial implications of conflict and catastrophe, guided primarily by her Iraqi roots. Yasmin is the founder and Editor-in-chief of the Student Iraqi Medical Assocition [SIMA] e-journal: Prospect.