Takato Nahoko, Iraq Support Volunteer
Photos: Morizumi Takashi

　On January 8, 2010, one family arrived in Japan from Ramadi, the capital of Al-Anbar Governorate in the western part of Iraq. Father is Dr. Ammar Muhammed Abdulla, a pediatrician, and Mother is Dr. Shayma Daham Auad, an obstetrician and gynecologist. The two doctors have been invited by the Japan Federation of Democratic Medical Institutions (Min-Iren) and are observing and learning the medical care at Kawasaki Kyodo Hospital in Kanagawa.
　The two young sons accompanying them are nursed at the hospital’s day-care center and are involved in “cultural exchange” every day. Two-year old Abdullrahman has captured the hearts of student volunteers with his endearing smile. And younger Ahmed already has an air of somebody, with his “bigger-than average 1-year-old” body frame and adaptable character.
　They are perfect goodwill ambassadors when they bow to someone saying, “Arito (Arigato = Thank you)”. It is my utmost joy to see this family finally in Japan.

U.S. Military arrests doctors in hospitals

　I visited Ramadi in April 2009 after 5 years and found Al-Ramadi Maternity and Children’s Hospital with full of problems.
　The hospital had a severe shortage of medical doctors, as many of the veteran doctors had either been killed or exiled to third countries, due to blackmailing. The strong religious identity of this area was disfavored by the central government of Iraq, resulting in medical service and supplies falling into arrears. Birth anomalies have apparently increased, but due to the lack of statistical data, the fact falls short of drawing international attention.
　Nevertheless, the situation had been somehow improved to the extent that patients were actually able to come to the hospital. During the previous several years, how many patients were unable to reach the hospital and were killed, as the U.S. military checkpoint set up near the hospital barred them! And how many pregnant women had do give birth to their babies on the 700 meter-long road while being made to walk to the hospital, after they had been stopped for far too long until labor started!
　In the hospital, doctors were subject to obstruction and humiliating acts by U.S. soldiers. Dr. Ammar was not an exception.
　 “The hospital was used as a base for sniper shooting for as long as a year and half. Once, I was arrested by the U.S. military inside the hospital. A soldier made me stand at the window, placed his machine-gun on my shoulder and shot up. At other times, they shot into our hospital windows from outside. Whenever we brought patients into the hospital, we swung our white gowns around instead of the white flag” he said.
　One day, during the operation, a soldier suddenly broke into the surgery room. When Dr. Ammar protested, the soldier shouted, “This is my hospital. I can go anywhere at my own discretion.”

The only remaining blood-pressure manometer was broken

　Now that the occupation forces are gone from the hospital, the situation got better, but the dysfunction of the hospital remained. Amidst such condition, doctors are struggling to give care to the people. In charge of the delivery room, Dr. Shayma laments the devastated state of the hospital. “On the rooftop and backyard, there are still piles of many medical equipments and machines destroyed and abandoned by the U.S. military, and many documents were burned there. Although there used to be over 300 beds, we have less than half now. Only one blood-pressure manometer survived the destruction, but now, that manometer has been broken” she said.
　Before coming to Japan, I asked what they would expect to find in Japanese hospitals, but it seemed difficult for them to answer that question. They might have known vaguely about the high level of medical care in Japan, but they were unable to imagine anything concretely.
　When I showed them some pictures of Kawasaki Kyodo Hospital, they were amazed at the blue-sky pattern wallpaper on the ceiling of the delivery room. When I said, “Maybe it’s intended to relieve the pain during the labor”, Dr. Ammar cried, “We’ve never had such an idea!”

Surprised at white sheets over hospital beds

　After they safely arrived in Japan, they had a tour of the facilities in the hospital, which I accompanied. Visiting the delivery room, they were excited to look up to the “blue-sky” ceiling. And they looked enviously at a stethoscope and a jaundice checker for children. They have long wanted to acquire them since they saw them on a catalogue.
　In Japan, we take it for granted that white sheets are put on hospital beds. But for them, who became medical doctors in 2006 and started working in the situation when Ramadi was in the worst condition, even such a sheet is luxury. Dr. Shayma explains the utterly poor situation in the hospital as follows: “Most of the medical equipments we have are broken down and not usable. Disposable tubes are used repeatedly for at least a week. As the sterilizer and disinfection apparatus are broken, we have to do with only rinsing them in water.”

Relations between shocking data and pollution from the war

　On the fifth day of their visit, the two doctors reported the situation of Al-Ramadi Maternity and Children’s Hospital before the hospital staffs and student volunteers. Shocking figures and data were reported one after another in their talk, at which audience uttered exclamations of surprise. These figures and numbers are just beyond imagination in Japan.
　In the Al-Ramadi Hospital, 40 to 50 childbirths are recorded per day. This is equivalent to the monthly number at Kawasaki Kyodo Hospital. Twenty of them are delivered by Caesarean section. The four delivery beds are always occupied, and some mothers are obliged to deliver on a regular bed. And every day, 2 or 3 congenitally abnormal babies are born.
　Seventy per cent of the newborn babies are hospitalized in the ward. In addition, 30 to 40 patients are carried in the emergency room from the outpatient section. 55 to 80 patients die in the emergency room every month. 160 to 240 newborns, including those in the hospital ward, the emergency room and the newborn room, die within 7 days of their births. They were just extraordinary numbers indeed.
　A variety of reasons can be found in this situation, including the broken down medical facilities, infectious diseases and others. But I may not be the only one that would want to suspect the effect of depleted uranium shells and other mysterious weapons used by the U.S. military.
　According to the report from the survey conducted by the Iraqi Environmental Ministry on the pollution cased by depleted uranium and other toxins, Ramadi was cited as one of the 42 “high risk areas” (The Guardian, January 22, 2010). In order to let know what is happening in Ramadi, more detailed data should be collected.

In the absence of medical facilities, diagnosis depends on examination of patients’ situations

　Dr. Sasaki Hideki (pediatrics), who is in charge of training Dr. Ammar, praises him for his high comprehensive faculty. While working with Dr. Ammar, he himself has noticed something new. “I draw attention to his stance of diagnosing patients only through their symptoms and clinical findings, not depending on medical tests”, he said. Although not all of these diagnoses are appropriate, such a stance towards patients has often been neglected by young Japanese doctors who tend to depend too much on tests.
　When the two doctors were led by Dr. Sasaki to visit the NICU (neonatal intensive care unit) of the Kanagawa Children’s Medical Center, they were really impressed. They shared their excitement with me on the phone at witnessing the state-of-the-art medical care in the center. They now have a desire to observe cardiac operations on neonatal infants.

Things they can introduce immediately in Iraq

　Dr. Shayma especially liked the ultrasonography. The machine was quite different from an outdated one in Iraq. Though she has learned how to use it, unfortunately it would be impossible to obtain such equipment in Iraq now. Other new medicines, technology, including blood analysis, and surgical procedures have also been stimulating for them, but they cannot be introduced right away back home.
　Among other things they paid attention to include thoroughgoing infection control, administration of patients’ medical records and better communication between doctors and nurses. Such things may more easily be introduced in Iraq.
　On a final note, I would like to appeal to the people of Japan. Please support them. And please encourage and praise them for their steadfastness in staying in Iraq and trying to save people’s lives, no matter how dreadful the situation was.

—————————————————-

　Min-Iren is raising fund for the humanitarian and medical support for the refugees of Palestine, Iraq and Afghanistan. Send your donation by postal money transfers to 00110-5-19927, c/o Zennihon Minshu Iryo Kikan Rengokai.