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One year after the World Health Organization (WHO) declared COVID-19 a pandemic, Iraqs health sector remains unable to adequately respond to the crisis. Iraq has struggled to deal with the COVID-19 emergency since the first case appeared in the country in late February 2020. Weakened by more than three decades of conflict, international sanctions, corruption, and social and economic neglect, the country and its health system were ill-equipped to respond to a pandemic.

As of late March 2021, following another major surge in infections, more than 844,000 Iraqis have contracted the novel coronavirus, and more than 14,200 have died. The number of cases is about 22 per 1,000 people, a rate that places Iraq among the hardest-hit countries in the Middle East. The official figures, which are based on limited testing and poor data systems, are almost certainly lower than the actual number of cases and deaths.

A crisis waiting to unfold

In many respects, Iraq was a public health crisis waiting to unfold. Decades of conflicts, coupled with international sanctions and lack of attention to the health sector, have severely damaged Iraqs health care system, shaping an environment that led many qualified doctors and other medical professionals to leave the country.

Iraq spends less than many of its neighbors on health. The countrys annual budget in 2019 was 133 trillion Iraqi dinar (ID); of that, only six trillion ID (4.5 percent of the annual budget) were spent on health and the environment. The World Health Organization notes that Iraq spent only $154 per person for health services in 2015, compared to neighboring Irans $366 and Jordans $257.

Iraqs weak, under-resourced public health system has had a deep and widespread negative impact on public health. Non-communicable diseases, such as cancer, heart disease, diabetes, and chronic lung diseases, account for 55 percent of deaths in Iraq. More than 30 percent of the population suffers from hypertension, 14 percent from diabetes, and more than 30 percent is obese. In the last three decades, the Iraqi population has increased significantly, to more than 39 million in 2019 from 7.28 million in 1960. However, the health system has not kept pace. According to the World Bank, for every 1,000 Iraqis, there are 1.3 hospital beds, a drop from 1.9 in 1980, and 0.8 physicians, a significant drop from 1.0 in 2014. This is far fewer than other countries in the Middle East.

According to Dr. Abdulameer al-Shammary, the former head of the Iraqi Medical Association, which regulates, oversees, and advocates for the rights of doctors, these challenges are multifold. He notes, The public health sector is suffering. The numbers of health professionals and centers are very low and do not match the increase in population. There is a lack of medical supplies and mismanagement of human resources. The waiting list in public hospitals is very long. Patients prefer to go to the private sector. There are no guidelines for treatment or proper sanitation or disposal of waste.

The long-term neglect of the health sector has also had a demonstrably negative impact on the countrys health infrastructure. Health centers suffer from chronic shortages of medical supplies and resources. For Iraqis, accessing public medical care is inexpensive. However, the quality of care is so substandard that many resort to private medical care if they have the financial means to do so. Because there is no private health insurance, the average Iraqi covers about 70 percent of their out-of-pocket health expenditures, making quality health care an expensive proposition for most people. Many Iraqis seek medical care in other countries, such as Indian, Iran, Jordan, Lebanon, and Turkey.

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Challenges Faced by the Iraqi Health Sector in Responding to COVID-19 [EN/AR] - Iraq - ReliefWeb

BAGHDAD It was a stark message: A convoy of masked Shiite militiamen, armed with machine guns and rocket-propelled grenades, drove openly through central Baghdad denouncing the U.S. presence in Iraq and threatening to cut off the prime ministers ear.

The ominous display underscored the growing threat that rogue militias loyal to Tehran pose for Iraq. It came at a time when Baghdad seeks to bolster relations with its Arab neighbors and is gearing up for early elections, scheduled for October, amid a worsening economic crisis and a global pandemic.

Last weeks procession also sought to undermine Prime Minister Mustafa al-Kadhimis credibility, with Iran-aligned militias driving down a major highway and passing near ministries as Iraqi security forces looked on. Ahead of a new round of talks between the U.S. government and Iraq, it sent a stark warning that the militias will not be curbed.

A fourth round of so-called strategic Iraq-U.S. talks is scheduled for next week after the Iraqi government requested it, partly in response to pressure from Shiite political factions and militias loyal to Iran that have lobbied for the remaining U.S. troops to leave Iraq.

The talks, which began in June under the Trump administration, would be the first under President Joe Biden. On the agenda is an array of issues, including the presence of U.S. combat forces in the country and the issue of Iraqi militias acting outside of state authority. The discussions are meant to shape the future of the U.S.-Iraq relationship, a senior U.S. official recently said.

It is a tightrope for al-Kadhimi, who has said that bringing armed groups under state control is a goal of his administration but finds himself increasingly helpless in reining in the groups. U.S. officials have said Washington will use the meetings to clarify that U.S. forces remain in Iraq for the sole purpose of ensuring the Islamic State group cannot reconstitute itself a signal that the U.S. seeks to keep the 2,500 remaining American soldiers in Iraq.

Political analyst Ihsan Alshamary said the militias military-style parade sought to weaken al-Kadhimis government and project strength.

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It also aims at sending a message to Washington: We are the decision makers, not the government, he added.

The militiamen in the parade were mostly from a shadowy Shiite group known as Rabaallah one of about a dozen that surfaced after the Washington-directed drone strike that killed Iranian general Qassem Soleimani and Iraqi militia leader Abu Mahdi al-Muhandis in Baghdad in January 2020.

Both Soleimani and al-Muhandis were key in commanding and controlling a wide array of Iran-backed groups operating in Iraq, and their deaths in the U.S. airstrike outraged Iraqi lawmakers, prompting them to approve a non-binding resolution to oust U.S.-led coalition forces from the country.

Since then, militias have also become increasingly unruly and disparate. Some Washington and Iraq-based observers argue the militias have splintered into new, previously unknown groups, allowing them to claim attacks under different names to mask the extent of their involvement.

They are tools used for negotiating purposes and putting pressure on Washington when it comes to (Irans) nuclear file, Alshamary said, referring to efforts under Biden to resurrect the 2015 nuclear deal between Tehran and world powers that former President Donald Trump withdrew from in 2018.

Rabaallah, for instance, is believed to be a front for one of the most powerful Iran-backed factions in Iraq, which the U.S. has blamed for rocket attacks targeting the American Embassy in Baghdad and military bases that house U.S. troops.

Last October, the group set fire to the headquarters of a Kurdish political party in Baghdad and attacked the offices of local media organizations in the capital. It has also been blamed for assaults on liquor stores and an Asian spa center in the Iraqi capital.

Rabaallah went so far as to try and dictate the exchange rate of the Iraqi dinar to the dollar, demanded the approval of a budget and denounced what it said was U.S. occupation of Iraq. It displayed posters of al-Kadhimi with a shoe printed across his forehead and a pair of scissors on the side of his face, with the words: Its time to cut his ear off.

Iraq lies on the fault line between the Shiite power Iran and the mostly Sunni Arab world and has long been a theater for settling regional scores. It has also been dragged into the U.S.-Iran proxy war. And though its relations with the U.S. took a hit following the airstrike that killed Soleimani, ties have improved since al-Kadhimi approved by both Iran and the U.S. became prime minister.

Political analyst Tamer Badawi said the Shiite militias aim to send a dual message to al-Khadimis administration. The first is a warning against any attempt at curbing the militias influence under the banner of fighting corruption. The other is to pressure the government to push the U.S. to scale down the number of coalition forces in Iraq.

For his part, al-Kadhimi has tried to curb the militias money-making border activities, including smuggling and bribery, and show his American interlocutors that he is capable of keeping domestic adversaries in check.

Badawi said the pressure from the militias will likely increase ahead of the strategic talks with the U.S. on April 7.

In the days after the Rabaallah parade, Iraqi security forces fanned out in the streets and main squares of the capital Baghdad in what a senior Iraqi security official described as a reassuring message.

But for Baghdad shopkeeper Aqeel al-Rubai, who watched the February militia parade from the street, the militia show was a terrifying sight that reflects a powerless government.

I saw that this country is insecure and unfit to live in peace, he said.

Karam reported from Beirut.

See the original post:
Militias a growing challenge for Iraq ahead of talks with US - Military Times

BAGHDAD It was a stark message: A convoy of masked Shia militiamen, armed with machine guns and rocket-propelled grenades, drove openly through central Baghdad denouncing the US presence in Iraq and threatening to cut off the prime ministers ear.

The ominous display underscored the growing threat that rogue militias loyal to Tehran pose for Iraq. It came at a time when Baghdad seeks to bolster relations with its Arab neighbours and is gearing up for early elections, scheduled for October, amid a worsening economic crisis and a global pandemic.

Last weeks procession also sought to undermine Prime Minister Mustafa Al Kadhimis credibility, with Iran-aligned militias driving down a major highway and passing near ministries as Iraqi security forces looked on. Ahead of a new round of talks between the US government and Iraq, it sent a stark warning that the militias will not be curbed.

A fourth round of so-called strategic Iraq-US talks is scheduled for next week after the Iraqi government requested it, partly in response to pressure from Shia political factions and militias loyal to Iran that have lobbied for the remaining US troops to leave Iraq.

The talks, which began in June under the Trump administration, would be the first under President Joe Biden. On the agenda is an array of issues, including the presence of US combat forces in the country and the issue of Iraqi militias acting outside of state authority. The discussions are meant to shape the future of the US-Iraq relationship, a senior U.S. official recently said.

It is a tightrope for Kadhimi, who has said that bringing armed groups under state control is a goal of his administration but finds himself increasingly helpless in reining in the groups. US officials have said Washington will use the meetings to clarify that US forces remain in Iraq for the sole purpose of ensuring the Islamic State (ISIS) extremist group cannot reconstitute itself a signal that the US seeks to keep the 2,500 remaining American soldiers in Iraq.

Political analyst Ihsan Alshamary said the militias military-style parade sought to weaken Kadhimis government and project strength.

It also aims at sending a message to Washington: We are the decision makers, not the government, he added.

The militiamen in the parade were mostly from a shadowy Shiite group known as Rabaallah (Quarter of God) one of about a dozen that surfaced after the Washington-directed drone strike that killed Iranian general Qassem Soleimani and Iraqi militia leader Abu Mahdi al-Muhandis in Baghdad in January 2020.

Both Soleimani and Muhandis were key in commanding and controlling a wide array of Iran-backed groups operating in Iraq, and their deaths in the US airstrike outraged Iraqi lawmakers, prompting them to approve a non-binding resolution to oust US- led coalition forces from the country.

Since then, militias have also become increasingly unruly and disparate. Some Washington and Iraq-based observers argue the militias have splintered into new, previously unknown groups, allowing them to claim attacks under different names to mask the extent of their involvement.

They are tools used for negotiating purposes and putting pressure on Washington when it comes to (Irans) nuclear file, Alshamary said, referring to efforts under Biden to resurrect the 2015 nuclear deal between Tehran and world powers that former President Donald Trump withdrew from in 2018.

Rabaallah, for instance, is believed to be a front for one of the most powerful Iran-backed factions in Iraq, which the US has blamed for rocket attacks targeting the American embassy in Baghdad and military bases that house U.S. troops.

Last October, the group set fire to the headquarters of a Kurdish political party in Baghdad and attacked the offices of local media organisations in the capital. It has also been blamed for assaults on liquor stores and an Asian spa center in the Iraqi capital.

Rabaallah went so far as to try and dictate the exchange rate of the Iraqi dinar to the dollar, demanded the approval of a budget and denounced what it said was US occupation of Iraq. It displayed posters of Kadhimi with a shoe printed across his forehead and a pair of scissors on the side of his face, with the words: Its time to cut his ear off.

Iraq lies on the fault line between the Shia power Iran and the mostly Sunni Arab world and has long been a theatre for settling regional scores. It has also been dragged into the US-Iran proxy war. And though its relations with the US took a hit following the airstrike that killed Soleimani, ties have improved since Kadhimi approved by both Iran and the US became prime minister.

Political analyst Tamer Badawi said the Shia militias aim to send a dual message to Khadimis administration. The first is a warning against any attempt at curbing the militias influence under the banner of fighting corruption. The other is to pressure the government to push the US to scale down the number of coalition forces in Iraq.

For his part, Kadhimi has tried to curb the militias money-making border activities, including smuggling and bribery, thus showing his American interlocutors that he is capable of keeping domestic adversaries in check.

Badawi said the pressure from the militias will likely increase ahead of the strategic talks with the US on April 7.

In the days after the Rabaallah parade, Iraqi security forces fanned out in the streets and main squares of the capital Baghdad in what a senior Iraqi security official described as a reassuring message.

But for Baghdad shopkeeper Aqeel al-Rubai, who watched the February militia parade from the street, the militia show was a terrifying sight that reflects a powerless government.

I saw that this country is insecure and unfit to live in peace, he said.

See the original post here:
Pro-Iran militias in Iraq go rogue trying to pressure Kadhimi | | AW - The Arab Weekly

I saw something new in Baghdad recently. At one of the citys many checkpoints, men in white coats and N95 masks were standing in front of the soldiers, checking whether passengers in minivans were wearing their masks. The cigarette vendors that wind their way through the waiting cars had added a sideline in selling surgical masks.

Apart from that, however, it is difficult to see the effect COVID-19 has had on the city. The pain I witness every day at the hospital we at Mdecins Sans Frontires (MSF) are running is hidden from most of the people who crowd the streets. But that suffering has now redoubled as Iraq is in the grip of a ferocious second wave, with Baghdad again its epicentre.

Since the end of September we have admitted around 350 critical and severe patients, but 120 of those have been in the last month alone. To cope with the influx, we have expanded from 36 beds to 51, but the death rate remains frightening. On a single day recently, despite the best efforts of our team, seven patients died.

We are all tired now, medical and non-medical staff alike. The first peak in Baghdad was long, from July to November, straining the supply of oxygen in the city and leaving the health system teetering on the brink of collapse.

The number of cases only briefly went down in December and January before mounting precipitously from February onwards. There were 714 cases on 31 January, and 3,428 on 28 February. March 25 saw the highest number of cases since the beginning of the pandemic 6,513 but even that number is likely to be underestimated. The virus did not leave us long to draw breath before being submerged by this second wave.

The death has affected me mentally, says Dr Yassin Hassan, who works with us in intensive care, but I try to overcome it, for the sake of other patients. I listen to music, or talk with my family about it and then come back to work.

The false hope of the end of the first wave hit him hard.The curfew was lifted, and the city came back to life, and then the numbers sky-rocketed again. Its sad now, we dont have beds for everyone.

I have been here in Baghdad for a year now, working to help the Iraqi authorities with their response to the virus. At first we started to work inside the respiratory care unit in al-Kindi hospital, but we quickly found that the hospital was unable to cope with the number of patients and the close follow-up they required. Many senior doctors were only present in the hospital for a brief period in the morning, and their junior colleagues were often unwilling or unable to take decisions without them, placing them and us in an untenable position as the outbreak progressed.

We opened our own unit in the hospital in September, first with 24 beds, before moving to a new building and expanding the capacity to 36 beds in December. We found new ways of working with our Iraqi colleagues and managed to bring the mortality down for the serious and critical cases we are treating.

Although this remains a brutally deadly disease in its severe forms, we are now discharging around 40 per cent of our patients a vast improvement on the rate of survival from when we initially took over. But we never expected to still be here, one year after we began what we thought would be temporary support to the Iraqi health system.

Without vaccination the end of COVID-19 is hard to see. Yet the country has so far received just 386,000 doses of the vaccine, a number totally inadequate for a country of 40 million. According to the Ministry of Health there are around 216,000 doctors, nurses and paramedical staff in the country.

Newly delivered doses may allow some of those medical workers to be vaccinated, but many of the doctors we work with do not know when their turn for vaccination will come, and in the meantime our colleagues continue to fall sick.

While other doses are supposed to arrive in the coming months, much more needs to be done to help Iraq get vaccines into arms. The country should be considered one of the priorities globally for vaccination efforts, and a priority in the Middle East where it has been one of the hardest hit nations.

With a health system weakened by years of conflict and its associated ills, and an economy struggling in the wake of the crash in the price of oil, the government will struggle to vaccinate all those who need it without substantial assistance from other countries in the procurement of vaccines and other international organisations in their distribution.

Until that happens we will continue working to save lives in our hospital. We know, however, that even when this wave recedes it will not be the end unless Iraqis get the vaccines they so desperately need.

Originally posted here:
Only vaccination will end the ferocious spread of COVID-19 in Iraq - Iraq - ReliefWeb

Almost 2,000 children under-10 across the country have been infected in just two weeks.

A rising number of infants and children in Iraq are reported to have been infected by COVID-19 without access to care, as the variant that was first discovered in the UK is wreaking havoc in the country, with reports of children dying[1], Save the Children warned today.

According to Iraqs Ministry of Health, thousands of cases have been recorded among children since the discovery of the variant in Iraq was officially announced on 15 February[2]. The number of children under 10 who were diagnosed jumped from 11,699 cases as of 11 March to 13,546 cases on 24 March, an increase of 15.7% in just two weeks.[3]

Although there is no definitive answer yet, scientists earlier suggested that the new variant is transmitting across all ages, including children.[4]Earlier in February, the ministry said the variant accounts for 50% of all new COVID-19 cases.[5]

Doctors have told Save the Children that they have seen an increase in children being hospitalised with COVID-19. But they fear its only the tip of the iceberg, as many cases are not taken to hospitals or are only diagnosed in clinics and pharmacies, where they are not officially recorded.

Dr. Taha Abdulmawjoud from Ninawa, who works with Save the Children, said:

We have seen children as young as 10 admitted to hospital and there is a higher percentage of children with the virus in primary health care centres and paediatric hospitals than before. We worry that many children will catch the virus without having access to proper testing or isolation, which risks them spreading among their friends and older family members.

The Ministry of Health said the virus is spreading quickly across villages and cities. In some instances, it has infected whole families. The infection rate has jumped by 110% over the last two weeks of February compared to the first half of the month[6].

Overcrowded schools are also likely to lead to a high risk of infections among children, Save the Children warned.

"We fear this new variant, particularly for first-grade students, *said Saleh*, a father of three from Jalawla, northeast of Baghdad. The communities around us are not very careful. We know the new variant can infect children. We have heard of serious infections of children."*

Save the Children is calling for urgent support to step up access to protective equipment, provide disinfection and sanitation kits to schools and enforce social distancing and mask-wearing rules.

Ishtiaq Mannan, Save the Childrens country director in Iraq, said:

These are worrying signs that COVID-19 is taking a heavy toll on children in Iraq. Infants and children under 10 have been either infected or have reportedly died because of this virus.

We are worried that the new variant will start spreading undetected among children. It could be a matter of time before Iraqs healthcare system is overwhelmed.

Save the Children calls on the Iraqi Ministry of Health to prioritise vaccinating frontline health workers and other priority groups, followed by teachers among others, as well as those who are in direct contact with children.

Since the beginning of the pandemic in Iraq, Save the Children has been raising awareness in communities, schools and among children on the virus and ways of prevention, running awareness-raising sessions on social distance and the importance of wearing masks. The organisation is also continuously providing hygiene kits and personal protective equipment to schools' staff and to health workers around the five governorates it operates within Iraq.

*name changed to protect childrens identities

For more information or interview requests, kindly reach out to:

[1] https://shafaq.com/en/Iraq-News/Children-die-of-Covid-19-in-Iraq-Health-...

[2] https://www.reuters.com/article/us-health-coronavirus-iraq-idUSKBN2AG1WT

[3] WHO data analysed by Save the Children https://app.powerbi.com/view?r=eyJrIjoiNjljMDhiYmItZTlhMS00MDlhLTg3MjItM...

[4] https://www.reuters.com/article/uk-health-coronavirus-variant-children/u...

[5] https://www.rudaw.net/english/middleeast/iraq/180220211

[6] Bi-weekly confirmed cases jumped from 23,232 between 1-14 February to 48,839 between 15-28 February according to official figures: https://app.powerbi.com/view?r=eyJrIjoiNjljMDhiYmItZTlhMS00MDlhLTg3MjItM...

Read the original here:
COVID-19 in Iraq: Hundreds of infants and children infected every day as new variant spreads - Iraq - ReliefWeb