The NewStandard ceased publishing on April 27, 2007.

Iraq's Only Disabilities Hospital Badly Underfunded, Inaccessible

by Dahr Jamail

With more patients than ever as a result of invasion and occupation, Al-Kena rehab is critically low on funds and resources; doctors say patients can't access facilities, hospital can't afford to provide services or make proesthetics.

Baghdad; Apr. 29, 2004 – Al-Kena Hospital, the only facility that provides rehabilitation services for people with disabilities in all of Iraq, has not received an emergency order for prosthetic supplies it filed nine months ago with the US funded Ministry of Health. Doctors at the hospital, which houses a prosthetics workshop, also complain they are only receiving 5 million Iraqi dinars ($3500) per month from the Ministry of Health, when the prosthetics workshop alone requires at least 3 million Iraqi dinars ($2070) per month to properly serve its patients.

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Dr. Thamiz Aziz Abul Rahman, a General Practitioner at the prosthetics workshop, said they lack the necessary machinery needed to make artificial prostheses. He said, "We are using antiquated machinery from the 1970s which is missing parts."

Standing near three broken machines used for constructing prosthetics and two ovens in need of repair, he continued, "In addition to this, the lack of adequate funding means we are unable to treat more patients who need prostheses, as well as a very long waiting list for people who need our care."

Even the shoe-making machine, which provides insoles for patients who require specialized footwear for treatment, is currently unusable, doctors said.

Three doctors staff the workshop, which serves 40-60 patients per day. Rahman stated, "The number we are treating has gone up dramatically during the occupation due to people stepping on mines." The doctor added that a rise in injuries from unexploded ordnance, car accidents, and shootings by US soldiers has added to the usual cases of amputations from diabetes and scoliosis.

The prosthetics workshop has only one wheelchair they are able to use to transport patients to and from the clinic, and they do not have enough funding to hire wheelchair assistants to help patients get around.

The hospital used to obtain funding from the Red Crescent Society of Baghdad, but due to the deteriorating security situation the Red Crescent has found it necessary to cut their services to the Al-Kena hospital.

Dr. Ahmed Kassen, a specialist in rheumatology at the hospital and supervisor of the workshop, said most of the materials used by the workshop for prostheses are imported from France and Germany. He added, "This takes time and we must await the shipments. They are also delayed by the security situation, [and] delays at the Ministry of Health for approvals of these materials."

Both doctors said the workshop has not received approval from the Ministry of Health for new materials since the US-led invasion of Iraq last spring.

"Nine months ago we submitted an emergency order for prosthetic materials to the Ministry of Health, and still we have nothing," said Rahman.

He also complained that the US military from a nearby base closed the entrance gate nearest to the workshop, which he said has forced caregivers to carry patients who have had amputated legs nearly a quarter of a mile to the clinic from the front gate.

Rahman said he asked the commander at the nearby US base if they could re-open the gate, but he said the only response he has received is that the gate has been closed for security reasons.

The prosthetics workshop has only one wheelchair they are able to use to transport patients to and from the clinic, and they do not have enough funding to hire wheelchair assistants to help patients get around.

Kassen said, "We used to have public busses before the invasion which would bring patients directly to us. But now, many people have to sometimes walk one mile or be carried that far, just to get to us. Now that we have no government, we have no public transportation."

Both doctors interviewed at the clinic said the lack of transportation and the US military closure of entrance gate has interrupted the rehabilitation of 60-70 percent of their patients.

"As you can see," Rahman said, "because of the closure people are unable to get to us without paying for a taxi which most cannot afford. Either this or they have to find someone to carry them or help them get to our workshop to be fitted with prosthesis. It is an unacceptable situation."

The doctors said that because of the limited access to the clinic, many patients are asking to simply be given their prostheses with no scientific fitting.

After the invasion of Iraq, US personnel from the Ministry of Health came to the workshop to find out what supplies were needed. Kassen said he provided both a catalogue and a computer disk of the materials the workshop needed but never heard from them again. He stated, "The Americans who came here didn’t even know what a clinic like this was for. Of course we got no assistance."

Spokespeople for the Ministry of Health did not return several requests from The NewStandard for comment on the lack of funding and supplies.

The workshop lacks even the most basic materials necessary for constructing prosthetics, such as leather, pins, glue, metal bars and joints. While they are able to obtain some of these in the market with their limited funds, the rest must be provided by the Ministry of Health. Rahman said, "We don’t have enough money, and barely enough of the most simple supplies we need to treat amputees. Of course we’ve had a dramatic increase in the number of amputees because of the invasion and now the occupation."

While helping a small boy with a new back brace to counter the effects of scoliosis, Kassen added, "We lack locking joints for prosthetics. Most of the time we are unable to serve smaller children and geriatrics. And if one component from the prosthetics is missing, we cannot help the people."

The hospital and workshop were both looted heavily during the chaos that immediately followed the invasion and have not received any extra funding or supplies from the U.S. funded Ministry of Health to compensate for this.

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The NewStandard ceased publishing on April 27, 2007.

Dahr Jamail is a contributing journalist.

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