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Healthcare in Iraq Pre and Immediately Post Operation Iraqi Freedom. Michael J. Keller, MBA, FACHE. Geography Medical indicators Health care professionals Ministry of Health Private sector . Geography. Land Mass Comparison -. Babyl Province. Medical Indicators.
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Healthcare in Iraq Pre and Immediately Post Operation Iraqi Freedom Michael J. Keller, MBA, FACHE
Geography • Medical indicators • Health care professionals • Ministry of Health • Private sector
Land Mass Comparison -
Physician Training • All conducted in English (British) • 4 year medical school, standard residency training programs • Iraqi developed and administered final exams since 1981 • Little or no professional contact outside Iraq during Saddam’s regeime • No new textbooks or journals >10 years
Nursing • Estimated 250 formally trained professional nurses (RN’s) • No nursing schools operating • No resources • Care provided by Aides & Orderlies • No appropriate work uniforms • Lack of basic care training
Allied Health Personnel • Medical Laboratory Technician – trained in Baghdad MOH • PT, OT, Speech, Respiratory, Medical Records – not to be found • Bio-Med - None • Management/Administration
Ministry of Health • Baghdad centric • Assigned staff upon completion of training • Handed down operating budget • Salaries controlled and ‘regionalized’ • Directed treatment protocols
Office of Public Health Dr. Hazim Al Nassiry, May 17, 2003
Medical Supply System • Kamidi • Central purchasing and distribution system • Provincial warehouse & cold chain storage • Former régime requirement for ‘testing’ of all pharmaceuticals and reagents • Ban on U.S. produced Rx’s & reagents • Oversaw Iraq Rx manufacturing • Endemic corruption and graft • Administration ‘clung’ to Kamidia until finally realizing that it was beyond rehabilitation.
Private Sector • Operated throughout the time of the former régime in all provinces • Obstetric & Ophthalmology • Forced to black market for supplies • Global fee - negotiated between physician & patient
Closing comments - • Dedicated and ethical providers • Desperately wanting to return to US/European standards of care • Appropriate spending investment and removing corruption are key • Exportation of knowledge and learning materials is the way ahead • MoH was among first ministry to be returned to Iraqi sovereignty
Questions & Comments A Portion of the Presidential Palace, Tikrit, Iraq