Source: Lancet Mars/March 2000; 355: 1093-94
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Yahoo! News: Health Headlines
Wednesday March 29 5:07 PM ET
(L'original sur Yahoo! News est désormais introuvable / The original on Yahoo! News can no longer be found)

Iraq medical system struggles under war sanctions

By Alan Mozes

NEW YORK, Mar 29 (Reuters Health) -- The embargo on Iraq imposed by the US and European nations since the Gulf War has had a devastating impact on the quality of healthcare in that country, according to an editorial published in the March 25th issue of The Lancet.

The authors of the article, Drs. Leila Richards and Stephen Wall, point out that the embargo has an ``intellectual'' component barring the exchange and import into Iraq of printed educational and scientific materials. They note that Iraqi doctors, hospitals, medical scientists and researchers lack up-to-date textbooks and medical journals.

Having traveled as part of a public health delegation throughout Iraq in May 1999 to examine the effects of the intellectual embargo, the authors note that a ban on access for Iraqi doctors to medical conferences both inside and outside Iraq, exists side-by-side with an almost total breakdown of the technical infrastructure -- a collapse which has resulted in a current widespread shortage of medical supplies and equipment, as well as inadequate access to both Internet and basic phone service.

After visiting 6 of Iraq's 10 medical colleges -- and having met with over 30 physicians and teachers, Richards and Wall note the long-term issue surrounding the flight of Iraqi medical professionals from the country due to an inability to cope with the poor working conditions and their exclusion from the world medical community.

The authors suggest that this exodus will compound the problem by leaving a vacuum of educated professionals who might otherwise be able to rebuild the medical system in the future.

In an interview with Reuters Health, Richards described the situation as very disturbing. ``The impact of this embargo should be very clear to the US government,'' she noted. ``The US government is saying that our quarrel is with Saddam Hussein and his regime and not the Iraqi people, so it seems that to promote professional ties and encourage opportunities for doctors to get together makes sense.''

Richards contends that ``this is the professional class we're trying to save and work with to promote a democracy and build a stable democracy, and instead we are watching and very much aware that tens of thousands of physicians and other professionals have left Iraq.''

She added that when such overall sanctions had been imposed on Iran after the US embassy take-over in the late-1970s, there had been recognition of the need to allow a continuing flow of medical information and exchange. ``But (for Iraq) there are no exemptions made and no consideration (regarding) the impact this is having on doctors (there) and the level of healthcare they are going to be able give with the sanctions imposed on them,'' Richards said.

Acknowledging that the situation is ``complex,'' Richards nonetheless said it was an urgent situation that must be addressed if medical care in Iraq is to be improved. ``We would like to encourage American non-governmental (organizations) to work in Iraq -- since there are already European non-governmental organizations there,'' she said. ``We would like there to be an opportunity for Iraqi social scientists to be able to get together with American and European social science work groups to organize research concerning the effect of the sanctions and figure out the best way to rebuild their institutions.''

Richards noted that the world can either help remedy the problems now or face an even more difficult situation down the road. Cautioning that the 'brain drain' is real and growing, she noted that ``eventually, government people and aid agencies are going to be going in and say 'all right let's fix everything', and the people that know the most about what has to be fixed and how to do it are the Iraqi professionals themselves.'' SOURCE: The Lancet 2000;355:1093-1094.

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