NOTE: This is a guest post from Matt Willingham, Press Secretary for the Preemptive Love Coalition.
Last week I went to a local teahouse here in Iraq with a local friend, and the conversation inevitably turned to politics: “If we could just fix the healthcare system!” my friend hissed from across the table. “Then maybe the hospitals would be better and people could be healthy.”
“Fixing the system,” “improving quality of life,” and “healthy children” are hot topics around here, and not just among my aid/development worker friends. Iraq’s healthcare system was once envied by much of the Middle East, and families from all over came to Iraq for medical treatment.
Unfortunately, the opposite is now true. Iraq has fallen far, and the people here know it and discuss it often. Also unfortunately, despite these conversations being well-intentioned (because we all want people to be healthy, right?) much of the talk is focused on symptoms rather than root causes–fish handouts rather than fishing lessons.
As development workers living in a place like Iraq, my team has seen plenty of people come to help, and we’ve seen most of them leave. And I believe one reason they don’t last is because they never really answered this question: how did medical care here get so bad?
Again, they focused on easing symptoms rather than doing the difficult work of getting to the root of the problem.
And that’s exactly why so many didn’t last: the real, root reasons for these problems are incredibly complex, difficult to talk about, and, to be frank, dealing with symptoms is easier and sexier than talking about a problem’s ugly and confusing root-underbelly.
So, using Iraq’s recent history as a case study, here are 3 ways to obliterate a nation’s healthcare system:
1. Cripple a country’s ability to operate politically and economically.
In 1990, the United Nations passed Resolution 661, which placed economically violent restrictions on Iraq’s ability to trade with members of the UN. The resolution was originally passed to “limit the aggressors” in Iraq (read: Saddam Hussein’s government), but ultimately led to widespread poverty and malnutrition among Iraqis.
Because Iraq’s economy is so dependent on foreign imports and exports, the limitation of trade by the UN caused the economy to crash. In 1989, annual income per household was $3,510 and by 1996 had fallen to less than $500.
Before sanctions, 93% of the population had ready access to healthcare institutions that were staffed primarily by Iraqi physicians who had been trained in Europe or the United States. After Resolution 661 passed, the Iraqi government was unable to sustain this level of healthcare for its citizens nor were they able to keep hospitals adequately supplied.
These sanctions, and the economic collapse they caused, primed the country for the health crisis it is in today.
Photos courtesy of Lydia Bullock, Matt Willingham, and Kendelyn Ouellette.
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