Signs of hope, even for poorest communities

Blue rubbish-disposal bags littered the flat, baked earth for hundreds of yards on either side of the road. Sinister columns of black smoke were rising from burning tips. The van turned off the main road and began shuddering and bouncing over the hard, unmade track. The track plunged through a sprawl of low, brick buildings - some half-finished - that comprise a smallish shanty town just beyond the northeastern limits of the Iraqi capital, Baghdad. The settlement is nicknamed Shishan - a wry reference to Chechnya. A nearby shanty town is called Tanak, or tin plate, after the first houses put up there were made from of oil cans. Place names change in Iraq and tell their own story. Not far from Shishan is the poor urban district of Sadr City. It was formerly known as Saddam City, and before Saddam’s time, it had been Al-Thawrah, or revolution. The people in Shishan, Tanak, and nearby Ma'amil are Shi'ah. The areas were populated by squatters about 30 years ago, when Shi'ahs moved into Baghdad from the south of the country. They have always been poor. Until May this year, Shishan had no public services at all, but now there is a new primary health-care centre built by Médecins Sans Frontières (MSF). The centre provides the settlement's 20,000 inhabitants with basic health education and services. Not far along the dusty track, a new school is being built by Green Helmets, a German NGO. It is a start, but the challenges faced by the local population are still formidable. On the day of IRIN’s visit, women were filling buckets with water from a hosepipe as children played near them in a muddy ditch. The women told IRIN that the water was being tapped from a broken pipe. They were perfectly aware that it was contaminated; a young man standing nearby said it might well cause typhoid in the area. The people of Shishan also go to the river, a few hundred yards away, to collect water. At the clinic, a man held his six-month-old baby in his arms, waiting to see the doctor. The baby was crying; a painful-looking lump was visible on her leg. He said the water she was usually being given to drink came directly from the river. Now, he added, she was dehydrated. About 50 people, many of them accompanied by children, were waiting to be seen at the centre. Ingrid Seymus, a nurse working with MSF, said the main health problems they faced were respiratory infections, diarrhoea and anaemia. Sa’diyah Zamil had brought in a small child with a rash on her legs which she said had been caused by the heat. She said both her children and the older members of her family had suffered bouts of diarrhoea. "Our biggest problems are the lack of electricity, the lack of water, and the roads in winter which get so muddy that people sink into them. It gets so bad that it stops our children from going to school," she told IRIN. These points are echoed by many other people - especially the shortages of electricity and water. Not far away, in Ma’amil, MSF has built another, larger primary health-care centre. Unlike Shishan, Ma’amil had a government-run clinic, but its population now stands at 100,000, and a second facility is sorely needed. A maternity ward and a child-care unit will be opened at the centre. The building housing it is spacious and cool with several consultation rooms and offices, as well as a pharmacy. The physician-in-charge, Dr Ahmad al-Khazraji, told IRIN that the local people's needs went beyond basic health care and proper nutrition. "Many of the risks are psychological. It’s a big thing to have three wars in 20 years and a million deaths. That’s the first priority: the Iraqi people all need psychological support," he said. Rasmiyah Fayyaz had come to the clinic suffering from rheumatism. Her husband was sick and unable to work, and she had 13 children. "We have no water, no electricity, no stability - a lot of difficulties one after the other. It’s a torture for us. I want to be able to relax and to have a normal life," she said. And yet, despite all their problems, people at the clinics were saying that Iraq was a rich country and that their problems were common to all Iraqis. Al-Khazraji was determined to look ahead, not back. "I prefer not to talk about the previous government. It’s gone," he told IRIN. "We have a new Iraq and we have a great job to do. I think our people understand many things and we have a good population. Iraq will be rebuilt by Iraqis themselves, not by others, and I think we have a good future."