Medicine shortage continues

Iraq's Ministry of Health (MOH) and other health professionals say there is still a chronic shortage of medicines in the country and that changes need to be made within the system in order to overcome the problem. Doctors say they are still in urgent need of crucial medicines. "We had a programme in which cancer and growth hormone drugs were available to patients according to their needs. The ministry used to offer a certain quantity to us every year, so there could be controlled assistance to the patient, but now all that is gone. You cannot imagine what effect the shortage of such drugs has had on patients," Intissar al-Abadi, chief pharmacist of Yarmouk hospital in Baghdad, the largest emergency support facility, told IRIN. According to a health worker at the hospital, some drugs used in performing emergency operations, anti-inflammatory drugs, Clarofan, an antibiotic used after surgery, and other antibiotics were in short supply. Such drugs are in high demand at the hospital, doctors say. They complain that for each antibiotic used, they need five times more and that this is causing a delay in the recuperation of patients. Catheters for children also cannot be found at all in hospitals across the country. Al-Abadi also said that other drugs such as the vaccine anti-Rh, given to pregnant women to prevent child deformities, has stopped being dispensed due to the possibility of toxins in it, and the remaining stocks in the country were returned to the MOH for laboratory checks. Patients in need of the drug have to search for it at private pharmacies, where it can be found, but at a very high cost. The security situation also continues to impede the mobility of health workers and blocks patients' access to health care. This has resulted in shortages of medicines and medical supplies, according to the World Health Organization (WHO). In an effort to ease the situation, the MOH recently received two shipments of medicines and medical supplies from WHO, including some 21 urgently needed medicines. An additional two shipments have arrived in Amman and will be taken to Baghdad soon. "One of the problems leading to the shortage of medicines is that, before, support came direct to the hospitals. Now it's all delivered to a distribution centre and from there to hospitals. This causes a delay in delivery," Dr Ibrahim Mousa, a pharmacist at the medical city in the Bad al-Muadhem sector of Baghdad, told IRIN. He said some of the medical aid sent to them is not useful for patients in his area, such as laxatives and vitamins. "We need emergency drugs for our patients," The Iraqi deputy minister of health, Amar Al-Saffar, attributes the problem to a number of factors: UN sanctions placed on the country following the first Gulf war in 1991, neglect by the previous regime of Saddam Hussein, which led to the degradation of the entire health system, along with looting of hospitals following the recent conflict. Al-Saffar said it was difficult to control the types of medicines coming from humanitarian organisations, but he added that they were liaising more closely with aid agencies on needs. "We have great projects lined up to overcome the problems in the healthcare system, but we need time and financial support," Al-Saffar told IRIN. Meanwhile, patients are continuing to suffer. "They told me to go and buy this medicine from outside the hospital. They asked for five injections and I don't have the money to buy one. I don't know what to do and my father is in a critical condition. Is this the new Iraq they promised us?" Rana al-Obaid, daughter of a patient waiting for assistance at Yarmouk hospital, told IRIN. In addition to the drugs shortage, doctors also complain about their pay, saying there is no difference between theirs and a secretary's salary. They are paid approximately $150 per month. "Sometimes I really lose the passion for working in my profession. What they have been doing with us is really a crime," doctor Hala Jallal, a clinical pharmacist at medical city, told IRIN. Medicine for hospitals countrywide are now stored at the Drug Distribution Centre (called Kimadia), located next to the MOH, before being distributed. This new process was established earlier this year by the MOH as a way of controlling incoming and outgoing drugs and to prevent corruption that was taking place in which supplies bound for hospitals and clinics were being stolen and sold off. "The best thing is to centralise," Al-Saffar said. "Since this process started it is easier to know where and how much medicine is being used at the medical centres and we have our auditors working everywhere searching for irregularities," he added. While there have been some slight improvements in the health sector, doctors say much more needs to be done. "Drugs are easily obtained now, compared to before, due to UN sanctions. But the biggest problem is that the shortage of them at hospitals causes the prices to rise," Dr Mustafa Al-Kubaissy, pharmacist, owner of a pharmacy near Harthya medical area, told IRIN. "During the night people come to the pharmacy to dump their old syringes and search for new ones, because they cannot dispose of them at the hospital. It is crazy, I'm very sorry that Iraq has reached this point," Al-Kubaissy complained.