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In document Iraq Key socio-economic indicators (Page 52-55)

2. Socio-economic indicators in Iraq – with a focus on Baghdad, Basra, and Erbil

2.5 Health care

In 2015, it was reported that Basra had above average high rates of access to the public water network and ‘improved water sources’, however, the quality of the water was poor.361 Access to safe drinking water represented one of the main problems in Basra.362 Southern Iraq’s freshwater, particularly in Basra, was largely from the Shatt Al-Arab waterway, which has become heavily salty due to upstream dams, drought, and pollution. In recent years, water shortages have caused reduced cultivation of crops, such as rice and wheat.363 Following a fact-finding mission to Basra City in September 2018, NRC found that the water crisis has negatively impacted livelihoods in agriculture in rural areas around Basra364, and forced 3 780 people from rural areas of southern Iraq to be displaced in August 2018.365 Due to water scarcity, a rise in rural to urban displacement was noted in Basra in September 2018.366 In November 2018, IOM reported that the number of families displaced by the water crisis and drought in southern governorates was 3 522 (most of whom were in Thi Qar).367

2.4.4 Erbil

The WFP Iraq Market Monitor observed ‘high price changes’ in month-on-month prices in Erbil markets for March-April, with a high predictability of future changes.368

Access to safe drinking water was nearly universal in Erbil governorate, with 89.7 % of households having the public network/tap as a source of freshwater supply, whereas 8.9 % relied on wells.369 Sources indicated that water shortages might occur in KRI as a result of rapid population increase and waste.370 The quality of Erbil’s drinking water was evaluated to be within acceptable limits.371 Houses in Erbil governorate were equipped with sanitation facilities, such as connection to the public sewage network with covered canal (25.6 %) or septic tanks (71.8 %).372

approximately 0.8 physicians and 1.3 hospital beds per 1,000 people (below the global averages of 1.5 and 2.7, respectively)’.374

The WFP observed that the Iraqi State provided ‘universal healthcare and medical supplies at a subsidised cost’ to all Iraqis. The source also reported on a low rate of less than one hospital per 100 000 persons. According to the report, even ‘[l]ower incidences of hospitals and physicians are observed in the governorates of Kirkuk, Thi-Qar, Nainawa, Maysan and Anbar’.375

Map 5: WFP Number of Hospitals per 100 000 Population 2019376

In its Iraq Country Factsheet 2019, IOM observed that public hospitals and clinics charged minimal fees, but might not provide all medical services. Moreover, most of the infrastructure was rehabilitated, save for the newly liberated areas. IOM stated that there might be waiting times for certain medical specialisations, particularly in big cities. Furthermore, patients should visit a clinic for diagnosis first before they were referred to the appropriate healthcare facility. The costs of medical services depended on numerous factors (e.g. age and gender) and costs of medications depended on diagnoses. Additionally, in public hospitals medications were provided at a lower cost but were subject to shortages.377 Reuters, citing Iraq’s former Minister of Health, stated that in 2018, ‘more than 85%

of drugs on Iraq’s essential medicines list were either in short supply or completely unavailable’, with cancer drugs being ‘among the scarcest and most smuggled’. Moreover, Reuters observed that pharmacies were full with smuggled drugs that either could be unsafe or expired.378

Although reliable data is sparse for the post-2008 period, the deterioration of the security situation after the ISIL offensive in 2014 has intensified the need for mental care and specialised staff, according to EPIC.379 In 2018, it was estimated that between 15 and 20 % of the country’s population faced

374 CRS, Iraq and U.S. Policy, 16 June 2020, url, p. 2

375 WFP, Iraq Socio-economic Atlas, 2019, url, p. 40

376 WFP, Iraq Socio-economic Atlas, 2019, url, p. 51

377 IOM, Country Factsheet: Iraq, 2019, url, p. 4

378 Reuters, The medical crisis that’s aggravating Iraq’s unrest, 2 March 2020, url

379 EPIC, Iraq’s quiet mental health crisis, 05 May 2017, url

mental health issues.380 WHO representatives, interviewed by Landinfo and DIS, in 2018 noted that with regard to mental health ‘there are huge needs and the available services do not meet the demand.’381 The growing mental health needs haven not been met due to a shortage of specialised staff, as, according to IRIN news, there were only 80 clinical psychologists in the country, working alongside a limited number of psychiatrists.382

2.5.2 Baghdad

According to the WFP Socio-economic Atlas, and based on 2017 data, there was one government hospital for 140 001-177 000 persons in Baghdad governorate. Regarding the overall number of hospitals (public and private), the WFP estimated a range of 50-95 in Baghdad governorate, with a rate of 10.1-15 % of physicians for every 10 000 persons.383 Moreover, mortality rates for children under five in Baghdad were 20.1-30 percent.384 The CSO stated that in 2017, the numbers of governmental hospitals and Primary Healthcare centres were 95 and 257 consecutively.385 According to the National Development Plan 2018-2022, and based on 2016 data, there was a deficit of 110 governmental hospitals and 538 primary health care units in Baghdad between the standard and actual numbers.386

The WHO Iraq Health Cluster Response Monitoring Interactive Dashboard 2018 indicated that in the Baghdad governorate, six organisations were operating health facilities in 12 locations. This included one facility for mental health and eight for treatment of common diseases.387 According to the Country Cooperation strategy for WHO in Iraq, inadequate mental health services were provided as primary care across all Iraq. In 2016, two trauma centres were opened in Baghdad. A UNAMI/OHCHR report noted that in 2016 there were 45 NGOs in Baghdad who had registered with the Ministry of Labour and Social Affairs and were specifically providing medical support on disability. According to the NGOs surveyed by the UNAMI/OHCHR report, there was only one centre for plastic limbs and medical cushions in Baghdad and one specialised hospital for persons with disabilities with spinal cord injuries.388

2.5.3 Basra

In a report published on 2 March 2020, Reuters stated that the healthcare system in Basra was underfunded, despite the governorate’s massive oil production. According to the report, doctors and nurses in Basra were ‘overworked’. Additionally, Basra suffered from a shortage in vital medical equipment, and had only three CT scanners and one MRI unit per million residents, ‘a fraction of the average rate of 34 CT scanners and 24 MRI units for developed countries’.389

According to the WFP Socio-economic Atlas, and based on 2017 data, there was one government hospital for 177 001-227 100 people in Basra governorate.390 The WFP noted that Basra governorate had a range of 16-26 public and private hospitals, while the rate of physicians per 10 000 persons was

380 Rudaw, Seminar examines mental health challenges in post-conflict Iraq, 2 April 2018, url

381 Denmark, DIS, Norway, Landinfo, Northern Iraq: Security situation and the situation for internally displaced persons (IDPs) in the disputed areas, incl. possibility to enter and access the Kurdistan Region of Iraq (KRI), 5 November 2018, url, p. 54

382 IRIN News, Iraq’s growing mental health problem, 16 January 2017, url

383 WFP, Iraq Socio-economic Atlas, 2019, url, pp. 51,52

384 WFP, Iraq Socio-economic Atlas, 2019, url, p. 61

385 Iraq, CSO, 2018 دادغب ي ئاصحلاا زجوملا [Statistical Summary Baghdad 2018], n. d., url

386 Iraq, Ministry of Planning, National Development Plan 2018-2022, June 2018, url, p. 173

387 WHO, Iraq Health Cluster Response Monitoring Interactive Dashboard 2018, url

388 UNAMI, Report on the Rights of Persons with Disabilities in Iraq, December 2017, url, p. 12-13

389 Reuters, The medical crisis that’s aggravating Iraq’s unrest, 2 March 2020, url

390 WFP, Iraq Socio-economic Atlas, 2019, url, p. 51

at 8.1-10 %.391 Moreover, mortality rates for children under five in Basra were 30.1-40 %.392 The CSO stated that in 2017, the number of healthcare facilities in Basra was 246, of which 19 were governmental hospitals and 139 were Primary Healthcare centres.393 According to the National Development Plan 2018-2022, and based on 2016 data, there was a deficit of 42 governmental hospitals and 154 primary health care units in Basra between the standard and actual numbers.394

2.5.4 Erbil

In the three governorates of the KRI, the ratio of government hospitals to residents was significantly higher, i.e. one hospital per 60 000-75 000.395 According to the WFP, Erbil governorate had a range of 27-49 public and private hospitals and a higher rate of 15.1-19 physicians per 10 000 persons.396 Moreover, mortality rates for children under five in Erbil were 10.1-20 %.397 Additionally, Reuters observed that in the KRI, there was 1.5 hospital beds per 1 000 people.398 According to the National Development Plan 2018-2022, and based on 2016 data, there was a deficit of 11 governmental hospitals and a surplus of 96 primary health care units in Erbil between the standard and actual numbers.399

Many of the basic primary care services were provided in the KRI, however not in a consistent way.400 The PHC [Primary Health Care] system covers all Iraqis, including non–KRI residents who are Iraqi citizens. However, non-KRI residents who do not have citizenship of Iraq cannot avail themselves of health facilities and medicines under the same terms as Kurdistan citizens.401 The same source noted that ‘all citizens are eligible for a broad package of health care, dental, and emergency services in public hospitals and PHCs. The services provided are limited by the budget, available equipment and medicines, and the education and training of the staff’.402 Syrian refugees residing in the KRI had the right to access public healthcare.403 The distribution of PHC centres was not necessarily uniform across the Kurdistan Region, with most main PHCs serving too many people, and most sub-centres serving too few people. The centres providing services to a larger population were, however, equipped with more doctors and nurses than the sub-centres.404 In August 2018, Rudaw reported that medication was illegally imported into the KRI and that this included counterfeit medication.405

In document Iraq Key socio-economic indicators (Page 52-55)

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