Today is not an easy day for Zuhair Fathallah. The surgeon from Basra is looking around the facilities in Glasgow's plastic surgery unit and is clearly impressed. But, for him, this visit is tinged with something else: the knowledge that he cannot offer such technology to his own patients in the hospitals of Iraq. For there, a silent emergency is happening, and it is one which has gone largely unnoticed by the world.
Dr Fathallah and five of his colleagues have come to Scotland to tell the story of that emergency. The story of the unsterilised equipment they are forced to re-use; the story of the malnutrition among their young patients; the story of the lack of help and resources from the authorities; and the story of disease, neglect and hopelessness.
''One of the simple things for a surgeon is a skin-graft knife,'' says Fathallah. ''I do not have any supply of it. It is supposed to be disposable, but we have to re-sterilise and re-use. That is forbidden, but what can we do?''
Fathallah's colleague, Dr Hashim Al-Khayat, a general surgeon, is just as exasperated. He recounts how operations have been finished using kerosene lamps after power failures. ''We put orders in many times to the coalition forces and now to the ministry of health,'' he says. ''But it seems there is a shortage of money or donations to get equipment.''
For Dr Abdul Jabbars Al-Zubaidy, a paediatrician and director of a hospital with a major children's unit
in one of the poorest parts of Baghdad, the most serious danger is
malnutrition. ''I consider malnutrition is really a silent emergency,'' he says, enunciating each vowel. ''When a child got injured the ambulance sang 'wah, wah, wah', but malnutrition is silent.''
The doctors hope their trip to Scotland will begin to change things for their patients. In fact, one of the doctors, Dr Hassan Al-Najjar, a dark-suited cardiologist from the capital, is serious about delivering his thoughts to Tony Blair himself.
The medics were bought to the UK by the Royal College of Physicians and Surgeons of Glasgow to find out how treatment in their specialities has progressed while Saddam Hussein, sanctions and the war have kept equipment and medical advances out of Iraq.
For Dr Al-Zubaidy, the trip is of vital importance. Impish in build, with laughter lines running from twinkling eyes, he has the friendly manner you might hope to find in a paediatrician. Yet as he describes the area where he is based, Al-Sadr City - one of the poorest and most desperate in Baghdad - the anguish concealed behind the smile grows more apparent. Between apologies for talking too much, he cannot appeal enough for the UK to help the children in the neighbourhood.
''This area has suffered a lot from Saddam's regime because this area was against the regime,'' he says. ''The problems of the children in this area are worse. There is a poor water supply. Since the last war until now there has been no improvement regarding this point. There is poor sanitation and poor sewage disposal.''
He goes on to describe how the pipes and the pumping station have broken from neglect, so there are puddles of water and raw sewage lying in the overcrowded streets. ''I was assessing the problems of the city with an engineer,'' he adds. ''He told me, 'look doc, some of the water
network and sewage network, they are near to each other, so when there is a break there is a connection. (A leak from one to the other.) I got a surprise from that. How could this happen? He said, 'do not be surprised when there is diarrhoea'.''
Right now, being the summer, he says diarrhoea is affecting most of the patients in the 100-bed children's unit at Al-Qadisya Hospital where he works. Thinking of the suffering of Iraqi children during the war, it is the image of 12-year-old Ali Abbas, who lost his arms and whose parents were killed during the coalition bombing of Baghdad, which comes to mind. But what Dr Al-Zubaidy depicts
is a slower, yet perhaps no less painful, misery.
Everyone in Iraq receives basic ration packs, the doctor included, and he lists the ingredients, remembering rice, flour, oil, tea, sugar, soap and seeds. ''Most of the time it is not enough, especially for children and pregnant women,'' he says. ''You have to buy more. But sometimes the families have to sell some of their ration because they have low income; they are obliged to sell to get other things like clothes or shoes for the children.''
His suggestion is extra food parcels for pregnant mothers and children under five and special packs for those malnourished. ''I ask the British government or the Royal College in Glasgow or the Royal Hospital for Sick Children (Yorkhill) to help us to solve the problem of malnutrition, at least in my area,'' he pleas and offers his utter dedication to help make a difference in return.
The problem Al-Zubaidy and his colleagues face is that poverty in Iraq has increased the chances of injury just as hospitals are unable to cope. As the electricity supply has failed, so cooking on primitive stoves has increased, leading to more accidents with fire. ''We have plenty of face burns, hand burns, abdomen burns,'' says Fatallah, ''and lots of patients are children.'' Like other consultants, he cannot recall any individual's plight because there have been too many.
Another problem Fatallah has faced is the number of Iraqi children being born with facial deformities, According to Fatallah, the number of babies arriving with a cleft lip and palate has doubled. He says he had treated 75 cases by July this year, compared to 65 for the whole of 2003 - a rise he blames on the anxiety suffered by pregnant mothers amid the bloodshed. ''The war was in March last year,'' he says. ''We were expecting the problem to start in January and it did. Nine months after the war.'' Yet he is not against the invasion and still describes himself as ''grateful'' to the coalition for ending Saddam's regime.
Dr Al-Najjar reiterates that message. ''It was a very, very good thing for Mr Blair to insist on going to remove Saddam.'' he argues. ''Iraqis, they do not care about the weapons of mass destruction. They care about removing this dictatorship. One of my relations asked me to go to 10 Downing Street to give Mr Blair a kiss. He means it. I feel very sorry, because the British people, instead of saying 'well done, Mr Blair', they are turning against him.''
But he does not gloss over the problems. There are, he reports, three cardiac centres in Iraq for 26 million people. Scotland has 15. ''You cannot compare,'' he says of the health service in the two countries.
Yet, as he and his colleagues treat patients back home in the autumn, they will be only more aware what
is on offer to the sick elsewhere in
the world.
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