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In an Iraqi ER, Doctors Attend to Disaster

Rush of Patients Hints at High Civilian Death Toll

By Anthony Shadid
Washington Post Foreign Service
Sunday, December 12, 2004; Page A01

BAGHDAD -- It was morning, the skies tinted gray by a winter storm, when the station wagon careered toward Yarmouk Hospital. Crowds scurried from its path before it screeched to a halt at the emergency room. Desperately, the driver pulled the bloodied body of Firas Abdel-Hassan from the back seat, which was littered with broken glass. Then he crumpled to the ground.

For a few minutes, the driver, Mohammed Abdel-Jabbar, sat in the parking lot, embracing his friend's body and weeping as blood collected in a pool on the pavement. His wails drew stares from some in the lot. Others gazed at the car -- four bullet holes in the windshield, three side windows shattered by gunfire, blood smeared across the dashboard.


Medics carried Hazim Abdul Husain, 32, to Yarmouk after he was wounded in a roadside bombing on Wednesday. (Mohammed Uraibi -- AP)

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"Help me! Help me!" he shouted finally. "Can someone help me put him in a stretcher?"

A bullet had burrowed a gash across Abdel-Hassan's scalp. His left arm was twisted at an angle impossible in life. Blood soaked his gray shirt; his dark blue pants were still a shade darker. With practiced routine, and barely a word, nurses rolled his corpse into the emergency room, where his name was recorded as the day's first entry in the tattered register of patients.

"Arrived deceased," it read.

"This is the grimmest shift," Luai Rubaie, a physician at the hospital, said as he settled into work. "You haven't seen anything. It's just the beginning."

He shook his head, as if uttering what was self-evident. "Day and night," he said.

Rubaie, a stocky man with a gentle face, displayed both the detachment of a physician and the anguish of a man whose country seems cursed by far too frequent deaths. Figures on civilians killed in the relentless violence in Baghdad and other restive regions are hard to come by, however. A report last month in Lancet, a British medical journal, said that at least 100,000 Iraqis may have been killed since the U.S. invasion in March 2003. A research group called Iraq Body Count put the number at a fraction of that -- probably 14,600 to 16,800.

The numbers vary widely for a reason: lack of information. The Lancet study based its numbers on a survey of 33 neighborhoods in Iraq; Iraq Body Count relies on media reports. For months, an authoritative account was provided by the Iraqi Health Ministry, but it quit publicizing the toll in the fall. It reported 3,853 civilians killed from April 5 to Oct. 5.

Rubaie knows the numbers only at Yarmouk, one of Baghdad's largest hospitals, located in a neighborhood with its own share of kidnappings, shootings, car bombings and armed clashes. He sees maybe 100 cases a day, twice as many as before the invasion in March 2003. Back then, he estimated, one in 1,000 was a victim of gunfire. Now half the cases are the consequence of the city's strife.

"It's a museeba," Rubaie said -- a disaster.

'It Was Just Banditry'

Abdel-Hassan was the doctor's first case in a six-hour shift that began at 8 a.m., and there was nothing he could do. Blood from the dead man's scalp dripped from the black leather stretcher to the grimy tile floor. A green sheet was draped over the body, then pulled over the head. Abdel-Jabbar tried vainly to pull a ring off one finger. Another friend splashed a cup of water over the dead man's right hand, loosening the ring. A nurse then tucked the limp arm under the sheet, blood already seeping across it.

"It was just banditry, right out in the open," Abdel-Jabbar said angrily, lighting a Viceroy cigarette in the emergency room.

"I swear, next week I'm going to leave the country," muttered Uday Nsayyif, another friend of the deceased man.


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