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Wounded Iraqis Left Broken and Burdened
With Medical Facilities Strained, Assistance Is Hard to Come By

By Jonathan Finer and Omar Fekeiki
Washington Post Foreign Service
Thursday, June 2, 2005

BAGHDAD, June 1 -- On a steamy June morning two years ago, a U.S. soldier's warning shot ricocheted off a sand berm and blew a hole in Raez Habib's life.

The stray bullet plowed through the meat of his left thigh and shattered his right femur, leaving him bleeding in the street, Habib recalled in a recent interview. A helicopter took him to a military hospital, where doctors amputated his right leg four inches below the hip.

The shooting was an accident, a tragic case of being in the wrong place at the wrong time, according to Habib and to statements from four U.S. service members who were at or near the scene, which Habib keeps in a tattered manila folder. He soon lost his job as a builder, because he could no longer carry heavy loads, and moved his family into his mother's three-room clay house.

Deaf since birth, Habib, 35, communicates through muffled groans and hand signals. "I have a wife and three children and no way to provide for them," he said, his fingers clenching the fabric of his long white robe as his younger brother Ghassan translated.

"We don't think about who to blame. It was his destiny," Ghassan Habib said. "It happened. We take care of him. That is all."

The U.S. military keeps a meticulous tally of its wounded -- 12,762 in Iraq as of Wednesday, along with 1,658 dead. Scenes of soldiers convalescing at well-equipped hospitals such as Washington's Walter Reed Army Medical Center are familiar symbols of the human cost of the war.

But more than two years after the U.S.-led invasion, there is little available data on the far greater number of Iraqi civilians wounded in the invasion and subsequent violence related to the insurgency. And few of the victims' stories have been widely reported.

While attacks on civilians are increasing, the wounded are getting little help from overburdened medical facilities, according to interviews with more than a dozen patients, physicians and health officials in Baghdad. The best rehabilitation hospital in the Iraqi capital is running out of artificial limbs and might soon close, its director said. And most of the wounded fall back on the only support network they have: their families.

Attempts to quantify civilian casualties here have largely focused on the number of dead, not the wounded. A widely criticized study by an international group of university professors released in October estimated that the invasion had caused 100,000 civilian deaths. At least 21,940 civilians have been reported killed in news stories, according to a database compiled by the group Iraq Body Count, which does not track the number of wounded.

"It is very difficult to give numbers, even roughly, because when we ask the Ministry of Health, they never tell us. For political reasons and some unknown reasons they don't give these numbers out," said Mazin Abdullah Salloum, general secretary of the Iraqi Red Crescent Society. "It doesn't help them to show the reality."

After a long period of not reporting casualty figures, the Iraqi Health Ministry said Wednesday that 775 civilians were wounded in May, compared with 598 in April.

Many of most seriously injured end up at the Rehabilitation and Rheumatological Center, on a leafy campus in northern Baghdad. A decade ago, most of its patients suffered from polio, vascular disorders or such diseases as diabetes that sometimes require amputations, according to its director, Emad Khudair. Today, more than two-thirds are trauma patients, he said.

At the rear of the facility is the rehabilitation center and prosthetics workshop, where Thamir Aziz, a physician, oversees about 40 technicians who craft arms and legs out of aluminum, plaster and polypropylene. His warehouse's shelves are stocked with artificial body parts: hands and feet of varying sizes, titanium knee and elbow joints, and aluminum shafts that will become limbs.

"Most of our equipment was looted during the invasion, so we do the best we can with what we have," Aziz said in a recent interview. "We have pages and pages of people waiting for prosthetics, most for at least five months."

For almost two years, the facility and Iraq's Health Ministry have been unable to import raw materials and manufactured parts for prosthetics from the French and German companies that make them, Khudair said.

Some doctors blame a financial dispute with the companies over an order that did not meet specifications. Others, privately, blame government corruption or say it has become much more difficult to obtain technical equipment because most humanitarian aid organizations have withdrawn from Iraq, concerned about the security risk.

Whatever the explanation, with supplies dwindling and about five new amputees arriving daily, Khudair said that unless a new shipment shows up soon, he will be forced to close the prosthetics wing in less than two months.

"I always imagine: What if this happened to me? Where would I go if I lost a limb and this hospital can't help me?" Khudair said. "It is a very hard situation. Our patients need our help and we cannot give it. I don't want to close the workshop, but what else can I do?"

In a nearby rehabilitation room, Ali Majeed grimaced each time he shifted weight from his sinewy left leg to the aluminum and plastic prosthesis that runs between his right hip and the ground. He paused to catch his breath, his arms draped over a pair of metal railings, as a hospital technician helped him shuffle a few more steps.

Majeed, 40, with close-cropped salt-and-pepper hair, said he was carrying a bag of groceries home in the Baghdad neighborhood of Shuhada last October when a gunman in a passing car sprayed his lower body with bullets.

"I don't have a problem with anybody, so I don't know why it happened," he said. "But the situation in this country makes you exposed to danger, even if you are just out for a walk near your home. You hear shooting wherever you go."

He and his family recently moved in with his wife's parents. "People help us. Our relatives help us. But I used to live in my own house," he said. "I am a different person now. To think I can't help my family or be there for them troubles me always. There is a lot of pressure in depending on other people."

Nearby, Hussein Abbas hops on his one remaining leg to maintain his balance. Once a welder, he said he now has trouble standing for long periods and has not been back to work since last May, when shrapnel from a rocket-propelled grenade shredded his left leg from his ankle to his thigh.

It happened during a power outage on a hot spring night, he said. He went to sleep on the roof of his home in the city of Iskandariyah, 40 miles south of Baghdad. Hours later he woke to sound of men attacking a police station across the street. They were in kaffiyehs, the Arab scarves worn by some insurgents. As Abbas scrambled inside his house, a grenade exploded a few yards away.

Attacks targeting civilians have increased more than fourfold in the past month, Iraqi Defense Minister Sadoun Dulaimi said at a news conference last week. U.S. and Iraqi officials have argued that the increase, and a decrease in attacks on so-called hard targets such as security forces, show that the insurgency is weakening.

"When the terrorists lost their ability to target Iraqi and coalition forces, they headed toward civilians," Dulaimi said. "This indicates their weakness and says they are losing."

Almost two years after being struck by the warning shot, Habib is still waiting for a prosthetic limb. He got one two months ago, he said, but returned it because the knee joint did not bend properly.

For many months after the shooting, which took place near the city of Balad, about 50 miles north of Baghdad, his family asked the U.S. military for financial help but was rejected several times, Ghassan Habib said. The military here pays restitution to the families of those deemed mistakenly killed or wounded by U.S. forces.

Letters that Raez Habib carries from service members familiar with his case shed light on his story. (None includes a unit designation, but the military's press office in Baghdad said the Army's 3rd Battalion, 67th Armor Regiment, 4th Infantry Division, based at Fort Hood, Tex., was responsible for Diyala province, where Balad is located, during the summer of 2003.) Habib spent almost a week in the Army's 21st Combat Support Hospital in Balad, according to a note signed by Maj. Beverly Beavers, the hospital's operations chief.

He was eventually transferred to an Iraqi hospital in town, Capt. Dillard W. Young wrote on July 13, 2003, adding that Habib needed "help with his medical payments."

Two other notes discuss the difficulty his family had in getting money from the military. An undated note signed by Lt. John M. Noga and addressed to "Claims office personnel" says, "I can't get a clear answer as to why this claim was kicked back."

"We want to know the reason for not paying this claim," Staff Sgt. Joseph Messenger wrote on Feb. 21, 2004, about eight months after Habib was shot.

Last March, the military paid Habib $1,000 in restitution, his brother said, but that money has been spent.

He and his wife and their three children are among 18 family members who share a three-room house in Balad Ruz, about 50 miles southeast of Balad. A visit there revealed it had just one bathroom; a single light bulb dangled in each room.

After Habib was injured, his two brothers left school to get jobs, and his mother, Majdiya Abbas, started baking and selling bread for extra money to feed her family. She will also pay the $100 for his new prosthetic and his cab fare to Baghdad to pick it up, Habib said.

"We have to play his role as a father. That's our job now, my job and his wife's," said Majdiya Abbas, 61. "He was our provider. He cannot be useful to us or to the world anymore."

Special correspondents Bassam Sebti in Baghdad and Falah Hasan in Balad Ruz contributed to this report.

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