Violence Invades Baghdad's Emergency Rooms
Seeking Priority Care for Their Wounded, Iraqi Soldiers, Police Attack Physicians

By Saad al-Izzi
Special to The Washington Post
Sunday, May 21, 2006

BAGHDAD, May 16 -- On a bad day in Baghdad's busiest Iraqi ER -- and they're all bad -- the men wielding AK-47 assault rifles and pistols can outnumber the men and women with scalpels and stretchers 2 to 1.

"Help us out here!" called a blood-soaked man who had hauled his third pickup-truck load of dead and wounded men and women from a recent market bombing to the emergency room at Yarmouk Hospital.

But armed Iraqi soldiers in camouflage and flak vests ignored the plea. Instead, they hustled comrades wounded in a clash with insurgents into the already crowded ER, where gunmen in civilian garb had brought their own bleeding friends.

"We have no problems with pistols and AK-47s, but sometimes they come with their bigger machine guns into this small ward," Nail Ali Hussein, a pediatric surgeon turned trauma specialist, said as he made his way around four Iraqi soldiers in battle gear clustered around a comrade with a chest wound. "A scratch," Hussein said dismissively of the injury.

Located in west Baghdad, the bloodiest half of the Iraqi capital, Yarmouk has coped for three years with an unrelenting daily stream of wounded, dying and dead. The U.S. emergency room depicted in the HBO documentary "Baghdad ER," airing for the first time Sunday night, does similar work for wounded U.S. military personnel and Iraqi civilians, but compared to this one it's secure and well equipped.

"All the hot spots are around this hospital," Hussein said. By the end of his 8 a.m. to 4:30 p.m. shift, he had treated about 100 patients, he said -- a normal work day, but "an indescribable burden."

Even in a Baghdad ER, some suffering stands out. For Hayder Ibrahim, a colleague of Hussein's, memories of Sept. 30, 2004, are among the hardest to shake. That day, bombers targeted an inaugural ceremony for a water treatment plant, striking just as U.S. forces handed out candy and cake to residents.

"I remember that day not because of the numbers, because sometimes we receive even more, but because they were all children," Ibrahim said. Yarmouk's ER was filled with some of the 35 children who were killed and 60 who were wounded.

For many medical workers, it's too much to take. Hundreds of physicians have left Iraq, fleeing not just the general violence but also those who attack them in an apparent attempt to destabilize the country by driving out its professionals. Physicians who stay face abuse by Iraq's security forces, who often demand priority -- and miracles -- for wounded troops and police.

"They think that everyone wearing a white coat can bring people back to life, even if they are shot in the head and their brains are out," Ibrahim said.

Employees at Yarmouk staged a two-day strike in March to protest the abuse. They described beatings, manhandling and insults by overwrought police officers and soldiers.

"Sometimes we overlook some of the violations, but other times they cross the line by starting to beat the doctors, and even start shooting inside the ward," Hussein said.

Partly as a result of the strike, the Interior Ministry assigned a force to guard the hospital. The Health and Interior ministries jointly agreed to post security units with heavy machine guns outside hospitals to protect medical workers, said Adil Muhssen, a physician who is general inspector at the Health Ministry.

The two ministries also pledged an investigation into attacks by Interior Ministry security personnel on doctors and nurses at the hospital.

"Unfortunately, the brothers at the Interior Ministry only did half of what they are supposed to do in the agreement," Muhssen said. The ministry was slow to post guards outside hospitals other than Yarmouk, and the promised investigation has yet to happen, Muhssen said.

Nouman Hospital in the embattled Sunni Arab neighborhood of Adhamiyah has fallen prey to the violence.

Earlier this month, men in civilian clothes with standard-issue police pistols entered the hospital, identified themselves as Interior Ministry forces and demanded that one of their wounded be treated ahead of other patients, said Mostaffa Mohammed, a member of the Facilities Protection Service of the Health Ministry. Forcing their way into an X-ray room, the men shot a hospital worker in the leg, Mohammed said.

Protection service guards took the men's weapons and called the Iraqi army, which detained the men, authorities said. But that night, the gunmen returned with the soldiers who had detained them, beat hospital workers with rifle butts and took away two hospital guards and a morgue worker, the hospital said. None of the three has been seen since.

Medical workers at Nouman declared an immediate strike.

"We can't run a hospital without a protection force," said Samir Adil, an emergency room physician there.

Adil and other physicians eventually ended their strike but now refuse to wear their medical gowns, hoping to avoid being singled out for abuse. The hospital's guards carry guns but wear civilian clothes for the same reason.

One thing Baghdad ER doctors don't do, they said, is turn away the wounded.

"We treat soldiers, holy warriors and even terrorists," Ibrahim said. "We made an oath to do our best, and it is not our business to judge people."

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