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For Iraqi Soldiers, A Medical Morass

Limited Options

When the new Iraqi army formed in 2003, Massen was among the first to sign up. He loved working with American soldiers and was thrilled with his job as a .50-caliber gunner. Catching suspected insurgents and liberating hostages was exhilarating.

That ended after the bombing in February. Because he was with an American unit, Massen was rushed to the U.S. military hospital in the Green Zone, called Ibn Sina. According to his medical report, doctors quickly amputated his left leg above the knee and two right toes. "The electric saw was used to flatten and bevel the bone," the report reads. "The toe amputations were done without complication."

Twenty-two hours later, the report says, Massen was stable enough to be transferred to Medical City, a sprawling complex in central Baghdad. Quick dismissals are routine at the 74-bed Ibn Sina, where officials say they keep unstable Iraqi patients as long as possible but must maintain space for the next wave of casualties.

Massen's two brothers followed his ambulance in their car with their guns ready -- insurgents are known to ambush ambulances carrying soldiers, they said. An hour later, Massen's brothers took him to Kadhimiyah Hospital, which they felt was safer.

But it was dismal, Massen and his two brothers said. They said there were few doctors, so they hired a private physician to stitch up Massen's stump, which they discovered had not been fully closed. Relatives scrubbed Massen's room daily, because no janitors came. The hospital did not have the painkillers and antibiotics Massen needed, so family members bought them -- at $15 a day -- from outside pharmacies. They had to "tip" a nurse $6 a day to administer injections and clean Massen's wounds.

"We had to buy him everything," said Massen's brother, Ali Mizher Massen, 37. "Starting with the water, the juice."

After 11 days, Massen went home, where he says he has continued to spend all his salary on treatment. His other brother, Ibrahim Mizher Massen, 32, said he sought aid at the Defense Ministry and was told requests for reimbursement must start at a soldier's unit. The unit sent him back to the ministry, he said.

"You know the bureaucracy -- this is all time and money," he said, sighing. "We gave up."

Still, Ali Mizher Massen keeps a neat spreadsheet tallying his brother's medical expenses, in hopes they might eventually be reimbursed. Among the items are 120 gauze bandages, 10 tubes of ointment and three surgeries.

Red Tape

Brig. Gen. Samir Hassan, surgeon general for Iraq's Defense Ministry, said that public hospitals are supposed to be free and that soldiers can be reimbursed for private services that are unavailable publicly. But he said public hospitals often do not restock medicines because their supply warehouse is in one of Baghdad's most dangerous districts. And the military does not yet have a solid system for compensation, which must be collected in person, he said.

"Certain people can reach us and we can pay for some of them, and others, it's very difficult. There is no exact policy. We are in the process of that -- how to refund, how to reimburse the soldiers," Hassan said, though he insisted his office, in the highly secured Green Zone, is open to soldiers who need help.

The system has progressed in the last year, said Hassan and Col. Amir Adolphe Edward, a U.S. Air Force surgeon who works with Iraqi security forces to improve health care. Last year, Hassan said, the prime minister's office approved $23 million for a military hospital in Baghdad. But the funds have been stalled by financial analyses and bidding, and Hassan predicted the hospital would not open until 2008. A temporary field hospital in central Baghdad could open within six months, he said.

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