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The coronavirus might not be the worst of it
The Washington PostDemocracy Dies in Darkness

For an Iraqi doctor, vaccination is bittersweet. It didn’t come in time for her father.

An Iraqi man receives the AstraZeneca vaccine at a clinic in Baghdad on April 11. (Khalid Mohammed/AP)
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BAGHDAD — As the needle slipped through her skin, Tamara Amer opened her eyes as if waking from a dream. She had spent the car ride in a daze, thinking of her father and wishing he were with her. She had felt as if she were in shock.

And then, with the prick of the needle — cold on her warm arm — a rush of feelings came back, she later recalled. There was sadness, hope and bittersweet joy. After she had spent a year of hell working daily in Iraq’s coronavirus wards, her mind was filled with the faces of patients who had died there.

But most of all, she thought of her father, and how they had dreamed of this day, before the virus entered their home. Remembering him from her hospital chair in Baghdad last week, Amer burst into tears.

In Iraq, the arrival of coronavirus vaccines in recent weeks had given medical workers hope that a route out of the pandemic was possible. Instead, the caseload is peaking. The country’s Health Ministry recorded 7,817 new cases Thursday, close to a record high, with health officials predicting the daily number would climb as Iraq’s vaccination program stutters and prevention measures like mask-wearing and social distancing are often adhered to only loosely, if at all.

Among the newly vaccinated are legions of Iraqi health workers, who say they feel like they are watching from the sidelines amid widespread suspicion of the vaccine.

“People don’t believe in anything,” Amer said. “Even if you give them scientific facts, they don’t believe them.” She was vaccinated in a Baghdad clinic, along with her husband and his parents. Her side of the family did not join them.

Even before countries such as Spain and Italy moved to limit the use of the Oxford-AstraZeneca vaccine, citing unclear research on potential side effects, more than half of Iraqis interviewed in a recent World Bank study said they were unsure about, or against, signing up for vaccination.

Most of Iraq’s vaccine doses are from AstraZeneca.

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Health experts attribute the suspicion in part to pervasive public distrust in medical institutions after decades of government failure. More recently, they say, Iraqi authorities have undermined public confidence in the process and safety of vaccinations.

“Delays in receiving the first shipment of vaccines combined with contradictory statements from health officials no doubt undermined public confidence in the health authorities,” said Ali Al-Mawlawi, an independent Iraq analyst monitoring the vaccine rollout.

Iraq’s health system was on its knees even before the pandemic hit, hollowed out by decades of corruption and underfunding. The challenges during this pandemic have felt relentless, medical workers say.

The country’s vaccination program began in March, with the arrival of the first 50,000 doses of a vaccine from Sinopharm, donated by China, and then a shipment of 336,000 doses of the Oxford-AstraZeneca vaccine, received through a World Health Organization-backed global initiative to ensure equitable access.

The numbers pale in comparison with Iraq’s needs: The country’s population is 40 million. Yet a month into the vaccination drive, only 118,000 people have been vaccinated.

In the program’s opening days, Iraqis lined up outside medical facilities in a hubbub of chatter. They wondered: Would the shot hurt — or even work? What about side effects?

Those lines have reduced to a trickle. Inside Baghdad’s Mohamed al-Jawad medical center, Ghassan Mohammed, an orthopedic doctor now overseeing the facility’s vaccination program, counts only about 10 takers daily.

“Honestly, it hurts to see,” he said. “If we could only get everyone vaccinated. It would be the happiest day of my life.”

Amer’s 67-year-old father, Amer Ramadhan, had been diagnosed with cancer before the virus arrived in Iraq, and the first covid-19 cases in Iraqi hospitals coincided with his first chemotherapy appointment. Amer, an oncologist herself, could not bear the risk he might be taking by going to the same medical facilities as those who were infected.

So she went back to her books and learned how to do his chemotherapy herself. He hated staying at home, but she insisted.

In Amer’s telling, it was her father, a retired schoolteacher, who had encouraged her to become a doctor in the first place. “No matter what happened, he just believed in me,” she recalled. After late nights studying, he would buy her ice cream. When she finished her finals, they celebrated at Baghdad’s Mutanabbi Street book market, scanning the stalls as he taught her the avenue’s history.

When the cancer took hold, she banned visitors from the house and told her father not to see anyone. “He didn’t like it, but he was a good listener. He did really great,” she said. “For that whole year, I was just trying to save his life.”

He finished his treatment in August, and she thought she had succeeded. Weeks later, they realized a vaccine for the virus might also be possible. For Ramadhan, then on antidepressants as he struggled to cope with his isolation, it was finally a reason to hope.

In October, the WHO said Iraq would be among the first countries in the region to receive vaccines. But none materialized. As fall turned to winter, the coronavirus caseload rose again.

Then Ramadhan developed coronavirus symptoms.

When he was hospitalized, Amer could barely find a bed for him. “For a whole year I tried to save lives. But when my father died, I couldn’t do anything for him. I just watched,” she said, her voice cracking. “There was no medicine. There was no cure.”

When Amer arrived at the Baghdad health clinic last week for her first shot of the Oxford-AstraZeneca vaccine, the corridors there, and in medical facilities across the capital, were quiet.

Those who had signed up for vaccinations were often medical workers. Others were elderly. They reminded her of her dad.

Once it was done, she went straight back to work, knowing the hospital wards would be full when she got there. In the car, she pulled out her iPhone and, in a Facebook status, wrote a message to her father, and to anyone who might pay heed.

“Corona took you away from me before you had the chance to take the vaccine,” she wrote by a photo of Ramadhan, smiling quietly in his flat cap as she nestled her head on his shoulder.

“I just wanted to tell people; I wanted to them to know,” Amer said. “Just get the vaccine, please. You can save your loved ones.”

Mustafa Salim contributed to this report.

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