4Basra

The article below was a diary piece for the Sunday Times (Irish edition) published in October 2012 (this is the original piece – published article was slightly different due to editing.)

John Reynolds Sunday Times Oct2012 (opens PDF document)

AS a part-time freelance business journalist, many of the Irish businesspeople I speak to in the course of my work are often on a plane or just getting on one when I contact them.

This week though I’m notching up a few air miles of my own to attend a TedX conference in Baghdad followed by a few days in Dubai to meet some supporters of my charity project 4Basra.

I’m interested to meet a few of the TedX speakers while also seeking inspiration for potential social business ideas that might generate funds for my Vienna-based colleague who organises life-saving operations in Europe for children from Basra.

Amongst a United Nations of passengers on the Emirates flight from Dublin – which makes for interesting people-watching as we board the plane – the service, food and attention to detail on it and the Dubai-Baghdad journey are all the more noticeable compared to the more workhorse, shorter flights that our island relies on.

ROUTE IRISH

THE Iraqi capital’s airport has seen better days and although an official from the Prime Minister’s office whisks me past my fellow passengers through a fast-track route, their efforts are unfortunately hampered by a 45-minute wait for the suitcase I had checked in.

We then take “Route Irish” (a title immortalised in a film by Ken Loach) in their Land Cruiser, passing workers who are landscaping the central reservations and verges of the road from the airport towards Baghdad city centre which was the scene of so many bomb attacks up until around 2006.

While it may now be safe, the following day two bombs explode beside a market in the Khadimiya district, killing 11 people and wounding 38 more.

Unable to find the location of a meeting where a group of students experimented with a 3-D printer, using it to design a logo and then print a three-dimensional mock-up of it, I organise a lift for the following afternoon with a friend of the organiser.

Declining my offer to contribute to his next fill-up, engineering student Mujtaba takes an indirect route through numerous checkpoints and several different parts of the city so we can drop off three of his fellow students who have also availed of a lift. We also collect Susu, the only female member of the group.

Zawra Park in the city centre is where I meet US-based Iraqi Bilal Ghalib who is behind this project, which aims to inspire young people to nurture their creative minds by experimenting with software, art, materials and gadgets.

We take panoramic photos to hopefully be uploaded to Google Streetview, so that the wider world can see there are playgrounds, fast food and toy stalls, boating lake and a zoo here and that Baghdad isn’t just about bombs and checkpoints.

After joining the group for a ride on the park’s Ferris wheel with views over the city as the light fades, the group lark around and strike various poses taking dozens of photos of each other. “We’re taking so many because we don’t have very many happy memories,” says Layth, a TedX volunteer who is studying medicine.

THE GREEN ZONE: TEDXBAGHDAD

TEDXBAGHDAD takes place in the heavily fortified Green Zone and the 700-strong audience is particularly enthralled by a youth orchestra, microphotographer Ghaith Salih, three young orphans-turned-musicians and artist and cancer survivor Mahdi Al-Mualim who uses candle smoke in his drawings.

One key message is that Iraq needs young skilled people to stay here and leaders who want to help their country: half its population are under 18. Perhaps that means people like Bilal, many of whose group seem to look up to him.

A thought-provoking talk by Matteo Montevani describes how climate change is causing worsening droughts in Iraq: “Agriculture is dying in the place where it was born.” Historians believe the first farming and seed cultivation took place in Mesopotamia – known today as parts of Turkey, Syria and Iraq.

One of the conference speakers is interested in visiting the hospital I help in Basra with a view to helping improve its budget for, and access to, vital medicines. Several people express an interest in my project and ask me to email them my details.

Another of the TedX volunteers tells me that Iraq needs and wants new ideas and ways of thinking, but that it’s sometimes very difficult when there’s so much bad news about bombs and terrorist attacks.

THE following day takes me to a US compound in the centre of the city to meet with managers of small business grant-making and healthcare USAID projects.

After lunch there with Ray Mendenilla and some of his colleagues, the healthcare project manager offers to continue talks about helping in various ways.

On reflection, it’s been an eye-opening visit. The young Iraqis in particular that I met were great ambassadors for their country.

I can’t help think Ireland should be reaching out more to Iraq and the other countries in this region. We’ve done it before: we used to manage the Ibn Al Bitar Hospital in Baghdad and train Iraqi doctors there in the 1980s.

The updated film from my visit to Basra last May is on: http://vimeo.com/45064203

4Basra is a partner of the Aladdin’s Magic Lamp Project – a Vienna-based charity that has been supporting the Basrah Children’s Cancer Hospital in the city of Basrah in southern Iraq, and which brings children from the region to Europe for life-saving medical treatment.

The Campaign for Children’s Health in Iraq has evolved into a new project – in which 4Basra is not currently involved - focused on improving medical care for children with cancer at a teaching hospital in Baghdad Medical City.

Meanwhile the efforts of 4Basra continue – focused on assessing the current conditions in Basra Children’s Cancer Hospital (and ideally the Basra Materntiy & Children’s Hospital) and seeking strategic partners to help to improve these services and build capacity.

IN May of last year I travelled to Basra with film-maker Dearbhla Glynn in order to visit the two hospitals supported by the Aladdin’s Magic Lamp Project.

A report written shortly after our return was published in the Irish Times.

A film from the trip will be completed in the next month or two, with the aim of attracting support specifically for the children’s cancer hospital in Basra from a number of people and organisations.

In the meantime, below is a ‘promo’ film featuring short excerpts from the film, edited by Cara Holmes and Dearbhla Glynn:

BASRA 2011 from CARA HOLMES on Vimeo.

By JOHN REYNOLDS

BUSINESS is booming for faith healers in Basra, according to Dr Akeel Al-Sabbagh, senior lecturer at the city’s Medical College and Director of the region’s Mental Health Council.

“Since the second Gulf War ended in 2003, there are thousands of them here, charging patients as much as 10 times what it would cost to see a doctor. It’s supply and demand. They realised the demand was there, that people had the money to pay for what they do, so more and more of them took the opportunity to profit from the situation,” he says.

Almost one in five Basrawis – 17 per cent of the city’s population – are suffering from trauma, or post-traumatic stress syndrome (PTSD), to give its medical name, according to figures from the World Health Organisation. “But I suspect the true figure is higher than that,” Dr Al-Sabbagh affirms.

Before seeking treatment at his clinic, most patients visit faith healers hoping that they will drive the ‘spirit’ they believe is causing their anxiety and mental illness out of their body.

“Sometimes the healers will hit them. I’ve had patients coming to me with facial injuries, bruises, fractures, broken bones, and even burns.

“While many had always been superstitious to a certain extent, most poorer and uneducated Basrawis became even more so after the war. Many believe in ‘Djinn,’ -the Devil – and his ability to enter their bodies unseen and harm them in all kinds of ways from within.”

He sees up to 80 patients a day – mostly children and mothers – and a significant increase from before the war, when he saw about 60 a day.

Many children from the region who have cancer also suffer from depression, have nightmares or have general trouble sleeping.

“I also see children who have become irritable due to their illnesses causing them to hit their siblings or lash out at other family members,” he adds.

Among his adult patients are those who were tortured by the police or by Saddam’s forces in the past. Some hear voices; others develop obsessions or start to hallucinate. Others with anxiety or other mental scars were the victims of kidnapping or had threats made against them.

However, there are very few psychiatrists in Iraq and virtually no psychologists at all in Iraq. There are only four in Baghdad, with a population of 5 million. In Basra, there are only two. There are only 18 beds for mental health patients in the city, which are always full, and no separate beds for children or teenagers.

Although the government now aims to rebuild the ruined mental healthcare system, there is still resistance to the idea of psychotherapy and treatment through talking to patients. Some of Dr Al-Sabbagh’s peers believe drugs or electroconvulsive therapy are more effective.

“Iraqi doctors don’t generally believe in psychiatry and psychology. The position of psychologist or even social worker is not recognised by the Ministry of Health.

“There is no college for psychologists anywhere in Iraq, you can’t take a degree in psychology here, and no-one wants to become a psychologist in Iraq,” he says.

At country’s first multidisciplinary clinic for PTSD in Basra, which is supported by Save The Children and where Dr Al-Sabbagh works as a consultant psychiatrist, a psychiatrist, a community health doctor, a social worker and a gynaecologist are leading a joint effort that involves deciding on the best form of treatment after taking all of a patient’s circumstances into account.

While the aim is to roll out more such clinics will be rolled out across the country, Dr Al-Sabbagh and his colleagues acknowledge that it will take many years before the system can effectively treat the post-war legacy of trauma and anxiety that remains among Iraq’s people.

In addition to Save The Children’s support, other help from outside the country is slowly making a difference. Last year, 360 primary-care doctors took two-week crash courses in depression, anxiety, psychosis and other afflictions, using a curriculum developed in London for Nigeria.

Danish and German NGOs have also been working in Iraq for the past three years to introduce doctors and social workers here to the merits of cognitive behavioural therapy.

Meanwhile, later this year additional multidisciplinary teams of Iraqi medical staff will train in the US through a programme that Dr Al-Sabbagh first became involved with in 2008 after forging links with counterparts in Boston.

Nevertheless, it may take some time before there’s a downturn in the questionable trade being plied by faith healers in Basra and elsewhere in Iraq.

John Reynolds visited Basra with award-winning Irish film-maker Dearbhla Glynn.

Thanks to Save The Children for their assistance. (savethechildren.org)

THE airy, bright and modern corridors of the new, $166m 101-bed Laura Bush hospital for children with cancer are a short car journey from the colourfully painted, but aging Ibn Ghazwan maternity and children’s hospital in the southern Iraqi city of Basra.

They provide a rare contrast to the greyish, brown city streetscape, whose dusty, fume-filled air – some of the most polluted in the world – will reach 60 degrees Celsius this summer.

Brightness and colour might inspire initial hope in the minds of concerned parents here, but both hospitals still lack vital machines and laboratory equipment needed to provide radiotherapy or to diagnose the numerous conditions that see up to ten babies die every day in the Ibn Ghazwan maternity ward.

“We are blind,” says Dr Ahmed Jafer, a paediatric specialist. “Ours is the only neo-natal unit in this region but we cannot quickly diagnose what exactly we are dealing with. Children are dying from malnutrition, diarrhoea, TB, meningitis, leishmaniasis, chronic liver disease, pneumonia, anaemia and congenital heart disease, all of which are easily preventable outside of Iraq.”

Add to this the high occurrence of miscarriages, up to 40 abortions every week, child leukaemia rates that more than doubled here from 1993 to 2007 and the weekly number of tumours and congenital deformities – missing eyes or limbs for example – that children are born with and you only begin to get a sense of the scale of the horror that has been visited on Basra’s children – and on many more across Iraq – since UN sanctions against Saddam Hussein began during the first Gulf War in 1991.

Dr Jafer and his colleagues may be metaphorically blind, but two year-old Abu Felah Reyal’s blindness – in his right eye, over which an enlarged tumour has developed – is very real. He has been undergoing chemotherapy at the Laura Bush hospital, many of whose patients are from Missan City, Zubair and Nasariyeh, which are south of Basra, near the border with Kuwait.

Four-month old Mustafa Farej, whose liver tumour has left him with an enlarged abdomen, has also had aggressive chemotherapy. He now has a chest infection and the expression on his face looks pained even as he sleeps on a bed in a quiet corner of the ward.

Large stickers featuring the happy smiling faces of Disney characters – Goofy, Mickey Mouse, Donald Duck and friends – adorn the walls, witnesses in a slightly surreal way to the fate of the patients here.

Senior and frontline medical staff say chemical weapons, including those featuring depleted uranium (DU), were used extensively in the border region during both the Iran-Iraq and both subsequent Gulf wars. Their poisonous legacy will continue to take the lives of children for years to come.

“You can find evidence of the effects of DU in patients’ urine, or you can do biopsies and establish a link, but we don’t have the facilities to do this. We have little doubt that DU is linked to the rise in cancer and deformities. We’re also seeing a rise in infertility in men and women, which is a concern,” says Professor Thamer Hamdan, Dean of Basra Medical College.

It costs over $200,000 (€139,000) to treat a child for Leukaemia. At the Laura Bush hospital, 80 per cent of the cost of the expensive medicines is met by the Aladdin’s Magic Lamp Project – a small Vienna-based charity – and its European partners. At the moment, the Iraqi government, through Basra’s local health authority, covers the remainder.

Save The Children and their funding partners are also providing assistance here, through teacher training, education, psychosocial, capacity-building and school water and sanitation schemes.

But senior medical staff in Basra also point to a shortage of people with the leadership and management skills that can be passed on to assist the improvement of the health, water and sanitation infrastructure.

Visiting one of Save The Children’s colourful ‘child-friendly spaces,’ about 40 boys and girls from the locality – who are usually segregated in school -  are playing and laughing together in a classroom about an hour’s drive towards the marshlands outside Basra,.

Thought to be the location of The Garden of Eden, the marshlands are a splash of green on Iraq’s dull landscape and in Chibaysh, in the midst of the reeds growing all around, tadpoles, sticklebacks, birdlife and buffalo appear to be thriving thanks to government and community regeneration efforts.

As we pass a tall, newly built concrete pier beside a community reservoir, some children are jumping off it, into the waters of one of the many irrigation channels of clear, pale-greenish water that criss-cross this vast area.

Splashes and laughter might be the everyday sounds of a normal childhood. But while a poisonous legacy of past wars also exists here, they are sounds that all too many of Iraq’s children, like Mustafa and Abu, may never know.

John Reynolds visited Basra with Irish film-maker Dearbhla Glynn.

Thanks to Save The Children for their assistance. (www.savethechildren.org)