Healthcare before and after 2009 in Ashraf
It is noteworthy to emphasize that the public health standards of former Ashraf residents were at the attainable quality of healthcare offered in Iraq before 2009. The camp residents used to enjoy free access to medical services and facilities and they managed a private hospital of their own inside their former camp (Camp Ashraf), self-contained and fully equipped with spiral CT-Scan, ultra-sound, laparoscopy, ophthalmic laser, radiology, orthopedic surgery, neuro-surgery, lumbar surgery, eye surgery and eye microscope, etc., as well as medical referral services and ensured availability of life-saving emergency services.
In 2009 an all-out logistical and medical blockade of the camp was initiated by Iraqi Army forces under the command of al-Maliki who started implementing an Iranian agenda.
Healthcare in Camp Liberty
In 2012 the residents were forced evicted from Camp Ashraf to Camp Liberty and the Government of Iraq blocked the transfer of the resident’s medical resources (equipment and supplies) to Camp Liberty leaving the residents’ doctors with no resources and capabilities to diagnose and treat or conduct surgery inside the Camp. Thus the camp healthcare system became totally dependent on what was offered by the very same government that had planned and perpetrated the attacks and incursions on their camps.
The current system is nothing but a substandard trivial primary care in a tiny Iraqi infirmary. In this infirmary only a general practitioner (GP) diagnoses the patients daily. There is not enough medicine. There is no emergency medicine and facilities and the GP’s job is just to refer the patients outside the camp. He only issues referral papers for incoming patients.
Since the Iraqi officers in charge of the camp are the very perpetrators of previous attacks on the residents, currently under the guise of “Iraqi camp management”, the patients are facing daily harassment before and during their trip to Baghdad hospitals. Access to specific physicians and medicine, the confidentiality of physician-patient relationship or the right of patients to have interpreter and accompanying nurses when needed, are frequently violated. Hospitalization of patients and purchase of medicine have been prevented in some occasions. Other examples of daily harassments include cancellation of medical appointments, delayed transfers of patients to hospital, or denial of permission to travel outside the Camp to receive treatment.
Methods used to deceive the UN monitors
Moreover, after patients receive the referral papers, the Iraqi camp management decides who goes to hospital or not or at what time he or she is permitted to exit the camp. Since the camp in under monitor by the UN monitors, in order to enforce this arbitrary blockade and simultaneously deceive the monitors the Iraqi management of the camp employs three methods:
a. The Iraqi government claims officially 4 to 5 patients can exit the camp to visit specialists at Baghdad hospitals! (Setting quota itself is a violation of the right of access and is in defiance to UNHCR call on the Iraqi government regarding residents’ certain right to freedom of movement). Nevertheless, every day the guards at the gate delay the departure of those permitted to exit the camp for long hours. As a result the patients reach the hospital after business hours when the hospital is already closed or is about to close. Consequently they return without being visited by the specialist or performing their Para-clinical examinations.
b. The second method is the omission of the patients’ interpreters. After all the impediments at the camp’s checkpoint if four patients arrive the hospital with the little time left then they face another obstacle since they only have one or two accompanied interpreters to translate for all with no ample time available. Subsequently 2 out of 4 patients generally return without having the chance to speak with their doctor.
c. The third method is limiting the number of hospitals to one for a group departure. Therefore if one patient is going to a hospital for chemotherapy and another patient has a corneal graft at an eye hospital one should sacrifice his\her appointment for the sake of the other.
It is worthy to mention that when a patient misses an appointment at secondary or tertiary care normally it will be postponed for minimum of 2 months period, depending on the specialty. During such period of time, the patient’s health is deteriorated and in some cases, reaches an irreversible stage.
The outcome of the ongoing Medical Blockade
The outcome of this Medical Blockade, taking into account the span of almost 6 years, can be outlined into the following facts and figures:
• 27 patients died due to lack of free access to vital medical services up to December 2015;
• By the end of 2014 the restricted access to secondary and tertiary care services outside the camp had piled up approximately thousand patients who had already received official referral forms from the GP at the Iraqi clinic inside the camp for an appointment with a specialist in Baghdad hospitals;
• The blockade also applies to the entrance of pesticides, bactericides and chemical disinfectants which has added to the Camp’s already existing hygiene deficiencies.