LIANE HANSEN, host:
President George Bush, Vice President Dick Cheney and Defense Secretary Donald Rumsfeld traveled the country this past week, carrying words of optimism, that the military and political situation in Iraq remains tenable. As they spoke, militants fought one another and bombed civilians in one of the worst weeks of carnage since the U.S.-led invasion of Iraq more than three years ago. By the end of the week, the Pentagon acknowledged in a report mandated by Congress that sectarian violence had reached new levels, with nearly 120 Iraqis killed every day.
Hospitals around Iraq have become overwhelmed by the casualties and by fighting that spills into their corridors. One Baghdad hospital that specializes in treating cardiac patients has endured wars and sanctions, but it may not survive the U.S. occupation. Death threats and the constant fear of kidnappers have driven all but 15 of its doctors away.
And as NPR's Corey Flintoff reports from Baghdad, heart patients now face a waiting list that can stretch as much as four years. So treatable heart problems can mean death.
COREY FLINTOFF reporting:
Dr. Athir Bakr al-Ansari(ph) is head of surgery at Baghdad's Ibn al-Bitar Hospital. He's a highly qualified heart surgeon and a devoted family man, but there are things he's not telling his wife.
Dr. ATHIR BAKR AL-ANSARI (Ibn al-Bitar Hospital): (Through translator) I found a note in my room here at the hospital. It said, get out of the country, your time is running out. I didn't tell my family about the threat. I didn't want to upset them. I did take some precautions, like changing the times I come and go from the hospital, but I didn't ask for bodyguards.
FLINTOFF: The doctor doesn't come and go from the hospital much these days. He lives there most of the time, in that room where someone was able to leave a death threat despite all the hospital security. He's put on weight and looks a decade older than his 43 years.
The hospital isn't a very inviting place. After the fall of Saddam, it was ransacked by looters who used the patient gurneys to cart away everything from drugs to air conditioners.
Dr. MOFAQ HUSSEIN (Assistant Administrator, Ibn al-Bitar Hospital): (Through translator) Look at this devastation. This used to be the cardiac unit. It's not even as bad as it was. They've cleaned out most of the debris.
FLINTOFF: Dr. Mofaq Hussein is the assistant administrator of the hospital.
Dr. HUSSEIN: (Through translator) We lost buildings and a lot of equipment. Up till now we've gotten nothing but promises from the Ministry of Health and the Americans.
FLINTOFF: One of the promises of the American reconstruction was a new cardiac unit. It's taken more than three years, but the painters are just finishing their work.
(Soundbite of hospital)
FLINTOFF: Death threats are one thing. A heavier workload and lack of facilities are something else. But there's another source of stress. Anesthesiologist Walid Bakra Thagil(ph) says it's the pain of having to turn patients away. He says some very sick people are waiting for appointments that can be years from now.
Dr. WALID BAKRA THAGIL (Ibn al-Bitar Hospital): (Through translator) We used to operate on six or seven cases a day, but now it's only two. We just don't have enough doctors.
(Soundbite of hospital)
Dr. AL-ANSARI: Very nice.
FLINTOFF: Dr. al-Ansari is performing two operations simultaneously in a pair of small rooms, packed with equipment and five or six members of each surgical team. They perform the more routine tasks as he goes from one patient to the other. This time the doctor speaks in English.
Dr. AL-ANSARI: This patient has a coronary artery disease, and we are going to do a coronary artery bypass, a grafting, now. He is mid-50s and he has appointment for six months.
Unidentified Man: Not so good.
FLINTOFF: Al-Ansari's second case is a 33-year-old woman who needs a mitral replacement. He says heart damage from rheumatic fever is common in Iraq, where most people live below the poverty line. There are also heart problems associated with malnutrition and the stress of living in a war-torn country. Al-Ansari says the hospital is facing shortages of lifesaving drugs and medical devices, even the glasses equipped with magnifying loupes for operating on children.
For doctors who can do this work, there are plenty of inducements for leaving the country. Al-Ansari says he's currently making about $350 a month. A salary for someone with his experience in Jordan would be from 10 to $15,000 a month.
Dr. AL-ANSARI: (Through translator) I have two offers to work outside the country, one in the United Arab Emirates and one in Jordan. If this harassment keeps up, I'll have to choose.
FLINTOFF: Another haven for Baghdad's doctors is Kurdistan in the north of Iraq. Before the war, the region became virtually autonomous under the protection of a U.S. and British no-fly zone. It's now safer than the rest of the country, and its economy is booming.
Another doctor who is facing the decision to leave is Haidar Sabiah Insyaf, a 32-year-old resident who came to Ibn al-Bitar to specialize in cardiology. As a Shiite from the south of Iraq, Insyaf has been threatened and ordered to go home. He says he won't leave, but he won't ask anyone else to do what he's doing.
Dr. HAIDAR SABIAH INSYAF (Ibn al-Bitar Hospital) (Through Translator) Why should someone study hard to become a doctor? My parents encouraged me to become a doctor, but if one of my relatives wants to do it, I'll never let it happen.
FLINTOFF: For now at least, Dr. al-Ansari says he's not leaving either. But he is appealing to the Ministry of Health and the U.S. government and anyone he can think of for support.
Corey Flintoff, NPR News, Baghdad.
HANSEN: NPR's Salim Amar(ph) contributed to that report.
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