When the wife of one of our Iraqi staff members in Baghdad was preparing to give birth to their first child, she discovered to her dismay that the female gynecologist she had relied on to attend the delivery had suddenly left Iraq.
Why would a qualified doctor suddenly abandon all her patients? The answer was a sad one: Gunmen had kidnapped the doctor's daughter and demanded a $25,000 ransom.
The gynecologist managed to pay the ransom to get her daughter back, but then immediately fled the country in case it happened again.
Our colleague's wife found another gynecologist, but not all Iraqi women are so lucky. About one-quarter of all births in Iraq are carried out without qualified medical personnel present. Iraqi children are dying in increasingly larger numbers because of the ongoing war and the cumulative effect of sanctions and conflict under Saddam Hussein.
A report out today from Save the Children Fund (www.savethechildren.org/publications/) paints a dismal picture of infant health care in Iraq, where one in eight children now dies before reaching the age of 5. That is a 150 percent increase since 1990, the highest increase anywhere in the world, even including sub-Saharan Africa where HIV infection rates are soaring and raising infant mortality rates there.
For Iraqis the plunge in health care is a tragedy. They used to have some of the best health care in the Middle East, and Arabs from neighboring countries used to come to Iraqi hospitals to get top level care. No longer. Many of Iraq's best doctors have fled after becoming targets for kidnappers. Others, the unlucky ones, have been killed.
Even getting to a hospital is a challenge. At night there is a curfew, so many women are now choosing Caesarean sections, which ensure against a late-night onset of labor when it is not safe to leave their homes. Even if they get to a hospital, the facilities are now substandard.
"We have a shortage in our medicine, especially for emergencies," said Zyad Mohammed, a gynecologist in Baghdad. "We don't have monitors for babies during delivery. … We don't have the supples and equipment that we need."
Sectarian concerns also intrude. The Health Ministry is controlled by Moqtada al-Sadr, whose Mahdi army militiamen are accused of harboring anti-Sunni death squads. Many Sunnis fear that if they go to a hospital they will be targeted by Shiite militants.
And the drugs that are meant to be supplied for free in Iraq's hospitals are often diverted to the black market, so patients have to buy their medications, often making them too expensive for poorer people.
"It is very frustrating, " Mohammed said. "Sometimes I think of leaving this job, because when I became a gynecologist I thought that I could provide help, but when I see I cannot do much, I become frustrated."