Global Policy Forum

Pressure increases as more people move to seek security

Escalating violence and widespread insecurity, combined with a worsening shortage of health workers, are putting severe pressure on the health of the Iraqi population. This pressure increases as people move within the country and into neighbouring countries in search of safer places to live.

Every day in 2006, an average of 100 people were killed and many more were seriously injured by gunshots, shrapnel wounds and burns. As the violence continues, these emergency needs are increasing the load on a public health system that is already stretched thin, and people are dying as a result. The government estimates that almost 70% of critically injured patients with violence-related wounds die while in emergency and intensive care units due to a shortage of competent staff and a lack of drugs and equipment.

WHO is concerned that health services within and outside Iraq will not be able to cope with the influx of internally displaced persons (IDPs) and refugees, as people continue to leave their homes and move within and out of the country. According to the UN High Commissioner for Refugees (UNHCR), nearly 2 million Iraqis are IDPs and as many as 2 million more have already left the country for neighbouring countries, in particular Syria and Jordan. These figures are expected to rise. WHO is concerned by the deteriorating condition of health care in Iraq and the increasing burden placed on host communities as they serve more and more people within and outside Iraq.

WHO will highlight these concerns at the UNHCR international conference "Addressing the Humanitarian Needs of Refugees and Internally Displaced Persons Inside Iraq and Neighbouring Countries", which is being held from 17 to 18 April 2007 in Geneva.

Shortage of basic services

The health situation for the general population is poor, with a shortage of basic services: 80% of people lack effective sanitation, 70% lack access to regular clean water, and only 60% have access to the public food distribution system. Diarrhoea and acute respiratory infections, worsened by increased levels of malnutrition, account for about two thirds of deaths among children under five. The chronic child malnutrition rate is estimated at 21%, according to the findings of the 2006 UNICEF Multiple Indicators Cluster Survey (MICS3).

In addition, public health gains during the last few years could be lost if the current situation is not urgently addressed. Currently, Iraq is polio free for the sixth consecutive year, but routine immunization coverage remains low, increasing the risk of the importation of polio or of other disease outbreaks. Some positive achievements in the surveillance of communicable diseases could be lost quickly if these efforts are not maintained.

Access to health care in central Iraq and in Baghdad is heavily restricted by security threats, putting the injured at risk, as well as those who need treatment for chronic ailments, or services for pregnant women, children and the elderly. Health centres are suffering from reduced staff and unreliable supplies despite the efforts of the national and international partners. The daily violence coupled with difficult living and working conditions are pushing hundreds of qualified and experienced health staff to leave the country.

WHO's health priorities for Iraq are to assist the authorities to prevent and contain potential disease outbreaks, cope with the burden of injuries through emergency medical services, improve access to essential services, and ensure the availability of basic supplies like medicines, medical supplies and equipment, potable water, and power and fuel for health facilities.

WHO is active in Iraq to assist national health authorities and civil society organizations in restoring basic public health services and in strengthening emergency services in hospitals The pre-positioning of medicines, medical and emergency supplies at appropriate locations is also key.

"WHO will continue to support Iraq and help the countries in the region strengthen their existing health services to meet people's needs," said Dr Hussein Gezairy, Regional Director of the Eastern Mediterranean Region of WHO.

WHO is present in Iraq with a team of 77 country officers at national and provincial levels, backed by WHO international technical teams. One of their main tasks is to support the Ministry of Health to sustain national surveillance and early warning system and immunization campaigns.