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Iraqis most hurt by cuts to children's hospital
House panel slices facility from reconstruction aid
By Deborah Horan
BASRA, Iraq - Intisar Marzouk's fourth child is dying in an Iraqi children's hospital ward filled with flies and the stench of raw sewage.
Her underweight 2-year-old boy is hooked up to an intravenous needle, an oxygen mask covering his face and pneumonia and meningitis riddling his body. Doctors say he needs intensive care, but there is no such unit at the Basra Maternity and Children's Hospital, a crumbling pea-green building with backed-up toilets and a leaky roof.
But it is the only decent hospital the dirt-poor southern region of Iraq can offer the frail boy named Hussein and his frightened mother.
"There is better medicine here than the clinic in our village," said Marzouk, who has seen two of her babies die in recent years and is waiting for another death in a dingy room that smells of sweat and human waste.
The Bush administration recently earmarked $150 million to begin construction on a state-of-the-art children's hospital that could eventually cost $500 million to $700 million and would replace Basra's dilapidated facility. The project was one of the items in a proposed $20.3 billion aid package for Iraq and Afghanistan.
But last week, the House Appropriations Committee sliced the hospital from the proposed reconstruction package.
Also removed were projects to establish Iraqi ZIP codes, upgrade phone numbers, provide expensive garbage trucks, build elaborate prisons and planned communities and a handful of other initiatives deemed expendable by congressional budget planners.
Of all the proposed cuts, the one that rankles Iraqis most is the Basra children's hospital.
"We're not asking for a cinema or a garden," said Dr. Muhsin Jaralla, a local physician who works with the World Health Organization and the Iraqi Health Ministry. "We're asking for a hospital. A hospital is essential. We are asking for your help."
British forces based in Basra have pledged to pay part of the $28,000 needed to repair the hospital's damaged sewage pipes and patch the roof.
But those stopgap measures will last only until the next time pipes burst or the roof collapses, said Dr. Mohammed Nasir, the hospital's general director. With an average bimonthly budget of about $56,000, the hospital is unlikely to be able to afford further repairs, he said.
"Building a new hospital is much smarter than trying to rehabilitate this one," Nasir said.
Built in the 1980s, the hospital was bombed twice during the eight-year Iran-Iraq war. Workers hastily repaired the damage in 1990, but no renovations took place during Iraq's 12 years of international economic sanctions, Nasir said.
International aid agencies have donated equipment and medicine, and the hospital functioned at a rudimentary level during the war to oust Iraqi President Saddam Hussein, though often without electricity or running water.
There are 400 beds in the hospital, one of only a handful that serve a region of 2 million people.
Doctors admit as many as 250 children and 150 women every day, but far more patients seek medical care. Many of them come from outlying villages and stay overnight, sleeping on the grounds.
Often there is standing room only.
In the maternity ward on a recent Sunday, about 50 pregnant women in black head-to-toe gowns and slippers crowded dimly lit rooms lined with thin cots.
A woman who had gone into labor clutched her back and wheezed as she followed a nurse to one of eight beds in three sparse delivery rooms, where every day 25 to 40 women give birth.
She will stay long enough to have her baby and rest for six to eight hours before giving up her bed. "If we don't do this, we won't have enough beds," said Dr. Asaad Issa, a hospital pediatrician.
In the pediatric ward, six infants lie in incubators donated years ago by aid agencies operating in southern Iraq. Ten more empty incubators line a second room, but the thermostats do not work. Shoved in a corner is a broken instrument used to treat jaundice.
"We need phototherapy for jaundice. We need incubators. We need everything. We need this new hospital," said Wafiqa Kareem, a pediatric nurse.
There is a children's cancer unit, an infertility center, even a clinic for "women's wellness," but they are units in name only, lacking such basics as intravenous sets, anesthesia, oxygen cylinders and surgical sutures, doctors say.
The hospital's child mortality rates reflect the shortages.
In the months since Hussein's government fell, 375 patients under 15 years old have died, the most of them younger than 5.
The mortality rate corresponds to roughly 11 percent of all child patients admitted since British forces entered Basra at the beginning of the war. The figure matches Iraq's child mortality rate - more than double the average rate in other countries across the Middle East and North Africa.
"There are a lot of children dying of diarrhea and malnutrition," said Nasir, the hospital director.
Other common causes of death include pneumonia, bronchitis, whooping cough, typhoid, gastrointestinal ailments and a blood disease caused by sand flies. Since the end of April, doctors in southern Iraq have diagnosed 126 cases of cholera in children, according to Jaralla. "All of these diseases should be treatable," he said.
U.S. officials in Baghdad said they hoped to bring a "world-class medical facility dedicated to children."
"If we don't get the hospital, we won't be able to serve Iraq's children as well as we could with the hospital," said L. Paul Bremer, the top U.S. civilian administrator in Iraq.
If funding for the hospital in Basra stays out of the U.S. aid package, Iraqi doctors hope they can secure donations elsewhere. In the meantime, the human toll remains severe.
In the emergency room where the little boy named Hussein remained close to death, Issa avoided telling his parents that their son needed intensive care that was not available.
But the couple sensed the urgency of the boy's situation. His father asked the doctor repeatedly whether there was a way to transfer Hussein to a hospital outside Iraq.
The doctor didn't answer him.
"We cannot do anything for this boy," Issa said. "We don't have the equipment for intensive care. We can't tell them this."
The Chicago Tribune is a Tribune Publishing newspaper.
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