Coalition aids sickly healthcare system

12 Sep 2003 | Staff Sgt. David Bennett

Walking through the kitchen of the An Najaf General Hospital, Sgt. 1st Class David Lukowski marveled at the freshly painted walls and tiled flooring.

Local workers were installing vents connecting two new stoves that were already in place. Considering the hospital's cook had been preparing all of the hospital's meals over an open wood fire on a bare concrete floor three short months ago, Lukowski, an Army reservist for the 432nd Civil Affairs Battalion of Green Bay Wis., viewed the ongoing renovation project as nothing short of miraculous.

"I can't believe the improvements," he said.

I will take more than bricks and mortar to improve the healthcare infrastructure in the Shiite city of An Najaf. However, it coalition forces are attemping to give the ailing Iraqi community a solid foundation to work with.

Attached to 1st Battalion, 7th Marine Regiment, Lukowski was given the job in April with improving An Najaf's healthcare system, which incurred years of neglect under former Iraqi President Saddam Hussein. Initial assessments revealed meager medical staffs, outdated equipment and crumbling facilities across the board.

"I'd been to one clinic that had eight staff members, no floor, and no aspirin," Lukowski said.

The Marinette, Wis. resident has been working with the An Najaf's new general director of health who was elected by popular vote in July.  The director, Falah Almuhana, is responsible for the management of five hospitals, 40 clinics and 5,800 city health employees in the An Najaf province.

Together, they have been developing a strategy to improve An Najaf healthcare service one building at a time. The men are also looking at a long-term strategy for making the system independent.

For the last two decades, the province has depended on the state to support needs, like additional medical equipment.  For now, healthcare providers in the southern Iraqi province rely on Coalition troops.

Improving medical services in An Najaf are the top priority, according to Lukowski. There is a plan on the table to convert four former Ba'ath Party buildings in An Najaf into maternity or emergency care centers.

"First, we were firefighting, putting out fires here and there," Lukowski said. "Now, we're trying to tackle real problems."

Boasting a population 1.2 million people, An Najaf is the third largest province in Iraq. In the face of a growing population the city's healthcare system has struggled to keep up with demand.

Dr. Ahmed R. Nusar, director of Al Furat Hospital in downtown An Najaf, is pleased with coalition-sponsored work being done in the hospital. However, he said the needs of the hospital, which offers several medical services including general surgery, cardiology, gynecology, orthopedics and pediatrics, go deeper than new paint.

"This is the beginning of the rehabilitation of this hospital, but it needs a lot of things."

He checks off a list including updated health equipment, more qualified staff and more medical supplies.

Lukowski, who is studying to be a nurse back at home, acknowledged that converting the city's healthcare system will take time, money and patience on the part of the Iraqis. All three run short in degrees Lukowski has learned.

While talking about situation, a local dentist who shares office space in Al Furat Hospital, asked Lukowski when the soldiers will get around to renovating his workplace. Lukowski tells the man to be patient.

So far, the coalition has invested nearly $250,000 into An Najaf's healthcare hospitals and clinics.  It will require much more than that to improve it significantly. The civil affairs members say that progress is better measured in the direction they are going.

"Looking at it monetarily, that isn't where the impact has been," Lukowski said. "We have a process that works. We have a general director who was voted in democratically. There's no more, "What does Baghdad say." Now it is, "What do we do for Najaf."


The system will undergo further change as many of the Marine and Army forces, including the 432nd, prepare to leave. A Latin American brigade made up of troops from El Salvador, Honduras and Spain will replace them soon.

Capt. Francisco Carreres, a medical officer with Spain's Rapid Reaction Force, based in Madrid, recognizes the problems of An Najaf's state of health, and places the blame squarely on the former regime.

"There is a lack of equipment, a lack of training," Carreres said. "There was no money (invested) in the hospitals for 10 or 20 years. They are so old and there was no renovation."

He points to the province's numerous rural clinics "some that are located 40 kilometers from the nearest hospital" that need the most help.

Nusar thinks that increased emphasis on patient care in the city and the rural areas An Najaf is a must. He said from what he has observed thus far, the coalition is on course to make a world of difference.

"The Spanish, Americans and Iraqis, they are brothers in humanity," Nusar said.