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With drugs in short supply, Iraqis face painful surgeries

A Jordanian doctor describes empty drug cabinets and surgeries conducted with out-of-date procedures.

©Associated Press
April 6, 2003

AMMAN, Jordan -- Baghdad's hard-pressed surgeons, flooded with war-wounded, are amputating the limbs of children and adults with too few anesthetics to block the pain and too few antibiotics to protect the patients, a Greek doctor newly arrived from Iraq reported Saturday.

"They don't have drugs," Dr. Dimitrius Mognie said. "I saw it myself. I opened the cabinets."

Mognie's account, after a full day touring hospitals during the U.S. bombardment, was a firsthand substantiation of a report by World Health Organization officials here, who said Friday the Iraqi capital was running low on anesthetics, analgesics and surgical items.

As U.S. forces probed Baghdad on the ground Saturday and pounded the city intensively from the air, the International Committee of the Red Cross said its workers reported several hundred wounded Iraqis and dozens of dead had been brought to four main city hospitals on Friday and on Saturday morning.

Mognie, 39, a general practitioner from Athens, is familiar with Baghdad's medical system, having traveled 16 times to Iraq since 1993 to research its health problems and offer support as a member of the international aid group Doctors of the World.

For the compactly built, energetic Mognie, this trip was dangerously different.

He and a colleague managed to get one of the few aid shipments into Baghdad over the risky road from Jordan -- 32 tons of blankets, food and medicine. They arrived in the two-truck convoy last Tuesday, and he spent his first night in a 30th-floor hotel room with a sweeping view of the thunder and fire of a city under air bombardment. "I couldn't sleep at all," Mognie said.

The next morning, at 9:45, he had just sat down to tea and a talk with doctors at a central Baghdad hospital run by the Red Crescent -- Muslim Iraq's Red Cross equivalent -- when four American bombs struck across the street.

"We all fell to the floor, and the glass windows shattered all over us," Mognie said. Two women in the room were hurt. He escaped injury but left a glass-flecked jacket behind.

At a children's hospital, Mognie saw bomb victims up close -- a 7-year-old girl badly burned on her side, a child with an amputated arm and a 9-year-old boy named Mahmoud with severe damage to his midsection. His parents said the boy picked up something while playing and it exploded.

The medical staff was evasive when asked what they needed, Mognie said, because they feared being critical of Iraqi authorities or because they were ashamed of how they were working. "I can't speak, but you can go and see," he said one told him.

"I went around and checked the drug cabinets, and of course I know," Mognie said. "They're using anesthesia meant for minor surgery for major surgery, like amputations."

Because they're short on crucial general anesthetics, such as Pentothal and nitrous oxide, they're using Ketamine, a "five-minute anesthetic," even for amputations, Mognie learned. Surgical teams were injecting child patients with Ketamine every few minutes to maintain the effect, he said.

The shortages extend to such items as gauze, tetanus vaccines and antibiotics to protect patients against infection during surgery, said Mognie, who returned to Amman on Thursday. "They're using iodine. That's a 30-year-old method."

The Greek physician, who speaks Arabic, spent an hour with young Mahmoud and his grieving father, mother and grandmother. The father, a teacher, made clear what Mognie said he's always heard indirectly from many ordinary Iraqis: They oppose President Saddam Hussein's government.

"We don't like this situation, 20 years of war," the father said. Said Mognie, "That's how they often put it."

The boy had undergone extensive surgery -- on the stomach, removal of the spleen, resectioning of intestines.

"Unless it becomes infected, he should live," Mognie said. But then he added, "I'm sorry to say, I think he will become infected."

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