‘A little understood, unfamiliar war’
– US defence secretary Donald Rumsfeld, resignation speech, November 8, 2006
Medact’s five earlier Iraq reports presented data on health and health services, and thus helped to fill some noteworthy gaps (Medact 2002, 2003, 2004; Yates 2005; Reif 2006). There has been a gradual and welcome increase in such information from major agencies including the World Health Organization (WHO 2006a, 2006b), the International Committee of the Red Cross (ICRC 2007) and Oxfam (Oxfam/NCCI 2007). In this report Medact shifts its focus to an assessment of the quality of the support given to the Iraqi health system after the 2003 invasion.
This report describes how the war and its aftermath continue to have a disastrous impact on the physical and mental health of the Iraqi people, and the urgent measures needed to improve health and health services. It focuses on the many failures of the occupying forces and their governments to protect health, or to facilitate the rebuilding of a health system based on primary health care principles. It assesses the current state of the health system, including the impact of insecurity, and the workforce, supplies, medicines and equipment it lacks. It also looks at health information and health policy. There is a special focus on mental health care, a particularly neglected area. The report ends with conclusions and recommendations, exploring what needs to happen now in Iraq and what lessons can be learned.