“We can make that happen, Sir.” he said without hesitation. I sometimes forget that the insignia on my collar actually means something over here. Not like at home. There’s no “I’ll try” or “Maybe” around here. It’s “Yes, Sir.” Boy could I get used to this. “We’ll go out with the chaplain’s convoy. He’s taking some food to the local widows. And no,” he added after seeing my look, “we didn’t make them widows. He’s just doing what chaplains do.”
So right after morning chow I grabbed my body armor and weapon – a requirement for going into town – and headed for the convoy. After a brief that covered every possible aspect of travel and every possible reaction to an enemy force, we mounted our MRAPs (mine resistant anti-penetration vehicles) and headed for town. Riding in an MRAP is like commuting to work in a Brinks armored car. It weighs more than an 18-wheeler and can withstand a 500-pound bomb. And just to make believers of anyone who would challenge us, the top of the vehicle has a mounted 50-caliber machine gun that gives new meaning to the phrase, “Reach out and touch someone.” “Go to condition 1,” the driver called back to the occupants of the MRAP. Everyone loaded and cocked their weapons, including me. I couldn’t get over the incongruity of the situation. We were heading out to do a good deed with enough fire power to destroy half the town.
“This is a lot of armor to deliver food to some old ladies,” I mused to the Lance Corporal at my side as we bounced down the road.
“Well, Sir, that’s what they say about us, ‘No better friend, no worse enemy than a U.S. Marine’.”
As we approached the ‘hospital’ I couldn’t help but think that this was going to be an interesting meeting. “I’ve never been to a medical staff meeting,” I told the Lance Corporal, “where I could shoot anyone who insulted me. I think I’ll like this.” My thoughts drifted back to some surgeons I’d known and wished could be here.
“Uh, yes sir,” the Lance Corporal said. I think the gleam in my eye was starting to scare him.
“Can you imagine what this place looked like back in the day?” I asked the chief as we pulled into the small isolated desert town.
“Actually, Sir, this town is mentioned in T. E. Lawrence’s writings, you know ‘Lawrence of Arabia’. This town is right on the way to all the ancient trading routes of the Middle East. And the Nazis recruited radical Islamists from here to fight in World War II. Nothing much has changed,” he said as we stopped and opened the doors, “except the trash.” My day dreaming about Lawrence of Arabia was suddenly pierced by the sight of the third world town before me. Trash was everywhere. Every house was surrounded by high stone walls with barbed wire on top. The streets were busy with cars and trucks, all honking at one another. Since we couldn’t park at the hospital we had to ‘foot patrol’ several blocks to our location. All the Marines were spread out and on full alert, pointing their guns at empty cars and passersby. Nevertheless, many of the locals gave us a friendly wave or nod while others completely ignored us. At one moment I felt nervous, like I should be watching for land mines or car bombs, while the next moment I just felt like an oddly dressed tourist. “They had a suicide bomber here last month,” one of the Marines said when he noticed my cavalier stroll. “A woman got pissed off when the Iraqi police arrested her husband and sent him off to jail. All they recovered of her was her head and feet. But she got one IP (Iraqi Police) and some folks who were just in the wrong place at the wrong time.”
“Let’s just hope no one is irritated at the IPs today,” I tried to joke.
After a short walk we came to the Red Crescent building, the interim clinic building until the hospital could be rebuilt. Some fighters, from outside the community I was told, had taken up positions inside the old hospital. Marines, doing what they do best, had destroyed the place. That was one of the final straws for the community. They started pointing out the outsiders, the violence dropped off, and the Marines funded the rebuilding of the hospital.
As Marines took up positions of security, I, the chief, and Dr. Dennis McKenna, an emergency physician from Albany, went in to talk to the staff. The hallways were choked with people of all ages. A few bearded men wearing light colored dashas, or ‘man dresses’ as the Marines frequently called them, seemed to be attempting to direct the crowd. Many women dressed in black burkas, some holding small children, were sitting on the floor lining the hallways, quietly waiting their turn to be seen. I peeked into a room where I heard a small child wailing. Several people were holding a child of five or six while a man placed sutures in a large laceration in the child’s thigh. There were no gloves, no drapes, and apparently no anesthetic. A gauze filled with iodine was the only passing attempt to keep the wound clean.
While waiting to see the head physician another doctor insisted that we wait in his office away from the crowd. When we found that he had one of the only air conditioners in the hospital, we were more than willing to oblige. The tiny room had a refrigerator, a bed with a wool blanket, and a desk. The doctor completely ignored the crush of patients in the hallway as we peppered him with questions about the Iraqi health system. As we talked, we watched as people presented to a window that was cracked open and passed money through a hole in the screen to a man seated at the desk. He would log their names into a book and issue a prescription-type piece of paper that allowed them to be seen by one of the doctors. We were told that patients would tell a doctor their symptoms and he would write on the piece of paper the medicine that they were to have. They would go to a pharmacy in town, purchase the medicine and return to the clinic to be told how to take it. Very few actual physical exams took place. No male physician ever touched a female patient. Each visit cost 500 Iraqi dinar, or a mere 43 cents. After a few minutes of conversation we were told that Dr. Dhea, the hospital’s main physician, would see us.
Unlike the first doctor, Dr. Dhea’s office was packed with people lined up to see him. He sat at his desk and scribbled on each bottle or blister pack of pills how each was to be taken, spending no more than 30 seconds with each patient. Some of the patients apparently tried to plead for more or different meds only to be waved off by a flick of Dr. Dhea’s hand. A little chubby three year old with a saline lock in his hand played around the doctor’s desk.
When the crowd finally dissipated, he turned to us with an apologetic smile and explained that most of the patients were basically healthy but came for a pill or a shot. Dr. McKenna just looked at me. “It’s the same the world over.”
“What can we do to help you,” I finally said. “Do you need supplies, equipment?”
“Of course,” he said with a humble nod. “But most of all I need access to your American expertise. I’m a surgeon. This child has nephrotic syndrome. I need access to American consultants who will help me manage this case. I emailed Mayo Clinic, but they must be too busy; they never returned my email. Can you help me?”
“I think we can make that happen,” I said with a feeling of satisfaction.
To be continued…
Would you like to help? Iraqi physicians like Dr. Dhea need our assistance. If you or your hospital are willing to assist in any way, to provide medicine, equipment, arrange consults on cases, or if specialists on your staff are willing to consult on cases, please contact EPM at: Consultants@epmonthly.com