Thursday, February 02, 2006Heckuva job.
BAGHDAD — The centerpiece of a $786 million plan to modernize Iraq's health care system has stalled amid spiraling costs and insurgent threats, jeopardizing one of the country's most ambitious reconstruction projects.
Initial plans called for completing 180 medical clinics by December 2005, but only four are finished, said Ammar al-Saffar, Iraq's deputy health minister. None has opened.
The plans have been scaled back to 142 clinics, but at the current pace the project may shrink further, said Jon Bowersox, senior U.S. consultant for health care reconstruction in Iraq. Only 94 of the facilities are more than half finished. “It's been slower than we anticipated,” he said. “It's behind schedule.”
The delays reflect a broader problem facing U.S.-funded reconstruction in Iraq. Congress approved $18.4 billion for Iraq reconstruction in November 2003, but by the following year, nearly one-third of the money had been diverted to help train and equip Iraq's security forces as the insurgency gained steam. Some projects were canceled, others scaled back.
A report released last week by the Special Inspector General for Iraq Reconstruction said 49 of 136 planned water and sewage projects will be completed and about 300 of an initial 425 projects to provide better electricity will be finished.
Because Iraq's health care network is in bad shape, it was a top U.S. reconstruction priority. The U.S. government tried to protect it from some of the cuts that other programs faced.
Only $7 million of the $793 million originally earmarked for health care was diverted to security. Even so, the project couldn't be insulated from the rising costs of construction materials in Iraq and securing construction sites, Bowersox said.
Construction on two health care centers in the Baghdad slum of Sadr City has been suspended for nearly a month because of threats against construction workers, he said.
Rebuilding Iraq is a critical part of U.S. strategy to win public support and undermine backing for the insurgency. “If (the number of centers) will be reduced once more, it'll be a big blow to our ambitions and our promises,” al-Saffar said. “We promised our people.”
The newest hospitals in Iraq are 20 years old. Some facilities date to the 1960s. Many of Iraq's 270 hospitals are frequently overflowing with victims of car bombings and other attacks.
Baghdad's Al-Kindi Hospital cares for an average of 300 patients per day, said Salwan Akram, a surgeon at the hospital. The number of patients surges after a car bombing or similar attack, which overwhelms the hospital's trauma center, he said.
The proposed network of clinics would provide health care to Iraqis across the country, not just in the cities, where most hospitals are concentrated.
“It's the core of their health care system,” Naeema Al-Gasseer, the World Health Organization representative for Iraq, said about the proposed centers. “We cannot build hospitals in every single district of Iraq. But (we) could have primary health clinics that reach people.”