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[casi] Chaos - and the Blue Cross

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It gets worse. The US Blue Cross Insurance set up is to run Iraq's health
services. How are Iraqis supposed to pay US type insurance, unpaid, sacked
from their jobs, largely destitute for decades -
this whole excercise must be something from which I'll surely wake up from
in a cold sweat, realising it was a terrible nightmare. It simply cannot be
real! f.

Sunday Herald 25th May 2003
A country finding itself again
2 - Recreating Iraq: Eyewitness
By Alex Renton in Basra
IT was about 9.30 on Thursday evening when shooting started -- one
Kalashnikov firing sustained bursts just outside the hotel. Then another
opened up, and a heavier gun nearby. In a few minutes it seemed we were in
the middle of a battle -- there was more firing than I've ever heard, in any
war zone. We looked at each other, two Oxfam staff and five from Unicef,
wondering at what point we should move under the dinner table. Then one of
the hotel staff said -- ''They're firing in the air. They are celebrating.''
He was right. The news had just come over from New York -- the new United
Nations resolution was passed. Basrans were celebrating the end of nearly 13
years of sanctions. It was one of those good moments, and we savoured it.
Then somebody said: ''Just wait till they read the fine print.''
There's truth in that. The ''resolution lifting the sanctions'' is misnamed
-- that overdue measure is just one in a list of 25 or so prescriptions now
agreed for the new Iraq. Some of these are sensible, some are deeply dubious
-- untested measures that stretch the existing boundaries of international
law and put the responsibility for rebuilding and reshaping Iraq firmly in
the hands of the countries that invaded it. The United Nations' role is
sadly limited, and the degree to which the Iraqi people will have a say in
the design of their future is left vague, at best.
At the heart of the resolution lies one assumption that many people inside
the country, outsiders and Iraqis, are far from sold on. It's that the
coalition, now Iraq's 'Authority', has the means to bring about the safety
and security on which all these grand plans depend. I've travelled from
Baghdad and across the south this week and, everywhere I've been, the
complaints -- whether they're about the price of food, lack of water, unpaid
salaries, or just plain fear of what's on the streets -- all lead back to
this one issue.
Basra celebrated on Thursday night, but during the day doctors and nurses
demonstrated at the United Nations and at the British military base. Their
banner read: 'Restore security, water and electricity or all the doctors and
nurses will go on strike.' One of the UN agencies reported an armed gang
invading a hospital, insisting one member's life be saved -- or else. A
teenage girl lost her baby and nearly died herself because of a power cut in
the middle of her difficult delivery. Several hundred Iraqi navy officers
demonstrated because they've had no pay since February -- 10,000 military
personnel are in the same state, and their complaints are now becoming
Among most Iraqis that you meet, confidence in the new regime is melting
away, like everything else as the temperature hits 50ūC. It's hard to see
how it can be restored.
Oxfam is working in Nasiriyah province , 150km north of Basra, in the dusty
semi-desert created by Saddam Hussein's lunatic plan to drain Iraq's
southern marshes (the dams are already being opened). Nasiriyah itself, a
sleepy, war- battered town of about 500,000, is pretty calm. But security
remains a crucial problem here, too. I travelled out early on Tuesday with
two of Oxfam's team of water engineers who are trying to get to the bottom
of the poor supply throughout this area. One cause was immediately visible
as we drove. The pipeline from Samawa to Nasiriyah runs underground, except
where it rises at maintenance valve points, every few miles.
''They break the valves, or they shoot holes in the pipe. There's no-one to
stop them,' said Mahassein Jarr, a municipal water engineer. He added that
the answer to the pipe-breaking problem was simple. 'Under the old regime
anyone who did that would be shot. These people need someone tough, or
they'll never be good.'
This is a familiar song in the new Iraq. It's obvious that the task of
replacing an authoritarian regime with a modern, liberal one is going to be
a struggle. How do you instil a sense of social responsibility into people
who have never been allowed to think for themselves?
We went to see some of the primary health care clinics in Nasiriyah's
poorest slums, where Oxfam is providing vocational training and equipment to
address the endemic illnesses. These clinics are nothing like as busy as the
little district health centres I've seen in northeast Baghdad, overrun with
patients. In one, three doctors have been seeing 400 people a day. Here
there's a different problem. The doctors are bored. They can't treat
patients -- as there's nothing to treat them with.
This, again, is a familiar complaint -- though there are medicines in
warehouses across the country, the re-established ministry of health still
has not put back together the structure to supply the hospitals and health
centres. This despite the coalition's Office of Reconstruction and
Humanitarian Assistance (ORHA) claiming the start-up of the health system as
one of its great successes. Stephen Browning, the American who is now the
authority's minister of health (with powers of veto over his Iraqi
equivalent), has promised a temporary free health care system, before the US
health insurer Blue Cross begins its contract.
There seems to be a yawning gap between the sort of promises you hear in the
marble palaces that ORHA and the new Authority operate from in Baghdad, and
the realities, as seen in a Nasiriyah health clinic. I talk to Wdad
Abdul-Sahib, 35, who was visiting the clinic because of a long-term kidney
complaint. She was less worried about that than her eight children, though.
One was injured in the eye and on one arm by a bomb during the fighting. He
is still in shock. Wdad's other major worry is lack of money -- and food.
'We are eating bread and milk, usually -- we have not eaten meat for one
month,' she says. Monthly food rations, distributed under the Oil For Food
programme before the war, have not been seen here since early March. Food
prices have gone up frighteningly in the town. The doctors say most mothers
complain their children are not getting enough to eat, since few people have
the income they got before the war. A kilo of meat has doubled in price (to
4000 Iraqi dinar, about £2) and 30 eggs have risen from 1200 Iraqi dinar to
3000. Fuel is now 25 cents a litre, up from 3 or 4 cents before the war; the
grumpy Iraqis in mile-long queues that block Baghdad streets ask -- with
some reason -- 'Where is our oil?' In Nasiriyah, where fuel is crucial to
boil drinking water, about half the town's trees have already been hacked
'There's another way of fighting us,' says Dr Ghassan al-Najab, chief doctor
at the Nasiriyah clinic. 'They are destroying us by doing nothing -- denying
us the chance to treat patients, denying us security.' He says he needs
antibiotics -- he has had no stock since before the war and that is running
out. 'This,' he says , 'is not liberation.' If this peace is to be won,
al-Najab and millions of Iraqis like him must swiftly be proved wr

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