A few years ago, Dr. Rafe al-Eissawi was an orthopedic surgeon in the embattled city of Fallujah—sometimes mediating with Americans, sometimes angering them with his public casualty reports. Backed by Anbar tribes and in the Sunni parliamentary block that is seeking to win a bigger role in the Shiite-led government, he became one of the technocrats in Prime Minister Nuri al-Maliki's cabinet and then one of two deputy prime ministers. Now he wins praise from Americans and Iraqis for his efforts to rebuild the country's infrastructure and attract investment.
Unlike most other top-ranking Iraqis who returned in 2003 from exile, Eissawi, 43, stayed in Iraq during Saddam Hussein's tyranny. He now heads a small party hoping to score wins Saturday in the first election expected to see widespread participation from Sunnis, who largely boycotted the local voting in 2005. He spoke to NEWSWEEK's Larry Kaplow in his Green Zone office. Excerpts:
NEWSWEEK: What makes the provincial elections Saturday important compared to other elections we've seen?
Rafe al-Eissawi: First, the type of participation. In the last elections some people participated and others boycotted. Now the trend, the attitude of the people is to participate nationwide. So we expect across the country to see better participation, and that means better representation of members in the provincial councils. Second, people have had a good opportunity to see the types of politicians they've had in the last two years. They have a good period just to judge whether they are competent enough or not and see the possibility to implement their promises.
And this time they can vote for individual candidates, not just party lists?
The open lists will give an excellent opportunity [but] there is a problem in the procedure. We have a high number of people who are [illiterate]. It may be difficult for them to select the name inside the list.
Are you concerned that, since some people will lose the election, we will see violence later?
I don't think that there will be violence because security has improved and there is better education among the people about the premature democracy in Iraq. You know, we are talking about a new model for Iraq. Still, there definitely will be change. Here in Baghdad, in mixed [Sunni-Shiite] areas, maybe in Al-Anbar province, Nineveh, Diyala, Basra, some other places.
You recently met Vice President Joseph Biden when he came to Iraq. What did you get from your meeting with him?
America is committed to help Iraq, and America is committed to implement the SOFA [Status of Forces] agreement regarding the  withdrawal. At the same time this withdrawal doesn't mean that America will leave Iraq to its fate. We, everyone, feel the necessity of the strategic relationship between America and Iraq, and we hope, both of us, things will improve on the ground to allow for exact implementation.
You weren't worried that Biden previously proposed that Iraq become a loose federation of three ethnic enclaves?
I think he expressed that when the sectarian violence was at a peak. Now the situation on the ground is different and the solutions should also be different.
Are some Iraqis afraid the withdrawal will be too fast?
I hope now, in the last year or last few months, people have started to trust more the Iraqi security forces. They feel that there has been some purging the ministries of the militias of the last few years. Still, we need more effort to make our institutions more national and professional.
You were the director of the Fallujah hospital and sometimes the American military disputed your reports of casualties. Now they work closely with you.
To me it is the same. I used to do my job in the hospital to serve my people. Now as a politician I do my job to serve my people. During the war I focused on decreasing the number of casualties simply because of my job as a doctor. Now shifting to politics, it's the same thing to me. I have to focus on building relationships exactly like doctors and to protect and preserve the rights of the people. Before I was focusing only on the ill, now I am focusing on the entire population.
I did not think at that time that I would work in politics at all. It was a decision of some of my friends, some of my tribe who elected me in the last election.
I think the Americans have changed a lot. At the beginning we were talking about war, and now we are talking about a strategic relationship.
Did your feelings for Americans change?
They attacked every house in the city. Anyone who is sitting in a city receiving casualties, you will not accept that behavior or those events at all. At the same time, I was a member of a delegation of citizens that was talking to the Americans in Camp Fallujah. I tried from that time to bridge the relations between Fallujans and Americans, and now I try to bridge the relations between Iraqis and Americans.
I hated the war, I hated the casualties and I hated the destroyed houses in my city. The [Americans] focused on how Al Qaeda was controlling the city but it was very, very difficult for the Iraqi people to kick Al Qaeda out during that period.
You never went into exile under Saddam. Do you look at things differently than politicians who returned from exile?
I look at the Iraqi politicians [in exile] as people who were trying to change the dictatorship of Saddam Hussein. But if you are talking about expertise, there might be more among those who were inside. But not all people could stay during the period of Saddam Hussein, so both are participating, those who were inside and outside.
I don't personally feel the conflict that some politicians focus on, inside and outside. Both of them are participating, but people inside are more expert.
You said you've seen changes in the Americans?
If you compare the type of behavior of America in 2003 and now, there is tremendous change. More friendly. It was a war. Now we are able to talk about building strategic relationship. So, yes, the Americans have changed so much [for the better], toward a good relationship, toward a new vision, new behavior.
What are the obstacles to developing Iraq's infrastructure, electricity and health care?
There's a migration of most the expert Iraqi people out of the country, which burdens the situation.
In making a plan for any ministry, definitely one of the obstacles is corruption, especially on a provincial level. As you know, Iraq was a tightly centralized government; most of the expertise was in Baghdad. You have to execute your budget in the provinces with people who are not expert in it. It is a very big challenge, not just an obstacle. There is improvement but still there are problems.
How about encouraging investment?
For investment to come to a country first you have to have a legal framework for investment and you have to have also improved security, and I think both of them are available.
Are investors afraid the U.S. troops won't stay?
No. If the Americans do not have troops inside Iraq, does that mean they will not invest in Iraq? Does any investor have to have his own army in the country? This means nothing to investors.
If it is secure enough, with good diplomatic relationships and a legitimate framework for investment, it's enough. And still we are talking about a long strategic framework with America, which will be enough to encourage investors.
How concerned are you about the drop in oil prices, as oil provides nearly all the government's revenue?
This is a very big challenge. We revised the budget three times because of this. It's a huge change, which will affect the main investment projects, not of the private investors, but for the ministries. No question.
What will that mean for the government?
Regardless of the crisis of oil and the change of prices, whatever the government can raise will not be enough to cover all the services. It means, at the end of the day, the necessity for private investment.
Are you worried the world's focus will turn away from Iraq to Afghanistan?
[Laughs] No. Iraq is a very important country in the region with focus or without focus. We are not just a spot in the desert.
Your predecessor in this job was badly wounded by a bomb. Are you concerned for your own security?
Building a country, you need to face challenges. Risk is everywhere, on the road, in civilian work, political work, everywhere. There were risks when I was a doctor. So I am not thinking about that because I have a very big objective to change the situation for my people.
Your party is made mostly of people who never left Iraq, right?
Completely, not mostly. One hundred percent.
If you win, could that prompt others, who stayed through Saddam but then left after 2003, to return? They'll see it's not just former exiles in power?
At the least, it will be a signal to encourage them.