In Iraq, The Doctors Are Out

But money alone won't bring back many doctors. As much as they like higher salaries, what they want is freedom from fear. Just last week, doctors in the southern city of Karbala temporarily closed their clinics, seeking protection from families who threaten violence when their loved ones aren't cured. The Iraqi cabinet has tried to help medical workers feel safer, even ordering the police to exempt doctors from the law requiring a permit to carry firearms on Baghdad's streets. Cops have been getting tough with other violators.

Above all, many doctors just want normal lives. Hasnawi has pushed hospitals to build living quarters for doctors, and one Baghdad medical complex recently completed an ambitious "White Zone" of renovated apartments where returning physicians could live and work within a secure perimeter. But the minister is now offering the apartments to visiting doctors, having discovered that most returnees prefer to brave life in their old neighborhoods.

The streets have been safer this year than they were during the mayhem of 2006, when many doctors fled. Dr. Bashir Farhan didn't even tell his parents late last year when he decided to return from a year's stint at a desert oilfield in Oman. He was afraid they would tell him not to come. Today he's a resident at a government hospital, and he has opened a little clinic of his own with some rudimentary medical equipment and a generator to keep the lights on. In the old days he refused to treat strangers, but now he depends on walk-in business. (In case of trouble, his hobby is body-building.)

One thing bothers him: the state of Iraqi medicine. There are few mentors at the hospital where he works, he says, and the doctors he is supposed to consult have given him some wrong diagnoses. Younger residents and interns come to him for professional advice. "It's self-teaching," he complains. "We are studying the textbooks and searching the Net." To cope with the shortage of doctors at home, the Iraqi government often sends patients to neighboring countries—where many of the best physicians and surgeons are Iraqi expats.

Other patients aren't so lucky. At a Baghdad children's hospital, Dr. Rafid Hmood tells of a 12-year-old boy in the cancer ward, blind and waiting to die. The cancer could have been stopped if doctors had removed the eye where the disease began, but the family had no access to qualified surgeons and oncologists in their home city of Kut. For fear of the violence in Baghdad, they waited a year before seeking treatment there. By then the cancer had destroyed both eyes and spread to the boy's brain.

Nevertheless, thousands of Iraqi doctors like Wasim remain outside the country. They follow the news from home—every assassination, every car bombing—as intently as they study their patients' vital signs. Dr. Raad Yusufani, who left Iraq in 2003, says he still gets calls from tribal leaders in Anbar province, where he used to run a hospital. They promise him "everything, including security," he says. But his life keeps slipping farther from the land of his birth. At the hospital he now runs, in the United Arab Emirates, 24 of the 49 doctors are from Iraq. His children have gone off to college in Jordan and Canada. When his mother died in Iraq two years ago, the family insisted he not risk going home for the funeral. Now his brother is suffering from a seven-centimeter kidney stone, and the family is trying to get him a visa to Amman to have it removed. They can't find a doctor Yusufani trusts in Iraq.

With Salih Mehdi and Yassar Ghani in Baghdad

© 2008