In December, 13-year-old Ahmed Awayid suffered a relapse of his leukemia and his parents once again began making the monthly trek from An Nasiriya to Baghdad for chemotherapy. But drugs were in such short supply that Ahmed was allowed only half the usual dose.
Even that didn't last long; his last scheduled visit was March 18, but with war about to begin, no one would take him and his parents on the long journey from this southern city. Throughout the war, his parents kept a vigil by his bedside, taking turns sleeping on a mat on the floor in his fourth-floor room at Saddam General Hospital in An Nasiriya. They were there through the heavy fighting that engulfed the city in the first two weeks, there when local Baath Party officials and 150 soldiers used the hospital as a hideout and there when American Delta commandos blew in the doors to rescue Pfc. Jessica Lynch. "We were scared," said his father, Mahawis Awayid, 52, "but we hardly noticed."
They're still there now, waiting for Ahmed to die. He's bleeding from his nose and gums, his body is covered in painful lesions, and his platelet count is virtually zero, according to pediatrician Dr. Tariq Dhayer. And the tragedy is, Ahmed suffers from a form of leukemia that would be highly curable in almost any other country. The recommended treatment for acute lymphoblastic leukemia is a bone-marrow transplant, and in Saddam Hussein's Iraq such procedures were banned. "Take him to Kuwait, you could treat him," says Dr. Meitham al Baka. "Take him to anywhere in Africa even, and you could treat him." It's not that Iraq has a backward medical system; the country's doctors are highly trained, its major hospitals at least well-equipped. But it was one of the whims of the tyrant's regime that bone-marrow transplants were forbidden. Now of course that could change, but it'll be years before a transplant center can be built and equipped, and Ahmed Awayid only has weeks, at best a month or two.
His mother, Jasmin Nassir, kneels by his bedside, unable to comfort him beyond fanning flies away, and holding his hand. The hospital is rationing painkillers now; its supply of morphine is down to a mere 400 doses, which won't last long in a 300-bed hospital running nearly full. It's hot in the room, without air conditioning in the 100-degree Fahrenheit weather, and she's wearing her heavy black chador from head to toe. She's there in the morning, and still there late in the evening. The next day his father, an occasional laborer, spends the day, along with an older daughter. The parents alternate taking care of their other nine children, two boys and seven girls.
The situation at Saddam General, recently renamed An Nasiriya General Hospital, is similar to hospitals throughout Iraq. They're short of everything after years of sanctions, in which the regime insisted it was unable to buy enough medicine and medical supplies--even while stockpiling huge hoards of cash and building enormous palaces. This hospital has run out of material to keep a blood bank going and the solutions necessary to run its kidney-dialysis machines. The supply of sutures is down to a few hundred pieces. Radiology is running out of film. Many key medicines are completely out of stock. Perhaps the worst example is Pentostam, a drug that is highly effective against leshmaniasis, a disease that mostly afflicts children and is spread by sand flies from the nearby Euphrates River. The hospital has none. Without treatment, the disease is 100 percent fatal. Now, doctors are using older treatments, which have horrible side effects and aren't very effective. Dhayer, the hospital pediatrician, says there are 70 such cases now, and most will die. "This is a disease that only presents in the south, and they didn't care about the south." Most victims are Shiites, who are the great majority in An Nasiriya and the surrounding area.
So far, aid groups have been little help to the hospital. "They keep sending us doctors, but we don't need doctors," says Dr. S. J. Bakhouri, the chief of radiology. Groups like Doctors Without Borders and Medicins du Monde have been through, but mainly offering physician-based services. "We need supplies. Stuff rather than staff." An American civil-affairs doctor, Navy Cmdr. Ace Walker, visited the hospital yesterday and agreed. "These guys are great docs, they just need the tools to do their job." He said the American military is already bringing some supplies to the hospital and hopes to get more in.
That won't, of course, help Ahmed Awayid. Even before his relapse, his chances weren't good; he was on a course of chemotherapy that the Iraqi doctors say was 10 years out of date. Fear of dual use of some chemotherapy materials, in bioweapons particularly, prevented their import. Once Ahmed relapsed, the normal course of treatment would have been a bone-marrow transplant. His parents know that, said Mahawis Awayid, the father. "The doctors told us there's no hope. We've told everyone in the family that he'll die, but we haven't told him," he said. "He's suffering enough."
He continues: "I know that a transplant is the only thing that can save him. Maybe the Americans could take him to get one." With so many other needy cases in Iraq, with the border closed and a state of war still in place, it's a slim hope, but all this Shiite family has.