x Abu Dhabi, UAEWednesday 24 January 2018

Iraq's healthcare woes boost traditional healing

Concerns over poor state-run medical services are driving many towards a cheaper and, sometimes less dangerous, alternative.

BAGHDAD // For many of the Iraqis in the heart of Baghdad's old Bab al Moutham district, the advances in medical science made during the course of the last century might as well have never happened. Rather than consult doctors with any semblance of modern training, scores of patients from across the country prefer to take remedies from healers with no formal qualifications and who consult medical texts written a thousand years ago by the Islamic scholar Ibn Sina.

Shops in the grimy souk are stocked with spices from India and China, their shelves lined with jars filled with concoctions designed to cure ailments ranging from sore feet to lung cancer. In essence Bab al Moutham has been this way since the days of the Abbasid caliphate. Perhaps its oldest, most respected practitioner today is Haji Kitab. His shop was opened by his great grandfather and passed down, together with the aged copies of Ibn Sina's medical texts, from one generation to the next.

"Our treatments are all natural and the knowledge of how to use them for healing comes from across the world," he said, standing beneath the bare bulb that lights his hole-in-the-wall cubicle. "With herbs and spices and plants it is possible to cure most diseases. From my father I learnt how to treat small problems, like common colds, and bigger problems, like heart and kidney diseases." Mr Kitab keeps ledgers filled with the names, ailments and prescribed cures of all of his patients, and claims most as success stories.

"I am not boasting when I say that I have saved the lives of many people; it is something I am proud of," he said, one of the record books open on the crowded workspace in front of him. According to Mr Kitab and the other healers, their businesses had all but died off during the early years of Saddam Hussein's rule, when Iraq's state-run medical services were among the best in the Middle East and freely available. Rather than work as healers, they were little more than spice merchants.

Trade then began to pick up during the 1990s - a decade in which crippling economic sanctions were imposed on Iraq - and boomed following the complete collapse of national infrastructure after the US-led invasion of 2003. Once again, Iraqis flocked to Bab al Moutham rather than hospitals in search of medical care. "I get a lot of customers who have had bad experiences with doctors and hospitals and who would prefer to put their faith in traditional methods," Mr Kitab said. "Natural medicines do not have harmful side effects, they will not cause damage like modern medicine. Many Iraqis have been killed by bad doctors and bad drugs, so people come to me instead."

A common complaint among Iraqis is that clinics, particularly outside of the capital, are dirty, poorly managed and hamstrung by corruption that sees supplies of drugs sold off on the black market. The ministry of health has established anti-corruption measures to try to tackle the problem, but it remains widespread. Patients and senior doctors alike also say the latest crop of medical school graduates are not up to the standards of previous generations, many of whom studied in Europe. Iraq produced some of the world's best doctors during the 1970s and 1980s, but today they are more likely to be found working in London hospitals than in Iraq, pushed out by violence, meagre salaries and restricted opportunities.

"I've been coming here for four years," said Abu Jaafer, a regular customer at Mr Kitab's store, making the long journey from Nasariya, 370km south-east of the capital, once a month for treatment. He lost a kidney before his first visit, something he blames on poor medical advice from a qualified doctor. "After my kidney problem I was advised by a friend to come here and I'm glad I did. Now my health is stable. I trust old Arabic medicine more than I trust the dirty modern hospitals in Iraq."

Another devotee of Bab al Moutham's traditional medicines is Abdullah Rusul Sultan, a 40-year-old diabetic from nearby Sadr City, the sprawling Shiite slum of northeast Baghdad. Unemployed, he cannot afford to pay for the drugs prescribed by hospital doctors. Traditional healers provide an affordable alternative, with many happy to give free treatment to the poor. Mr Sultan said he would prefer to have high-quality modern western medical treatment but, failing that, traditional Arab healing methods were better than the government provided facilities.

"I know that traditional medicines are not as good for dealing with the big diseases or medical problems, but they are a good solution for the poor," he said. "And at least you can be sure that spices and herbs are not going to make your condition worse. If you go into a hospital here, you are likely to come out more sick than you went in. There are too many bad side effects from hospitals." In another dirty corner of the herbal medicine market, Abu Mona, a shop owner, said he had thousands of regular customers from across the country, mainly the poor.

"People come and we treat them even if they have no money," he said. "They trust us more than they trust trained doctors and they trust our medicines more than they trust dangerous chemicals and drug given out in hospitals." The growing popularity of traditional healers is something the government and trained doctors broadly frown upon. But some medical professionals accept it is a natural response to failures in state-run health facilities.

"Iraqi people in general are less confident than before in the national health system and not without reason," said Sahban al Kafji, a retired surgeon who used to work in Baghdad's al Kindi hospital. "Doctors with experience have left Iraq and the new, inexperienced doctors have killed many people by giving the wrong medicines, by making wrong diagnoses." Dr al Kafji urged the government to make improving health care a national priority.

"I have a friend working in al Kindi [hospital] and he recently had to do an operation to take a bullet out of a wounded soldier," the 68-year-old said. "There was no electricity so they worked by the light from a cigarette lighter. How can a healthcare system function that way? Why would people have confidence in it? "We need to find a solution to this otherwise more and more people will go back to the old healers."