• National Vaccination Day reports

I I I I I I I I r r r r r r r r a a a a a a a a q q q q q q q q M M M M M M M M i i i i i i i i n n n n n n n n i i i i i i i i M MO OH H- -O OC CP PA A H He ea al lt th h This week’s briefs: • National Vaccination Day reports from governorates indicate good participation. The World Health Organization and UNICEF released vaccines following reestablishment of critically needed cold storage. • Pharmaceutical and medical supply deliveries. 28 convoys totaling 500 tons of pharmaceuticals and medical supplies have been delivered throughout Iraq. • The Ministry of Health and non-profit WIRED International partner to set up Medical Info Centers in Baghdad. Computer CD-ROM libraries are funded by the US Department of State and private donors • Security for Iraqi Medical Facilities. US medical elements completed the assessment, training and certification of 112 Iraqi Nationals who will provide protective services for critical medical facilities and the Iraqi MOH. Another 170 student’s l graduate Saturday. • Adopt-a-Hospital Program paper was finalized and circulated at a donor conference in New York, Ny. It will soon be available on the CPA website. Public health: vaccine campaign U.S. helps plug vaccination gap in postwar Iraq BAGHDAD (Reuters) - U.S. troops on Sunday helped Iraqi health workers immunize children who missed their jabs because of the U.S.-led invasion launched three months ago. Jim Haveman, the U.S. official supervising efforts to rebuild the shattered Iraqi health system, blamed Saddam Hussein for diverting money from health care to palaces. s s s s s s s s t t t t t t t t r r r r r r r r y y y y y y y y o o o o o o o o f f f f f f f f H H H H H H H H e e e e e e e e a a a a a a a a l l l l l l l l t t t t t t t t h h h h h h h h W W W W W W W W e e e e e e e e e e e e e e e e k k k k k k k k l l l l l l l l y y y y y y y y U U U U U U U U p p p p p p p p d d d d d d d d a a a a a a a a t t t t t t t t e e e e e e e e 1 T Te ea am m C Cu ur rr re en nt t P Po ol li ic ci ie es s a an nd d I In ni it ti ia at ti iv ve es s, , V Vo ol l. . 3 3, , W We ed dn ne es sd da ay y, , J Ju un ne e 2 25 5, , 2 20 00 03 3 "In 2002, Saddam Hussein's regime spent 10 percent on health care when compared to what it spent 10 years earlier.” "In 2002, Saddam Hussein's regime spent 10 percent on health care when compared to what it spent 10 years earlier. Health care money was diverted from the (U.N.) oil-for- food program. "That money was spent on palaces and used for extravagant luxuries," Haveman said. Escorted by U.S. combat troops, he watched Iraqi nurses jab screaming babies and toddlers with vaccines for diphtheria, polio, measles, tetanus, tuberculosis and hepatitis B. UNICEF has received $7 million of U.S. government money to fund the resumption of regular vaccinations halted by the invasion launched by the United States and Britain on March 20. The war brought the Iraqi health system, already battered by nearly 13 years of U.N. sanctions, close to collapse. While some Iraqis loudly protest against the U.S. occupation, the vaccination campaign appeared well received. "The parents know they (the U.S. soldiers) are here to help them. They feel safe. We are not frightened," said Dr. Sana Jawad, manager of 25 clinics in the south of Baghdad. U.S. forces were widely criticized for failing to prevent looting of many clinics and hospitals across Iraq after the collapse of Saddam's government on April 9. Since then soldiers of the 82nd Airborne Division have helped guard some health facilities in southern Baghdad, as well as working to restore power, fuel and oxygen supplies. But for an anti-war poster hanging on one hospital wall, the American presence appeared welcome at five health care centers that U.S. officials took reporters to on Sunday. Haveman said his focus was on basic health care, with an eye toward trimming infant and child mortality rates. He said the child mortality rate was 108 per 1,000, double what it was two years ago. The next vaccination campaign day will be held on July 22. All vaccinations will once again be provided free of charge. I I I I I I I I r r r r r r r r a a a a a a a a q q q q q q q q M M M M M M M M i i i i i i i i n n n n n n n n i i i i i i i i M MO OH H- -O OC CP PA A H He ea al lt th h Diarrheal disease Diarrheal disease continues to occur at about twice the usual rate. Work is going on to remove sewage and garbage from the streets, and to repair the water distribution network. However there are still areas where water quality remains poor, and power supply problems continue to impact adversely. Levels of chlorine added at treatment plants have been increased to offset high levels of organic contamination, and imports of chlorine have been increased. Stocks of Oral Rehydration Salts (to prevent dehydration in people with diarrhea) are now sufficient for immediate needs, and more will arrive next week. There are also adequate supplies of intravenous fluids, drugs and other supplies for those with very severe infection. The Ministry of Health along with the CPA Public Health team is working on a rapid assessment of the local capability to resume vector spraying in the relevant parts of Iraq. The assessment is looking at the condition of equipment for insecticide fogging and residual spraying, and the supplies of insecticide. The objective will be to carry out an emergency program in early July, to make up for the missed May program, and then resume the regular program when next due, in October. In the central (Baghdad), south and west areas the main target is the sand fly (which can transmit Technology Corps -- brings IT to Iraqi medical students s s s s s s s s t t t t t t t t r r r r r r r r y y y y y y y y o o o o o o o o f f f f f f f f H H H H H H H H e e e e e e e e a a a a a a a a l l l l l l l l t t t t t t t t h h h h h h h h W W W W W W W W e e e e e e e e e e e e e e e e k k k k k k k k l l l l l l l l y y y y y y y y U U U U U U U U p p p p p p p p d d d d d d d d a a a a a a a a t t t t t t t t e e e e e e e e 2 T Te ea am m C Cu ur rr re en nt t P Po ol li ic ci ie es s a an nd d I In ni it ti ia at ti iv ve es s, , V Vo ol l. . 3 3, , W We ed dn ne es sd da ay y, , J Ju un ne e 2 25 5, , 2 20 00 03 3 leishmaniasis), while in the north and east the main target is the mosquito that can transmit malaria. week at the two other primary teaching hospitals in Baghdad and at the Spinal Cord Center, a specialty clinic for severe neurological injuries. MOH partners wit U. S. Global Selnow and WiRED International technologist Freeman Pangborn are in Iraq this week sponsored by State Department’s Bureau of International Information Programs, the Bureau of Education and Cultural Affairs, the Bureau of Near Eastern Affairs, and the Office of the Under Secretary for Public Diplomacy and Public Affairs. This innovative public diplomacy collaboration supports U.S. government activities to rebuild critical infrastructure in Iraq and target key audiences, including the medical community. The U.S. Global Technology Corps sends U.S. citizens overseas as volunteers to further the Department of State’s International Affairs Strategic Goals by introducing, implementing and fostering information and communication technology in technologically challenged environments. Pharmaceutical supplies BAGHDAD -- Tuesday the MOH along with USGTC non-profit partner, World Internet Resources for Education and Development (WiRED) International opened a ten workstation computer center with a 130 disk CD-ROM library of current health education information at the Medical City Center of the University of Baghdad, the largest teaching hospital in Iraq. Dr. Gary Selnow, executive director of WiRED International, presided at the opening ceremony. Selnow was joined on the podium by the Coalition Provisional Authority’s Senior Adviser to the Ministry of Health, Mr. James Haveman and Dr. Saeb Saddiq, Director General of Medical City. Despite periodic power outages during the ceremony, more than sixty doctors, nurses and students packed the newly equipped medical information center and flocked to the workstations following the conclusion of the formal opening remarks. Three similar medical information centers will be established this flow at impressive rates MOH and NGO representatives continue • 500 tons of pharmaceuticals valued at more than 3/4 billion dollars have reached hospitals and clinics across Iraq. Military medicine -- update from the Al Karkh district I I I I I I I I r r r r r r r r a a a a a a a a q q q q q q q q M M M M M M M M i i i i i i i i n n n n n n n n i i i i i i i i s s s s s s s s t t t t t t t t r r r r r r r r y y y y y y y y o o o o o o o o f f f f f f f f H H H H H H H H e e e e e e e e a a a a a a a a l l l l l l l l t t t t t t t t h h h h h h h h W W W W W W W W e e e e e e e e e e e e e e e e k k k k k k k k l l l l l l l l y y y y y y y y U U U U U U U U p p p p p p p p d d d d d d d d a a a a a a a a t t t t t t t t e e e e e e e e 3 M MO OH H- -O OC CP PA A H He ea al lt th h T Te ea am m C Cu ur rr re en nt t P Po ol li ic ci ie es s a an nd d I In ni it ti ia at ti iv ve es s, , V Vo ol l. . 3 3, , W We ed dn ne es sd da ay y, , J Ju un ne e 2 25 5, , 2 20 00 03 3 working on a new distribution plan for pharmaceuticals. To date the MOH Emergency distribution measures led by Dr. (Lt. Col.) Chuck Fisher have maintained a steady flow of drugs and medical supplies from the warehouses of Kimadia to hospitals and clinics throughout the country: like those needed to treat cancer. They are either in short supply or completely gone. We evaluated the two warehouse facilities in Erbil. They were impressed by the cleanliness and professional organization of these warehouse complexes, which each had AC and good lighting. • Evaluation of staff • Share recommendations • Met with tribal leader • Met with NGOs in Erbil • Recognized the vast difference between the North and the South • Plan to use Erbil as a model the rest of Iraq. The cold chain rooms were all functional with generator backup. The city power is quite reliable in Erbil. They discussed excess capacity, which could be used to store the needs of other Kimadia facilities if space becomes an issue. Future assessment trips will be directed to Southern Iraq. They accepted lists of needed drugs and supplies and we will work with Kimadia Baghdad to ensure that Erbil and the other northern governates receive their needed supplies soon. The following bullets concisely illustrate much of the trip: • Meeting with Dr. Lezgin Ahmed, DG of Planning and Health at MOH • Meeting with WHO in Erbil • Meeting with USAID in Erbil • Meeting with all Northern governorate representatives • Review and assess the warehouses in Erbil • Cold chain evaluation • Discussion of excess capacity in Northern governorates • Interaction with regional CMOC • Pharmaceuticals and other medical supplies distributed through Kimadia will continue to be provided to hospitals free of charge. • All Patients in public hospitals and health centers who are prescribed pharmaceuticals will receive them at no charge. MOH team forges north on multi-task mission: medical eval and pharmaceuticals assessment Team doctors traveled to Erbil, Iraq on June 21 to evaluate an ill boy who had an object lodged in his lung. Surgery will be scheduled in the next few weeks. The team also went to assess the Kimadia warehouse complex in Erbil. The number one concern was critical drugs Al Karkh medical district health administration took a quantum leap forward this week with the purchase of three computers and printers for the district office. These computers will be used to standardize inventory procedures and track clinic operations. This is the first step in a 6 month initiative to provide all public health clinics in Al Karkh with a computer. The computers were purchased by the Al Karkh District leadership through a grant from coalition commander discretionary funds. US Military and Iraqi physicians will be teaming up next week to provide physical examinations for 137 disabled veterans in the Baghdad area. No patients should be paying charges either for drugs or for other patient services in any public health facility. I I I I I I I I r r r r r r r r a a a a a a a a q q q q q q q q M M M M M M M M i i i i i i i i n n n n n n n n i i i i i i i i s s s s s s s s t t t t t t t t r r r r r r r r y y y y y y y y o o o o o o o o f f f f f f f f H H H H H H H H e e e e e e e e a a a a a a a a l l l l l l l l t t t t t t t t h h h h h h h h W W W W W W W W e e e e e e e e e e e e e e e e k k k k k k k k l l l l l l l l y y y y y y y y U U U U U U U U p p p p p p p p d d d d d d d d a a a a a a a a t t t t t t t t e e e e e e e e 4 M MO OH H- -O OC CP PA A H He ea al lt th h T Te ea am m C Cu ur rr re en nt t P Po ol li ic ci ie es s a an nd d I In ni it ti ia at ti iv ve es s, , V Vo ol l. . 3 3, , W We ed dn ne es sd da ay y, , J Ju un ne e 2 25 5, , 2 20 00 03 3 The Al Thura Handicap Community located in the Al Dawra neighborhood is home to 137 disabled veterans and their families. This closed community was supported by the Ministry of Defense under the previous regime. A major military effort is underway to coordinate immediate assistance for this community whose clinic and community building was severely looted during the war including infrastructure repair, replacement of damaged wheelchairs, clinic supplies and medical records. therapeutic oxygen supplies, routine maintenance – are available for each Directorate. Hospitals and clinics should contact their local Directorate for further details. Governate information from three regions this week. A computer donated by Wired International will allow for data entry and project tracking. A decision will be made in the near future on whether to re- introduce some patient charges for the remainder of this year, and if so at what level. For the meantime, the no charge “holiday” announced in May continues. Ministry of Health Engineers The Project Management Team for Hospitals has completed “bills of quantity” for 5 hospitals this week and will liaison with 3 NGOs on possible projects for the future. Payment of salaries for healthcare workers The Project Management Team for Clinics made contact with over 50 clinics in Baghdad this week in preparation for the massive clinic rehabilitation efforts in the coming months. The Project Management Team for Generators completed the requirements work for the $9 Million emergency generator contract for the 5 highest priority hospitals in Baghdad and 6 Baghdad clinics which have no power due to a lack of grid power or generator failure. Emergency repairs in excess of $60K have been contracted and will start this week. This includes $36,000 in emergency generator repairs at Al Mansoor A number of hospitals are reporting errors or omissions in the April salary payments and these are being resolved as quickly as possible so that no Iraqi healthcare workers miss out. Directorates are now submitting their payroll lists for the May and June salary payments and we hope to be able to make the first payments early next week. As previously announced in this Update, salary payments for May and June will be made simultaneously and will be paid in dollars. Other financial issues The Ministry of Health has submitted its proposals for the healthcare budget for the remainder of this year (July to December 2003). Decisions will be announced during July. Health Facilities Infrastructure Update Budgets to cover non-salary expenditures for June – the cost of providing meals for patients and residents, fuel, Facilities Project Management Database This week the database team started the design phase for the facilities project management database which will include assessments, updates, back- ground information and any projects related to a facility. The team made contact and started receiving MoH I I I I I I I I r r r r r r r r a a a a a a a a q q q q q q q q M M M M M M M M i i i i i i i i n n n n n n n n i i i i i i i i s s s s s s s s t t t t t t t t r r r r r r r r y y y y y y y y o o o o o o o o f f f f f f f f H H H H H H H H e e e e e e e e a a a a a a a a l l l l l l l l t t t t t t t t h h h h h h h h W W W W W W W W e e e e e e e e e e e e e e e e k k k k k k k k l l l l l l l l y y y y y y y y U U U U U U U U p p p p p p p p d d d d d d d d a a a a a a a a t t t t t t t t e e e e e e e e 5 M MO OH H- -O OC CP PA A H He ea al lt th h T Te ea am m C Cu ur rr re en nt t P Po ol li ic ci ie es s a an nd d I In ni it ti ia at ti iv ve es s, , V Vo ol l. . 3 3, , W We ed dn ne es sd da ay y, , J Ju un ne e 2 25 5, , 2 20 00 03 3 Pediatric Hospital in Medical City and Al Samaraay Hospital today. Liaison with IOs and NGOs The WHO has been approved for $260,000 for continued renovation to the MoH central building plus four other projects including: three laboratories and Kimadia Warehouse #2 will receive funding for repairs. CPA, MoH and the WHO will work cooperatively on these vital projects. Continuing Education Continuing Education for Engineers will start this coming Monday morning. The subject of the lecture will be biomedical engineering. New Projects World Medical Mission and Samaritan’s Purse are looking into aid for the Al Eskan Central Children’s Teaching Hospital. The CPA and donor community is looking into a renovation of the sewage system in Al Mansoor Pediatric Hospital in Medical City. Teams Building MOH engineering reps from all over Iraq have started coming to the central ENG DEPT -- National Nurses Group meeting for nursing in Iraq at the Convention Center. Ministry reps return from NY. Donor conference It will involve Iraqi nursing delegates and experts from throughout the country to identify and address major development- al needs for the nursing profession in Iraq. Short-term, urgent nursing concerns as well as long-term, structural changes will be focused on. Friday, MOH’s Dr. Said Hakki. IRDC Director for Health and Dr. Emaddin Saod Al-Kubaisy, a representative of Iraqi Resident Doctors and surgeon at Al-Saheed Adnan hospital, return from donor conference in NY, Ny. The meeting is being sponsored by USAID and hosted by the 352nd Civil Affairs Command Public Health Team. A special invitation is extended to NGOs, IOs, UN agencies, and any other interested parties. Trip report and Adopt-a- hospital overview: See Update next week’s issue. Events calendar This is another first for the MOH, providing nurses the opportunity to contribute and develop their profession and healthcare in Iraq. Women’s health issues June 28th at 10:00 a.m. Graduation of the MOH’S second Protective Facilities Service class at the Convention Center July 3rd at 11:00 a.m. MOH – NGO meeting on Health at the MOH Bldg. July 15-16th National Nurses Group Meeting at the Convention Center A.S.A.P. – July The MOH Advisory Team will relocate in the MOH Bldg. to conduct all MOH business and meetings. Meeting, July 15 & 16, 2003 BAGHDAD -- The National Nurses Group in the MOH announces a national consultative A group of senior women from across the Ministry of Health met today to discuss ways of identifying and taking forward women’s health issues including: • Identifying the issues affecting the health and welfare of Iraqi women. • Involving women across the health sector to ensure that women’s views are gained at all levels and are representative views of women in the Iraqi health system Please e-mail your questions or comments and event calendar input to: andersondm@orha.centcom.mil