As of 26 July 2020, Iraq reported 107,573 COVID-19 cases, with 4,284 deaths. Although these numbers may seem small when compared to reported cases in other countries, the ineffective healthcare system in Iraq, coupled with the long-standing effects of war and the general distrust many Iraqis feel towards the government, exacerbates the threat of the virus in Iraq.
COVID-19 introduces a new, perilous threat to Iraq, with its ineffective public health system that has weakened as a result of 40 years of crisis, poor governance, and corruption. There is a lack of medical equipment, personal protective equipment (PPE), and healthcare professionals. Therefore, Iraq is unable to provide sufficient tests to its citizens, or to treat large numbers of sick people.
“COVER-UP” OF THE ACTUAL NUMBER OF COVID-19 CASES
On 2 April 2020, Reuters published a report showing that the Iraqi government had concealed the correct number of COVID-19 cases, and that the actual number of infections and deaths were much higher than the reported figures. As a result of this, the Iraqi media regulator suspended Reuters’s licence for three months and fined it £16,600 for breach of media broadcasting rules. This harsh response by the Iraqi government suggests that there was merit in the discrepancies reported by Reuters. Reports from Iraqi doctors and other healthcare professionals have also criticised the official figures, implying that the number of cases reported by the government was not correct.
One of the factors that could explain the government’s failure to keep accurate records of COVID-19 cases is the lack of doctors and healthcare workers who could conduct tests and record accurate figures. Moreover, the government mainly relies on patients self-presenting at public hospitals and only recently started community-based testing. This is an unsustainable approach, as relying on self-presentation requires that Iraqis trust their government and healthcare system. The majority of Iraqis have no trust in the current government, led by those who supported the invasion of Iraq. This is because of the sectarianism and corruption among politicians and civil servants.
Consequently, in October 2019, a series of mass demonstrations escalated and spread nationwide across most of Iraq’s cities. The peaceful protestors demanded reform of the political system that allowed for corruption, a lack of economic opportunities, and the privatisation of public services to flourish. The Iraqi government and paramilitary groups responded to these protests by killing over 300 people and wounding nearly 15,000. The distrust in the Iraqi government has also led many people to refuse quarantine, believing that the state is arresting their freedom. Therefore, the distrust in government puts Iraq’s response to the outbreak at a particularly high risk of failure.
A DAMAGED AND INEFFECTIVE HEALTHCARE SYSTEM
Under the regime of Saddam Hussein, the healthcare system in Iraq started to deteriorate. With the wars and sanctions on Iraq in the 1990s, and as a result of the war in 2003, the public health system weakened systematically. In addition, the damaging of the public health system is partially linked to the privatisation of the health system that has occurred over the last 15 years. As Sami Adnan, an activist of Workers Against Sectarianism, puts it: “Today we have to pay for every single visit and often, in order to get treatment, we are obliged to give a bribe to the few remaining doctors in the country.”
For the last 17 years, Iraqis have suffered the consequences of the illegal invasion led by the US in 2003. The war did not only lead to a loss of lives, but also affected Iraq’s infrastructure, health services, and governance. Since the invasion of Iraq, the Iraqi government has repeatedly failed to provide an effective health system. The current Iraqi Health Ministry has failed to provide sufficient ICU beds, ventilators, and PPE in response to COVID-19. Consequently, healthcare professionals are concerned that the Iraqi healthcare system is unprepared for the virus. This lack of preparation for COVID-19 forced a few Iraqi doctors to reach into their own pockets in order to purchase medical equipment. Several doctors also used social media to help provide urgent medical advice.
Another issue amidst the COVID-19 crisis is that the Ministry of Health works with security forces and police to impose curfews and quarantine. For Iraqis, this means that the same security forces that cracked down on peaceful protesters in 2019 are now behind the COVID-19 response. This has created distrust between Iraqis and military forces, and, as a result, many people refuse to follow the guidance issued by the Ministry of Health. This has, in turn, resulted in religious authorities, including Grand Ayatollah Sistani, asking people to comply with quarantine requirements. However, even this appeal is insufficient, as trust between government and citizens is vital in combating the virus. Furthermore, the Iraqi government must provide more technical and financial support to healthcare professionals and institutions.
Besides the political factors, there are social factors that make Iraq particularly exposed to the virus and which contribute to the spread thereof. For instance, men in tribal communities opposed the quarantining of female family members who tested positive for COVID-19. In addition, some religious leaders have propagated that Muslims would not be hit by the virus, because God protects them. This has led many followers to now refuse to be quarantined.
For a war-torn country like Iraq, an inadequate response to COVID-19 puts its population at real risk. The reaction to COVID-19 exposes the long-standing failure of governance following the invasion of Iraq led by the US. To combat the virus, the Iraqi government must invest in Iraq’s healthcare system and provide enough ICU beds, ventilators, PPE, and healthcare professionals.
Aya is a final year LLB student at Middlesex University. As a person who fled the war in Iraq, she has always been passionate about human rights and international affairs. Consequently, she chose to study UK and European Human Rights in her second year of LLB. She will also start the LPC with LLM in Human Rights in September 2020. Her goal is to practice human rights in the future.