Weekend House Call: Iraq's Health System in Tatters, Struggles Towards Recovery
KELLI ARENA, ANCHOR: WEEKEND HOUSE CALL is next but first these headlines. President Bush is hosting the leader of Mexico at his Texas ranch today. It's an effort by Mr. Bush to patch up relations with Vicente Fox, which have been strained in recent years. President Fox is expected to press Mr. Bush for more liberal immigration policies for Mexicans. In the Middle East, Palestinian gunmen in Jeeps attacked an Israeli military post. One Jeep has been made to look like an Israeli military vehicle. The Israelis killed one of the attackers. The other Jeep blew up, killing three Palestinian security officers. No Israeli casualties reported. And updating a story that we told you about earlier, 12 Russian polar explorers have been rescued from an ice flow in the Arctic. The scientific team has been at the North Pole station for nearly a year. Most of their research station fell into the Arctic Ocean when the ice shelf suddenly broke off. Two Russian helicopters few through total darkness to reach the stranded team and their dogs. WEEKEND HOUSE CALL with Dr. Sanjay Gupta begins right now.</s>DR. SANJAY GUPTA, HOST: Good morning and welcome to WEEKEND HOUSE CALL. We're talking about a public health system falling apart, women having babies, released from the hospital in mere hours, children dying from treatable illnesses, hospitals looted and unsanitary. Of course, it's not in your hometown. It's in Iraq. Today, nearly one year after the war started, we're taking you inside Iraq's hospitals to talk with the people struggling to try and make this system work. We're also going to take you to Jordan to meet an 8-year-old who survived the war and is battling cancer now with the help of her neighbors. Her recovery, like her country's progress, is measured in small successes.</s>GUPTA (voice-over): This hospital in Baghdad specializes in pediatric care. It's not enough, though, to meet the challenge. According to the Iraqi minister of health one in ten infants will die before they're a year old. Antibiotics that save lives and cost just pennies in the United States are in short supply. These women, for example, are at risk of dying from routine infections. In Iraq about three in 1,000 mothers die after childbirth. Some hospitals go dark at night. Why? Because there aren't enough light bulbs: yes, light bulbs. Doctors have been using texts books that are decades old and providing patients with the associated obsolete care. Sadly, the Iraqi health care system that 30 years ago was the finest in the Middle East needs more than a financial Band-aid. It needs to be overhauled.</s>TOMMY THOMPSON, HHS SECRETARY: What we're going to do as a department is to collaborate and to cooperate and to partnership with the people in Iraq to rebuild that medical system back to what it was in the 1970s.</s>GUPTA (on camera): Without question Iraq's health system faltered, some believe because of a cruel dictator who made his people pay for the embargoes placed on his country. Others believe three wars in 20 years were more to blame.</s>THOMPSON: Sure the war complicated things, but it was much more the neglect of Saddam Hussein for over 15 years that really ruined the medical infrastructure in Iraq.</s>GUPTA (voice-over): To be sure, best estimates say Iraq spent around $20 million on health care in 2002. That's about 68 cents per person. This year the expenditure will be close to $900 million, or about $40 per person, most of that money from oil revenues. For reference, in the U.S. around $4,000 is spend per person by the government. And the newly appointed minister of health wants even more.</s>DR. KHUDAIR ABBAS, IRAQI HEALTH MINISTER: It could take as much as, you know, to take $1 billion as a start. It's not bad as all, but I would wish 2004 to have, for example, $2 billion.</s>GUPTA: Starting from scratch will not be easy, but most Americans and Iraqis agree that is what needs to be done. For too long, little or no money was spent on the infrastructure needed to provide basic care and prevent disease. Nine hundred million dollars may change that, slowly.</s>GUPTA: Just to put this into perspective of how far this system has fallen. Over two decades ago, 97 percent of Iraqis, living in the city had access to health care. The health system included malaria and TB control with a large immunization program. Fast forward now past the Iran-Iraq war and the Gulf War to the mid-'90s. Only a quarter of the equipment in hospitals actually worked. Surgeries were restricted, due to lack of anesthesia. And food rationing limited people to about half their daily needs. By the late '90s, only 10 percent to 15 percent of Iraqi citizens were getting the health care they needed. Fast forward to the present, and it's one year after another war. So how are the hospitals doing? Take a look.</s>GUPTA (voice-over): If you want to know just how strapped the Iraqi medical system is for resources, look at this. They are painting over the windows in an effort to seal this operating room from contaminants outside. It is reflective of a severely underfunded Iraq health system that has failed its people.</s>DR. SHAKIR AL-AINACHI, IRAQ MINISTRY OF HEALTH: The amount of money spent was very, very few. It was $16 million for the whole country, and you can imagine. This is 25 million, how much cents were for a person.</s>GUPTA: That comes to just 68 cents per person. The feeling among the citizens was clear. They have long thought of hospitals as a place you go to die. (on camera) This hospital in Baghdad is supposed to be one of Iraq's finest. It was cleaned up yesterday for a visit from the secretary of health, Tommy Thompson, but just a few weeks ago it was a disaster. DR. SALMA HADAD, PEDIATRIC ONCOLOGIST? The sewer system wasn't working. The ventilation system wasn't working. Also, there are many days the hospital has stayed without water and the patients had no water. Sometimes the families were brought water from their homes.</s>GUPTA: And that is in the capital city of Iraq. Move further out and the situation is even more dreadful.</s>UNIDENTIFIED FEMALE (through translator): Yes, it's hard to get clean water. We are able to get just a little of it.</s>GUPTA: the system is remarkably primitive. And it's not just the lack of water. It is raw sewage contamination, lack of electricity and medications, and the prevalent fear the doctors and nurses still have for their own lives, fear if not of Saddam Hussein himself, then of his supporters.</s>HADAD: You know we are under oppression, and nobody can blame the government for anything. Even we can't comment.</s>GUPTA: But the newly appointed health minister is quick to lay blame on the former leader instead of the wars or the embargoes.</s>ABBAS: He would like to make some more political propaganda, saying, "Look, America and Britain and the whole West are punishing us and this is the result."</s>GUPTA: today the sanctions are over, and the coalition authorities believe that Iraq's 240 hospitals are in better shape than they were last year. They are all up and running, and both doctors and nurses are being paid, up to $400 a month for some doctors, money that comes from oil revenues. But, still, new light bulbs, and that fresh coat of paint aren't enough to save sick patients.</s>GUPTA: Kids are especially at risk in a country that can't handle the most basic of needs. Eight agencies on the ground in Iraq estimate one in four children in that country don't have access to safe water, and sometimes any kind of water at all is hard to come by. A third of all kids are malnourished. For many this problem starts before birth with an estimated 25 percent of infants born underweight.</s>GUPTA (voice-over): It is often said that children reflect the health status of a country. Based on that, Iraq's situation has been dire for some time.</s>ABBAS: The diarrhea problem, for example, and the chest infection and the infant mortality. Partly due, for example, to lack of pure water to drink, the contamination which happens in food.</s>GUPTA: The most basic of health hygiene denied, leading to out of control infant mortality rates. The best estimates are that one in ten newborns will die. Of those who do make it, nearly eight percent waste away and die of malnutrition before the age of 5. The problems, in part because of the sanctions, in part because of three wars in 20 years. Perhaps because of a cruel dictator.</s>THOMPSON: Saddam and his wave wanted to use this as a way to show the world that America was being evil, which it certainly wasn't. He was evil, and he was evil personified. And now we have to rebuild that for the people of Iraq.</s>GUPTA: And so now, without looking back, Iraqis want to move forward with the help of the Americans.</s>HADAD: I hope that there many be rebuilding the health services, and our health system back again like it was before, to give these children the best chance of a cure and survival.</s>GUPTA: The specific goal, to save half the children who now die by 2005, comes with a $1 billion price tag. The payoff: to allow a new generation of Iraqis to grow and reflect the best of the nation. (on camera) Depending on who you ask, Iraq's health system is either in total chaos or as good as it's ever been. So which is it? Coming up, we'll let you decide. (voice-over) Secretary Tommy Thompson walked these wards and saw firsthand the state of these hospitals. Can this crumbling system and its youngest victims be helped? We'll ask him after the break.</s>GUPTA (voice-over): Twenty-six thousand tons of pharmaceuticals and supplies have been delivered to Iraq since May of last year. To put that sum in perspective, that's equal to a medium-sized cruise ship.</s>GUPTA: Along with supplies, Iraq is getting more money. Just last week several countries agreed to give a total of $1 billion towards reconstruction. But even with that oil revenue money coming in, the violence and disorder continues in Iraq. So what does the future hold? I sat down with HHS Secretary Tommy Thompson while he was visiting Iraq last week.</s>GUPTA: Joining us now, secretary of Health and Human Services, Tommy Thompson. Mr. Secretary, thanks for joining us. A few questions for you. First of all, what is the purpose of your visit out here?</s>THOMPSON: The No. 1 purpose is to see how we can, from the Department of Health and Human Services, rebuild the medical infrastructure in Iraq. Iraq in the 1970s was a world power as it relates to medical excellence. They had great medical schools. They had great training. And people from all over the world went to Iraq to get cured from diseases. And then systematically, Saddam Hussein has destroyed the medical infrastructure, the medical system. Doctors are poorly trained, and just because of lack of training. And now we have an opportunity to rebuild that. The second thing, of course, is to carry the message from President Bush that the country of Iraq is a country that has got a tremendous future, and what we're trying to do is really, as a country, as the United States, is to show we can rebuild a country and do it in a way that's going to help to enhance the quality of life for its citizen.</s>GUPTA: Five years from now what is Iraq going to look like, health wise?</s>THOMPSON: I think you're going to see that Iraq has the potential, and I hope accomplishes that potential, to be a regional medical center for excellence.</s>GUPTA: A lot of reports now that there's inadequate water, dirty water. There's inadequate electricity. There's poor security at hospitals and people aren't getting care. And it's due to the war. What do you say to those people?</s>THOMPSON: I don't think the war in and of itself. I think it was so debilitated from all the years of neglect and intentional neglect from Iraq. But then after the war everything, you know, was pretty much raided by, you know, the individuals that came in. They stole everything out of the clinics, took the wires out of the walls. And anything that they could, they hauled off. And as a result of that, there wasn't anything left.</s>GUPTA: Medical diplomacy certainly sounds like a good idea, but a lot of people back home are going to ask, "Well, our health care system is a little bit broken, as well. Why isn't that money being spent on America?"</s>THOMPSON: A lot of it is coming from oil revenues. And if you are able, you know, to rebuild the medical system in Iraq, and the money we invest up front, just like the Marshall Plan after the Second World War. We got paid back many times over with the rebuilding of Europe. There's no question that our medical system in America is stretched and it is stressed, and we have to make improvements there. And we have to invest in our medical system in America. It's, by far, the best. But in order for us, really, to have a wonderful worldwide health system, and be able to, you know, be able to help American citizens, you have to be also concerned about the world problems. Because diseases don't stop at the borders. People are -- of all walks of life, of all ethnic groups and all religions, you know, recognize the importance of good health. And we have, as a country, you know, we have the greatest medical system that's ever been developed. And if we would export that, I think it would stand us in good stead all over the world.</s>GUPTA: You met a little girl today, Sama. She's 8 and a half years old. She has leukemia, and she comes from Iraq. She would have died if she's got no treatment and didn't come to Jordan. Talk about her.</s>THOMPSON: That mother and daughter from Iraq were so appreciative. All she could say is thank you, and she would grab a hold of you and just say thank you. Because what we did and what the hospital and the staff at King of St. Jordan (ph) cancer center, is given that child hope and given that child a chance to live. And if it wouldn't be for that regional cancer center in Jordan that was really assisted by my department through the National Cancer Institute, that hospital probably could not take care of this little girl. But because we, in the last couple of years, have invested our professional staff and some dollars in a partnership with that center, they are capable of handling cancer cases like this little girl and other cases like this all over this region.</s>GUPTA: While Iraq's health care system is failing, its neighbor Jordan has a health care system that is flourishing. When we come back, we'll tell you how one country is helping another. (voice-over) Coming up, we'll meet Sama, 8 years old and battling cancer in a new country. Find out how Jordan is becoming a safe haven for some children who made it through the war and are still fighting for their lives.</s>BRUCE BURKHARDT, CNN CORRESPONDENT (voice-over): Environmental labels are everywhere. Claiming, products are organic or hypoallergenic, labels we use to make the right choice for our health, for the environment. But do labels always tell the truth?</s>URVASHI RANGAN, CONSUMERS UNION: We have come across a number of labels that have very few, if any, standards behind them.</s>BURKHARDT: Consumers Union, publishers of "Consumer Reports," helps shoppers sort out the wheat from the chaff on their web site, eco-labels.org. With the site consumers can compare products and print a report card to take along when they go shopping. Eco Labels has done the research to see which claims are real. A watchdog like Eco Labels helps, but in the end, making sure that product claims are responsible is up to the consumer, an educated consumer. Bruce Burkhardt, CNN, Atlanta.</s>GUPTA: Welcome back to WEEKEND HOUSE CALL. Well, this time last week I was in Amman, Jordan, visiting a cancer center where some sick Iraqi children were being treated. It's hard to believe now, but Baghdad's hospitals used to be some of the region's best, but decades of war and sanctions have left them unable to care for people battling cancer, people like Sama. She's just one of the children whose lives have been changed by ending up in Jordan. Here's her story.</s>GUPTA (voice-over): Although she may not look it now, last February, 8-year-old Sama Hussein lay dying from leukemia in a Baghdad hospital.</s>UNIDENTIFIED FEMALE (through translator): the first thing we noticed is that she was pale. Went to the doctor, found she had leukemia.</s>GUPTA: But now she is in remission in a hospital in neighboring Jordan and even being visited by the U.S. secretary of health. Sama was found by European relief workers, and she was not alone. (on camera) True to the adage sometimes good comes from bad, children from all over Iraq now find themselves here at the King Hussein Cancer Center. Some will live; some will die. But all will get treatment that they otherwise would not have received. (voice-over) Twenty children in all made the two-hour flight to Amman. Thousands more wish they could. Even before the war, hospitals in Iraq were not set up to take care of cancer patients. After the war, an already bad system became even worse. (on camera) What would have happened if your daughter didn't come to Jordan?</s>UNIDENTIFIED FEMALE (through translator): She would have certainly died.</s>GUPTA (voice-over): Now she has an 80 percent chance of survival. The cost of caring for Sama and other children is approximately $50,000 each, treatment being covered by private benefactors. And the U.S., with the National Cancer Institute, is making good on their promise to rev up the staff and technology, Jordanian doctors here conferring with colleagues in Ireland on U.S.-provided equipment.</s>THOMPSON: What we did and what the hospital and the staff at the King Hussein Jordan Center -- Cancer Center is given that child hope and given that child a chance to live.</s>GUPTA: Of course, most children won't be as fortunate as Sama, and Jordan can't be the answer for every child. Eventually, Iraq will have to provide for its own.</s>GUPTA: Doctors in Iraq struggle to help children like Sama and the countless others who come in with more basic illnesses like pneumonia or diarrhea. But oftentimes even these infections, which are curable in the United States, can be deadly in Iraq. We'll be right back.</s>GUPTA (voice-over): When WEEKEND HOUSE CALL returns, we'll give you some web sites where you can go to get more information and give a helping hand. But first, check out these medical headlines.</s>UNIDENTIFIED FEMALE: Kids who are on high fat or low fat diets may gain more weight than those on moderate fat diets, according to a study by the American heart association. The study found the healthiest diets are those with 30 percent to 35 percent fat. And McDonald's is saying bye-bye to super-sized fries and sodas. In an attempt to encourage its customers to slim down, the fast food chain plans to have extra large side orders phased out by the end of 2004. Also this week, the National Institutes of Health put a stop to an estrogen-only hormone replacement study on heart disease. The NIH said a higher risk of stroke in study participants outweighed any benefits the study may have offered. Researchers found estrogen alone had no effect on a patient's risk of heart disease.</s>GUPTA: For more information about Iraq and other countries struggling with medical crises, click on www.who.org. That's the web site for the World Health Organization. Select which country you're interested in, and you'll get a wealth of information on the country's health problems. You can also go to web site for the International Red Cross. That's at www.icrc.org. You'll find updates on their latest projects and can make donations online by clicking "help the ICRC." That's in the upper right-hand corner. You can specify which country you'd like the country to go to or just have it go to those most in need. That's all the time we have for today. Continue watching CNN for updates on Iraq's road to recovery, and stay tuned for more medical news, as well. Coming up this week, a new report comes out about spinal cord injuries. Researchers say they may have found a new treatment for patients with this devastating injury. And a study due out this week calls into question the standard advice to radiologists when checking mammograms. CNN is the place for all your medical news. Make sure to tune in next weekend. We'll be talking about extreme baby making. Some people are traveling as far away as Lebanon to get pregnant. Then there's the experimental treatments here in the U.S. And what about IVF? Make sure to watch next weekend. We'll answer all your questions: 8:30 Eastern on WEEKEND HOUSE CALL. I'm Dr. Sanjay Gupta. Thanks for watching. TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com Struggles Towards Recovery>