Marin Independent Journal (Marin, CA)
Saturday, February 28, 2004

Marin doctors witness Iraq's medical needs
Physicians meet with colleagues at Baghdad forum

By Jennifer Upshaw, IJ reporter

Marin physicians - fresh from a mission to help overhaul Iraq's stagnant medical system - said they have both hope and fear for the future of medicine in the war-torn nation.

Anesthesiologist Dr. Thomas Cromwell, of Belvedere, Calif., urologist Dr. Ira Sharlip of Kentfield and plastic surgeon Dr. Bernard "Bud" Alpert of Ross - all of whom work for California Pacific Medical Center in San Francisco - traveled to Baghdad in mid-February for a four-day conference aimed at reviving the country's shattered medical structure.

Alpert, who visited Baghdad on a monthlong mission last spring, recruited the two and a fourth Bay Area physician, an Iraqi native, to participate in the conference with about 30 American physicians.

The two Marin physicians who had never visited Iraq described the experience as remarkable.

"It was fascinating, it was depressing, it was hopeful, it was sort of a lifetime opportunity," Cromwell said. "It was really an incredible experience ... it was depressing to see to the extent their medical care was deteriorating."

During the conference, steps were taken to assist the Iraqi physicians in organizing a professional society, creating specialty societies and beginning communication between the two nations. The physicians want to improve resources, such as gaining online access to electronic information.

The doctors reported encountering a cadre of talented and educated physicians who have been cut off from modern advances.

Sharlip said doctors were "hungry and desperate even for modern technology and upgrading their education" after more than two decades under a regime that apparently would not allow physicians to leave, or to import materials or equipment to enhance their skills.

"Medicine sort of stopped about 20 years ago," he said.

Hundreds of Iraqi doctors, as well as the president of the Iraqi medical society, the minister of health, and the coalition government's chief administrator, L. Paul Bremer, turned out for the conference, which was moved from an area of the city with several teaching hospitals to a safer section known as the "green zone."

Bremer paired the physicians' conference with the regrouping of the Iraqi symphony and the Iraqi Olympic Committee as signs of the country's emergence from war, according to Cromwell.

Inside the green zone, security was omnipresent, he said.

"We got on the bus and on the seat of the bus was a helmet and a flak jacket," Cromwell recalled. "At this point, you realize they are not fooling around."

Sharlip said he was struck by the condition of the city.

"To me, the big story is that life in Baghdad is a lot more normal than what we conclude from media reports," he said. "That's a story that hasn't been told. It should be told.

"Baghdad is a functioning city," Sharlip continued. "It's not functioning normally. There are big problems in Baghdad."

Frequent power outages, long gasoline lines, significant traffic jams, violence and unemployment continue to haunt the Iraqi people, he said.

"To be sure, I don't want to paint the picture of life being normal in Baghdad because it's not," he said. "It's not the kind of situation where this city is completely paralyzed - life is going on there."

Several times, they left the safety of the green zone, once to dine with the family of an American colleague whose relatives still lived in the city.

Another trip was made to the Palestine Hotel, a target of violence on numerous occasions. While in the area, the men visited a roundabout where a statue of Saddam Hussein once stood, made famous after American soldiers pulled it down.

At the close of the conference, they found physicians to be "very optimistic and hopeful things will change," Cromwell said.

Returning with a sense of achievement that's tempered by pragmatism, Cromwell acknowledged much will depend on the troubled nation's future.

"It may all be for naught depending on what happens to the government - if it degenerates into some kind of civil war, which it could," he said. "Hopefully it will become more stabilized."

Meanwhile, there is work to do, Cromwell noted.

"The hospitals are dilapidated and dirty and very Third World, but with time and effort they will be fixed," he said. "The structure is there, the interest is there, and the enthusiasm is there in Iraq, and I think it will come back very rapidly."

Said Sharlip: "I'm cautiously optimistic about the future of Iraq. I'm very optimistic about the future of medicine in Iraq."

Contact Jennifer Upshaw via e-mail at jupshaw@marinij.com

Posted: 3-05-04

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