The Waiting Room of Last Chances

Sometimes it feels like Iraq stopped, like a spent watch, in 1980. The same year Saddam pre-emptively invaded Iran and flushed his oil revenues down the Shatt al Arab. For a while he pursued a policy of guns and butter, borrowing crippling amounts from his neighbors (only too eager to watch the regional powers bleed themselves into the sump). Hospitals were built, art museums opened, tanks purchased, neurosurgeons sent abroad for study, fighter jets imported, nuclear reactors built, and on and on. But this pace slowed and then halted as the money dwindled.

Life in Iraq exists in a dim half-light, half-government now. All the grand concrete edifices from Saddam-the-glory-years only occasionally see light, provided by groaning generators. The hospitals are the worst. In dirty corridors, relatives squat next to plastic bags full of food for their loved ones. No one looks anyone in the eye. There’s a listlessness that goes beyond despondency. There hasn’t been anything anyone could do for a long time.

The first time I went to the Italian Red Cross Hospital, a little girl waited patiently to have a bandage on her neck changed. She smiled shyly; her mother, with three other small children crowding around her and a babe in her arms, smiled, too. An Italian doctor came over and tickled the baby, sprung lollypops from behind the kids’ ears, and then blew up balloons. Everyone laughed when they popped.

“Yes, very good; they treat her very well here; I am glad,” the mother told me. These small words of relief and gratitude were so anomalous in this city of grinding concrete indifference, it got to me. After weeks of listening to stories of multiple compound-fracture lives, I thought myself immune to optimism.

The Italian Red Cross is a bright shining thing. One of scarce health-care NGOs still operating in Baghdad, they have run the hospital with about 40 Italian staff intermingled with Iraqis since the end of the war. They didn’t leave after the International Committee of the Red Cross was bombed last October. Asked why not, they just shrug—inimitably Italian, wonderful and warm, as they puff cigars under “no smoking” signs written in Italian, English, and Arabic. The staff talks sentimentally about being kissed by patients in thanks, about the marvelous Iraqi people who have suffered so badly in this wonderful country.

The Italian Red Cross Hospital specializes in burns and plastic surgery. With a 20-bed burn unit, it’s the only such hospital in Iraq. Doctors see between 20 and 35 burn patients a day. The stories come from ordinary every day domestic distaster: mothers and children hurt in cooking fires, overturned pans of burning oil send the nylon clothing up in flames. Men come in with their legs and hands burned from sloshing gasoline while holding a burning cigarette or from mixing smoking with fixing engines or filling kerosene heaters.

“It’s the cooking fires and lack of education,” said Enrico Santinelli, one of the administrators. “Sometimes the husbands lock the door on their way out, the woman burns herself, maybe she is there all day suffering until he comes home—and infection, you know, with burns, it is very big problem. Sometimes they spend days at home before they go to a hospital, there are no telephones, there are problems with moving around: It is the conditions of life.”

In addition to burns, the Italians have a general and pediatric clinic. The packed waiting room here is the room of last chances. Some of the cases date from years back, injuries and diseases never cured or recurring or its patients needing drugs or operations that can’t be performed in Iraq. I saw a 3-month-old baby whose body was covered in a vast black blistered mole, a 16-year-old girl who has suffered tremors and deafness since she was a child. Her father said that the Iraqi doctors told him she needed a drug only available in Russia or Bulgaria. So much edge-of-the-abyss hope gathered in this place. A small birdlike girl, paralyzed and shrunk, one hand moved like a claw and she spoke in rasping frog noises. A father came up and told me about his new baby who was born a hermaphrodite; he had applied for her to be taken to Italy. It was difficult, he said, in this society; they didn’t know what to call it, first Ibrahim, then Noor. “She needs hormone medication that isn’t available here.”

Parents clutched documents and papers and reports as tenderly as their own children. One mother showed me a scrap of paper that read:

This woman’s son was injured during the war. Her son’s leg was blown off, and he is unable to pass feces. She has paid for his treatment with her own money. She is currently out of money and seeking help. I have sent her to Adhamiya but they were unable to assist her. Please help her with this situation,Signed, SSG Harden, Roan, U.S. Army

Her son was about 10 and hopped about on his diminutive crutches. He didn’t mind much, he just wanted a new leg.

All the patients and their families sat quietly. So far, the Italians have treated over 40,000 cases since the war and have sent 64 to Italy for treatment. They wished to send more, but it’s difficult and expensive.

I sat in the examining room with an Italian surgeon and an Iraqi doctor. The walls, painted in a warm cream, had pictures of fuzzy bunnies and caterpillars tacked on them, and there were pots of brightly colored cloth roses around. Fifteen more patients to go today, after already seeing more than 30. A man with a leg ulcer that wouldn’t heal properly needed surgery to correct a vein problem; after him, a 4-year-old boy with a brain tumor came in. His parents had traveled all the way from Mosul. The boy’s shaven head revealed a pink horseshoe-shaped scar from previous surgeries. Twice a neurosurgeon in Mosul had operated, but the doctor had left Iraq, and their son’s condition had worsened. They desperately wanted to get him to Italy. The doctors held up the pictures from the latest MRI scan; the tumor looked white and large.

The doctors thought the tumor was too far gone to send the boy to Italy. “Very invasive … these tumors are too quick … high recurrence rate.” The father and mother stood very still, waiting for the Iraqi doctor to translate. When he heard the negative news, the father’s face paled, but he managed to smile down at his son, who leaned against his father’s legs and yawned.

The next patient: a 5-month-old with hemangioma, a benign tumor of the blood vessels. A huge cauliflower growth, as big as the baby’s head, grew out of his cheek—a mass of blue veins and bright red burst blood vessels under the skin. “Tell the mother I am writing urgent on the MedEvac form,” the Italian doctor told his Iraqi colleague. “This is genetic, but we saw four of these cases last week, four in one morning!”

Have you ever seen anything like this before?

“No, never. The tumors are huge, we talk about it among ourselves. You can’t say anything, not definitely. But they are huge and congenital and invasive. It is strange, no? Something happened to these people.”

Dr. Romano Tripodi, the director of the hospital, took me to get something to eat. Ever gracious, ever hospitable, the Italians all live in a sectioned-off ward in the hospital. Claudio, a big beefy man who was a mechanic in Bologna, is the chef. As Claudio manhandled wheels of parmigiano and proudly showed me his cache of salami, Tripodi apologized, “I am so sorry we do not have any wine.” Then he explained the Italian Red Cross philosophy: “We tell the Iraqi doctors who work here to be gentle. It is the most important thing.”