As many as half of Iraqi doctors have left the country since the U.S. invasion in 2003, according to a recent report by Oxfam International that cited statistics from the Iraqi Medical Association. Some doctors have fled after being targeted because of their religious sect or profession. Others have sought better opportunities in Europe or elsewhere in the Middle East.
"We are concerned because there's never enough medical staff," said Navy Cmdr. Steve Frost, who has supervised the construction of clinics in and around Baghdad. "Medical staff seems to be leaving the country for other jobs and it takes time to train" them.
Frost cited a broad shortage of doctors, nurses and technicians such as X-ray specialists. The construction of the clinics was overseen by the Army Corps of Engineers and control of the completed facilities is being turned over to the Iraqi Health Ministry.
The exodus of qualified workers from Iraq is not limited to the medical profession. The Oxfam report said 40% of all Iraqi professionals, including teachers and engineers, have left the country since the war started.
Health services "are generally in a catastrophic situation" in Baghdad and across the country, Oxfam said.
Some of the clinics that have opened recently are already attending to patients at nearly triple their capacity, Frost said. That is in part because many Iraqis believe that hospitals are under the control of armed sectarian militias, said Quraish Alkasi, president of the Society for Iraqi Surgeons.
Each clinic has X-ray and dental facilities, a pharmacy, a laboratory and a cafeteria. Some also have classrooms, labor and delivery rooms, emergency facilities and apartments that allow doctors to live on-site.
Abd al-Samad Rahman Sultan, Iraq's health minister, said in an interview that he believed there were enough doctors to staff the clinics but agreed there was a shortage of nurses, anesthesia specialists and pharmacists. "As needed, we'll have specialists visit (clinics) one or two days per week" to alleviate the shortage, Sultan said.
The lack of trained gynecologists and obstetricians is particularly acute, Alkasi said. "We'll end up with junior specialists who will be able to solve some of the problems but not all" of them, he said.
Some doctors who have remained in Iraq have taken up residence in the Kurdish region of northern Iraq, where security is better, Alkasi said. Others are hiding in their homes or have returned to their home provinces outside Baghdad, where many are no longer practicing medicine, he said.
The effort to construct the clinics began in 2004 and is now 95% complete, Frost said.
In March, Frost said he was traveling to supervise construction of a clinic when his armored vehicle was hit by an explosively formed penetrator, a sophisticated type of roadside bomb the U.S. military says is primarily supplied to insurgents by Iran. He suffered a severe concussion and internal bleeding and was later flown to Germany for surgery.
Frost said the payoff for his pain has been "seeing the smiles on people's faces when they bring their children to see a doctor" after a clinic opens.