-의료시설-
세계보건기구(이하 WHO)의 조사팀은 키르루크의 병원 상황에 대한 일괄적인 조사를 실시했다. 의사 2명, 약사 2명, 엔지니어 1명으로 구성된 조사팀은 수도와 전기 시설이 심하게 파손되었고, 약탈로 인해 의료시설이 크게 피해를 입었다고 보고했다.
조사팀은 한때 사담 종합병원이라 불리웠던 아자디(Azadi) 병원을 살펴보았다. 400개 병상에 단지 40명의 환자만 있을 뿐이고, 그것도 경미한 부상자들뿐이었다. 조사팀은 환자수가 적은 것에 대해 두 가지 이유가 있다고 결론내렸다. 첫째, 현재 상황에서 중환자의 생존 가능성이 지극히 낮다는 점. 둘째, 의료진이나 환자들 모두 병원이 안전하지 않다고 여긴다는 점이다. 현재 50-75% 의료진만이 일하고 있다. 대부분 임금을 지불 받지 못하고 있고. 4월도 마찬가지 상황이다.
키르쿠크에는 두 곳의 병원이 더 있는데, 거의 피해를 입지 않은 소아병원과 일부 약탈당한 종합병원이 그 곳이다. 두 병원 모두 대략 25% 운영율을 보여주고 있다. .
키르쿠크의 주요 의료품 창고가 완전히 약탈당한 상태여서, 의료진은 매우 어려운 상황에 처해있다. 모든 의약품이 약탈당했고, 심지어는 출입문과 냉방장치도 약탈당하거나 파손되었다. 의료센터 모두 약탈당했고, 정부의 지역 보건소도 같은 처지이다.
WHO는 아자디 병원에 긴급 물품들을 제공해 줄 수 있었다. 다른 긴급 의약품이나 의료장비도 제공하기로 합의했다.
이 상황은 단지 한 도시에 지나지 않으며, 이라크 대부분 지역이 같은 상황에 처해있다고 판단한다. 약탈당한 의료시설, 두려움으로 병원에 오지 못하는 의료진과 환자들. 수도와 전기 시설의 피해로 보건의료 시스템을 복구하고 재건하려는 일은 한 층 더 어려워졌다.
이라크 전역에서 의료 활동가들은 모든 노력을 다하고 있다. 많은 활동가들이 매우 힘든 상황 속에서 일하고 있으며, 일부는 병원이나 현장에서 자고 있다. 바그다드, 나시리야, 바스라의 의료진은 무장한 약탈자에 대항하며 병원과 진료소를 방어하고 있다. 그러나 상황이 호전되지 않는다면, 현상유지도 힘들 것이다.
WHO는 다음의 주요 임무가 조속히 이루어져야 한다고 판단하다:
1. 보호: 의료진, 환자들, 의약품과 의료시설들이 약탈과 그 위협으로부터 보호되어야 한다..
2. 운영비 지급: 대부분 병원이 전기와 물이 부족하다. 그들은 원활한 진료를 위해 하루 수백 리터의 연료가 필요하다. 이를 위해 현금이 필요하다.
3. 이라크 의료진에게 생계비 지급: 무보수로 의료진이 계속적으로 일할 수 없다. 그들은 가족을 부양하기 위해 돈이 필요하다.
4. 시설 보수와 위생 관리: 많은 병원들이 전쟁과 약탈로 피해를 입었다. 조속히 보수하고, 위생 관리에 힘써야 한다.
5. 발생된 상황과 장소에 관한 정보: 이는 신속하고 지속적인 조사를 요구한다. 매우 필요한 일이자 꼭 해야 할 일이다. 구호품 등 필요한 물품의 우선 순위를 정하기 위해 정확한 정보가 필요하다.
6. 의약품과 의료장비: 상당수가 약탈당한 상태이다. 조속한 의료 지원이 다시 이루어져야 한다.
(자료출처: WHO, 2003년 4월15일)
UN humanitarian briefing
14 April 2003
WHO health briefing on Iraq
Hospitals
An assessment team from the World Health Organization has conducted its first comprehensive survey of the situation in hospitals in the northern city of Kirkuk. The team, made up of two public health doctors, two pharmacists and one engineer, reports that the water and electricity infrastructure in the town is severely disrupted and that health facilities have been seriously damaged and disrupted by looting.
The team visited Azadi Hospital (which used to be called Saddam General Hospital), which is the main hospital in Kirkuk Governorate. They found only 40 patients in a 400-bed hospital, all with minor or moderate injuries. They concluded that there were two main reasons for this small number of patients: first, that in the current circumstances the chances of survival for anyone with a serious injury were very low; and second, that both health staff and patients had concluded that it was not safe to come to the hospital. Currently, between 50% and 75% of the health staff are not coming to work. Most have not been paid and there appears to be no system in place to pay them for the month of April.
There are two other hospitals in the town: a maternity and children’s hospital, which was left largely intact; and the General Hospital, which was partially looted. Both hospitals are estimated to be running at about 25% of their normal capacity.
The work of those who are able to get to work at any of the hospitals is made extremely difficult by the fact that the main health storage facilities in the town have been completely emptied by looters. All medicines and medical supplies have been stolen and even the windows, doors and cooling system have been either stolen or destroyed. All health centres in the town have also been looted, as well as the local office of the Department of Health.
The WHO team was able to supply Azadi hospital with some urgently needed items, such as Oxygen cylinders. An agreement was reached to supply urgently needed medicines and other supplies.
This is only a snapshot from one town and WHO believes this situation is repeated across much of Iraq. Health facilities have been looted, vital supplies and equipment stolen, and both staff and patients are either afraid or unable to travel to the hospitals. Combined with the damage done to water and electricity systems, this makes the task of rehabilitation and reconstruction of the Iraqi health system harder than ever.
Health workers across Iraq clearly remain committed to their patients and their work: many continue to work in extremely difficult situation; some sleep in their hospitals or other workplaces; there have been many reports from Baghdad, Nasiriya and Basra of medical staff defending their hospitals and clinics against armed looters. However, unless conditions can be improved, even this level of dedication will not be enough to keep the system running.
WHO believes that the key tasks which have to be tackled immediately are:
Protection: health staff, patients, supplies and facilities must be protected from looting and threats.
Paying running costs: most hospitals are short of electricity and water. They need fuel – hundreds of litres a day – to power their generators so that the electricity works, operations can be undertaken, water is pumped in and sewage is removed. They must pay for this fuel in cash: they cannot get credit.
Meeting the living expenses of staff: this must be addressed urgently. Medical staff will not be able to continue working unless a system is put in place to provide them with the money they need to buy food for their families and to enable them to meet their daily living expenses.
Maintenance and cleaning: many hospitals have been damaged by conflict or looting; they need repairs and they must be kept clean.
Information on what is happening, where: this calls for rapid and continuing assessments. The needs are great and must be met. Accurate information is essential if supplies and other needs are to be prioritised – and met.
Medicines and medical supplies: much has been stolen; replacing medical stocks will be an urgent and vital need.
For further information, please contact WHO spokespersons Melanie Zipperer in Amman (00 4179 477 1722) or Iain Simpson in Geneva (00 4179 475 5534)
The following WHO specialists are available to respond to media questions: Dr G Popal, Head of the WHO country office in Iraq (+962 795 7092); Dr Mohamed Jama, Deputy Regional Director, WHO Eastern Mediterranean Regional Office, Cairo (+202 276 5026 ); Dr Jim Tulloch, WHO Regional Health Coordinator, (+4179 509 0640); Dr David Nabarro, WHO Executive Director, Geneva (+41 22 791 2363, +41 79 217 3446)