Since the end of the war, Iraqi nurses have had difficulty getting to work. The roads were deemed insecure at off hours, there was an acute fuel shortage, and the cost of city transportation was prohibitive. But at the same time, the needs in the hospitals were far greater than ever before. To remedy this challenging situation, International Medical Corps offered to give them a lift.
Nine fifty-seat buses were hired to take some four to five hundred nurses to medical city, a two-mile area in Baghdad that contains five hospitals and two teaching facilities. It is literally the heart of the healthcare system in this city of five million people, and over one-third of all city nurses work there.
Helping the nurses get to work every day is a critical first step in the reactivation of the healthcare system in Iraq. However, a more in-depth examination of the nursing profession in Iraq reveals an occupation in decline. Unlike in the United States where nursing is seen as an honorable profession, in Iraq, nurses are viewed as glorified cleaners. But this has not always been the case.
In the early 1990s, healthcare workers, who are paid centrally through the Ministry of Health, began to ask for a much needed wage increase. The official response was that there was no money and as a cost saving measure, Sadam Hussein announced that families should provide patient care, not nurses. Since then, the role of the nurse in Iraqi society has been in slow decline.
Seta Ardashes, the head nurse at the Nursing Home hospital in medical city, has lived through this change. Having been a nurse for thirty-one years, she is considered by her peers to be one of the best in her field but she admits that the past decade has been a difficult one. Salaries shrank to an unfathomable $10 a month, work lunches were only provided to the doctors, and the free distribution of new uniforms stopped unilaterally (the one she wears is several years old).
The duties of a typical floor nurse include inserting IVs, giving medication, keeping patient charts and cleaning the ward—much like the role of a nurse’s aide in the U.S. They do not take vital signs or bathe the patient and are in no terms seen as a partner to a physician. There are also social stigmas at play, such as the inability of women in Iraq to work in the evening, and the necessity for male patients to be cared for by male nurses and vice versa.
With this stark professional trajectory, one might wonder what would motivate a young student to enter nursing school. Herein lies the problem. The generation of nurses that Seta represents will retire soon and the nursing schools are nowhere near full. This points to a huge nursing shortage in the next decade, unless something is done quickly.
Enter International Medical Corps.
International Medical Corps is taking on the challenges of nursing like no other international actor in Iraq. International Medical Corps’ international nursing staff is working hand-in-hand with their Iraqi counterparts throughout the country to assess what challenges need to be addressed in the near and long-term. And the plan is starting to crystallize.