- BAGHDAD -- On the front desk
of the emergency room the American soldiers keep a light green hardback
book where they record all the gunshot, stabbing and shrapnel injuries
that arrive at Yarmuk hospital in central Baghdad.
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- In the three weeks since they started the book, more
than 170 gunshot victims have staggered, been wheeled or carried through
the front gate.
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- The soldiers' diagnosis are typically blunt. "Shot
in nuts" read one entry. Next to 50 are the letters "DOA"
(dead on arrival).
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- It is not surprising that Dr Mohammed al-Fahad is weary
of treating the wounded. And it is not surprising that he is angry, too.
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- It has been more than three months since the Americans
arrived in Baghdad, but still the electricity cuts out in the hospital.
Staff have seen pictures on television of how the local prison has been
refurbished, but all the Americans have done here is stick up no smoking
signs and try and limit the visiting hours.
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- The night shift at the hospital is just beginning and
already Dr Fahad is treating his second patient. Entry wounds, exit wounds,
bullets lodged in the subcutaneous knee joint, like the one he is trying
to remove now, he's seen them hundreds of times in the past few months.
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- "We consider this a silly case," he says, making
an incision with a scalpel across the knee injury. Not that Haijhen Fahd,
30, lying back on the gurney in the emergency room and by the look on his
face trying desperately not to scream, is finding anything about his case
frivolous.
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- Pain
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- A guard at one of Baghdad's water plants, he had been
standing outside minding his own business when he had felt an excruciating
pain in his leg.
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- He had been hit by the what the doctors call an "indirect"
bullet, fired off by somebody in some distant part of the city, zinging
through the hot and humid air, before choosing, by some cruel twist of
fate, to barrel its way into his leg. His friend Kanaan Tofeeh had bundled
him into a car and driven him to the emergency room of Yarmuk hospital
in the centre of the city.
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- He had arrived just before 9pm, as the night shift was
beginning, but the register on the counter in the trauma room already listed
six others admitted for "bulleting" [sic] injuries that day.
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- And this, according to the surgeon, now digging around
deep inside the hole with a pair of small forceps, is a quiet one.
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- "Before the war, people with this sort of injury
we would put them to sleep, but now we do not bother - there are too many,"
he says before finally, with a flourish, holding up a small copper pistol
bullet and dropping it with a clunk into a kidney shaped metal bowl.
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- He sews up Mr Fahd's wound, and the guard limps out of
the hospital clutching a little glass vial filled with antiseptic and the
bullet wrapped in a cotton swab.
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- The trauma ward at Yarmuk is a brutal place in every
sense of the word.
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- There are no sheets on the trolleys, or pillows on which
patients can rest their heads. There is no room for sentiment here, no
caring bedside manner from the doctors, no kindly nurses to mop a brow
in the suffocating heat.
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- It had risen to 52C (126F) during the day and by 10pm
is still in the high 40s; the electric fans mounted on the ceiling do little
to take the edge off the temperature.
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- The doctors who are not tending to patients huddle around
a single, small air conditioning unit, the only one that is working in
the entire room.
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- As the evening draws on, an old man, bleeding from a
wound to his ear, stumbles into the room. "Alibaba! Alibaba!"
he shouts, indicating he has been attacked by a thief.
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- According to the doctors, he is a regular at the hospital,
and is a touch deranged. Nobody pays him any attention until he vomits
what looks like blood all over the floor. Raed Jassem, 24, is one of the
men who tries to keep the hospital clean. In Yarmuk, there is a lot of
blood and there is a lot of vomit, most of it deposited on the brown concrete
tiles. But Mr Jassem, who has been trailing his mop around the hospital
for almost two years, says he has got used to it.
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- Not that the doctors have.
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- "Watch this, you won't believe it," one of
them says as the cleaner begins washing down one of the gurneys with the
same rag he has just been using to clean the floor. "It is not his
fault, he does what he can, but he is not provided with anything else to
clean with. What can he do?"
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- Mayassa Khanas, 20, is the latest arrival in the ward.
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- Earlier in the day she had been sitting in the garden
of her family's home in the Saydiyea district of Baghdad when another indirect
bullet fell out of the sky and struck her on the head.
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- Now she is lying, still conscious, on a brown plastic
mattress on a trolley, while the doctors treating her try to work out exactly
what to do.
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- The image of her skull on the acetate plate of the x-ray
looks normal except for the unmistakable shape of the bullet wedged into
the bone, its sharp tip protruding just far enough into the cavity below
that they dare not try to remove it themselves.
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- They would like to send Ms Khansas to a hospital down
the road where there are specialist neurosurgeons. But it has been closed
for two days because of problems with power, and there are rumours that
it could be closed for a further two weeks.
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- "For an operation you need machines, but if the
power goes the machines die. If the machines die the patient dies,"
says Dr Emil Sabah, 25.
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- The hospital is guarded by members of the 1st Armoured
Division from Fort Riley in Kansas. Nicknamed the Ironstones, they used
to sleep in quarters at the back of the hospital but have recently moved
to the presidential palace compound because of fears over their security
at Yarmuk.
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- Only Captain John Margolis and a couple of their other
commanding officers are still living in a small office next to the emergency
room.
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- There seems to be an uneasy truce between the doctors
and the Americans. The doctors don't like the way the soldiers sometimes
try to interfere, especially stopping them smoking in the wards.
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- "Like it makes any difference," says Dr Sabah,
pointing at the bloodstained floor and walls.
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- But Capt Margolis, who seems a good, well-meaning man,
is unrepentant.
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- "This is freedom and freedom can mean different
things, and in this case freedom means we are going to have to enforce
our values on them," he remarks without irony.
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- "The Iraqi doctors who have been to the west want
their hospitals to be like ours and we have to change their values to do
it."
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- Vendettas
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- The captain and his soldiers seem to be having a hard
time coming to terms with what they see and what goes on at the hospital
- the family vendettas that have seen armed men trying to get to an injured
enemy in a ward to revenge a dead relative, the horrific injuries, and
the blood.
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- Just after midnight the power goes out and the hospital
is plunged into darkness. The generators are broken so there is nothing
to do but wait for it to come back on. A doctor is sent to ask the Americans
if they have any fluorescent sticks to help light the ward.
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- "You know we used to have some of them, but they're
all on back order right now," says one of the privates.
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- Dr Sabah says: "I think after you have seen this,
if you got sick you would rather wait until you get home before you are
treated. Am I right?"
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- Twenty minutes later the power comes back on. By now
the hospital is quiet. There is a curfew across Baghdad, and only the most
ill dare make the journey through the American roadblocks to the hospital.
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- Most have no way of calling an ambulance; the only vehicles
that are allowed to race through the city's eerily deserted streets with
impunity. The doctors bed down on empty gurneys, waiting for the early
morning rush when the curfew is lifted.
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- It is the one chance they get to rest before the start
of another day in the Baghdad emergency room.
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- Guardian Unlimited © Guardian Newspapers Limited
2003
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- http://www.guardian.co.uk/Iraq/Story/0,2763,1016199,00.html
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