The coronavirus faces a great challenge in Iraq: With only 0.8 doctors and 1.4 beds per thousand people, hospitals, which aren’t up to the pressure of “regular” patients, certainly can’t deal with the spread of the virus that is killing thousands of people, or with those suspected of being infected.
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According to official reports, there are about 1,500 patients throughout the country, a bogus figure since testing is nil and the ability to pinpoint the locations of infected people is almost nonexistent. Not to mention the more than 1.5 million refugees living in Iraq, without any sort of documentation or supervision and no access to medical centers.
The devastated health care infrastructure is not a recent challenge. It started back in the first and second Gulf wars, the sanctions on Iraq for more than 12 years, between 1990 and 2003, and the occupation of Iraq by the coalition forces, during which medical personnel fled or lost their jobs as part of the purge of Saddam Hussein loyalists.
Later, when Iraq was partially occupied by the Islamic State, hospitals in the south and west of the country came into the hands of ISIS forces that led to the flight of thousands of doctors and nurses and to the destruction of the physical health care infrastructure. To this day, the Iraqi government has been unable to rehabilitate much of the healthcare system. The state budget for 2019 allocated about 18 percent to defense and only about 3 percent to health care.
Beyond the unstable medical infrastructure, Iraq currently has no government that can make decisions, set priorities and deal with the severe economic crisis that arose even before COVID-19 struck.
Since December 2019 the country has been ruled by a transition government after the previous prime minister, Adil Abdul-Mahdi, resigned following a huge wave of protests that engulfed Iraq for weeks. Two of his successors, who were appointed by President Barham Salih to form a new government, failed due to disputes over ministerial portfolios and budgets.
A new nominee, Mustafa al-Kadhimi, a former head of Iraqi intelligence, has now been appointed to put together a government that will be able to deal with the pandemic and its enormous costs. His chances are not much better than those of his predecessors. Ethic and political divisions still run deep, and now plunging oil prices are added to the equation, which strip Iraq’s main source of income and the basis for collateral it can offer in exchange for loans from international institutions.
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The closing of the border with Iran due to the spread of the coronavirus is not hermetic, and smuggling continues, but officially imported merchandise, valued at about $12 million a year, has been hit hard.
To all the explosive obstacles that face the government, another has recently been added – the rift in the Shi’ite militias that could spark violent conflict between pro-government forces and those loyal to Iran. Four units, numbering 30,000–40,000 fighters, have recently broken off from the Shi’ite militias trained and deployed by Iran, and have begun negotiations with the Iraqi defense minister over the possibility of joining Iraq’s regular army. These militias are loyal to the Shi’ite religious leadership in Karbala and Najaf, led by the influential Ayatollah Ali Al-Sistani.
The split was apparently due to a dispute over the appointment of a successor to Abu-Mahdi al-Muhandis, an Iraqi military commander who was killed in January by an American air strike together with Qassem Soleimani, the commander of the Iranian Al-Quds Force. Iran decided to appoint Abdul Aziz al-Mohammadawi, known as Abu Fadak, who was very close to Soleimani. But the breakaway militias oppose this, not only because they are against him personally, but also because they want to be free of Iranian control.
That is not the only split in the militias’ ranks. It turns out that among the militias loyal to Iraq as well there are disputes over appointments and budgets, after Iran restricted its funding to these forces. As a result of these splits, the hierarchy and obedience shifted to the militias’ high command, headed by the Iraqi Faleh al-Fayyadh. The latter has declared that the Shi’ite militias are the only guarantee for the realization of the “Khomeini project,” that is, the establishment in Iraq of a state based on Islamic law, like Iran.
This development has led to some militias operating independently against American targets, while other commanders believe that this should be avoided so as not to give the United States an excuse to attack their bases. This is ostensibly good news for the Iraqi government, which is trying to form an agreed-on government, as well as for the United States, which is waging war against the Shi’ite militias as part of its fight against Iranian influence in the Middle East.
However, experience shows that such rifts can lead to violent power struggles between the militias, and spark a wave of terror against the civilian population and direct attacks on government institutions. The American demand of every potential prime minister is to dismantle the Shi’ite militias only strengthens the opposition of those militias, and of the Shi’ite parties that support them, to any prime minister who would succumb to American pressure.
At the moment it seems that the political fate of the latest nominee for prime minister, al-Kadhimi, whose list of intended ministers some of the Shi’ite parties have opposed, will be no different than that of his predecessors. When those are the rules of the political game in Iraq, it is unlikely that such leadership will be able to find time to deal with the coronavirus pandemic and its economic ramifications in Iraq.