Iraqi health care workers threaten nationwide strike to demand resources to fight pandemic

By Jean Shaoul
11 September 2020

Medical school graduates and health workers have taken to the streets of Baghdad in protest over the lack of resources to tackle the COVID-19 pandemic. They are demanding oxygen for patients and personal protection equipment for staff, as well as jobs for health care graduates.

At least 1,500 doctors have been infected and 44 doctors have died, a likely underestimate, while 3,000 doctors over 60 years of age were instructed to take early retirement.

Health care workers are threatening a partial strike, exempting emergency wards and intensive care units, and later a nationwide strike. It comes as Iraq has recorded around 250,000 coronavirus cases and more than 7,730 deaths. The worst affected areas are Sulaymaniya and Erbil governorates in the Kurdistan Regional Government (KRG), the semi-autonomous region in northern Iraq.

Iraq had initially contained the pandemic with lockdown measures, but cases and deaths have more than doubled since early July, when the government began the gradual lifting of restrictions, resumed international flights and opened Iraq’s borders.

Hospitals have been overwhelmed. Iraq’s health care system, once the best in the Arab world, was gutted by the 1991 Gulf War, a decade of US sanctions, the 2003 US-led war and occupation of Iraq, and the wretched political sectarian system imposed by Washington. More than 20,000 doctors have fled the country in recent years because of insecurity, threats, and the assassination of hundreds of doctors in targeted killings.

As a result, the health service now employs only 30,000 doctors, about 0.8 doctors per 1,000 people, which is one of the lowest numbers per capita in the world, with hospitals becoming a place to die as health care budgets were turned into a mechanism for doling out patronage. Today, 31,000 recent health care graduates have been unable to find jobs, leaving them at risk of losing their practicing certificates.

In June, the incoming government of Prime Minister Mustafa al-Kadhimi caused outrage and derision when it called on the governorates to recruit volunteers from retired doctors or graduates provided that they “do not shoulder any financial obligations.”

The health care system, like all of Iraq’s decimated public services, have fallen victim to successive government-sanctioned looting operations and most recently the catastrophic fall in oil prices and the OPEC-agreed cuts in production. Oil revenues, which constitute 90 percent of government income, have been halved, plunging the economy into the abyss.

The approval of the 2020 budget has been delayed by the unrest that started in October when mass protests against the appalling social conditions, government corruption and the entire political setup forced the resignation of Prime Minister Adil Abdul Mahdi. It was the first time since the 2003 US-led war that a government had been forced to resign due to popular pressure.

Iraq’s economy has already contracted by more than 9.7 percent, in contrast to 4.4 percent growth last year. The government’s budget deficit, about $20 billion, is expected to soar, while its debt to foreign financial institutions has risen to more than $104 billion. The government is likely to need a further $40 billion of external financing that Washington will only green light if Baghdad implements free market “reforms,” privatisations and the slashing of the public wage bill, subsidies and benefits that will further impoverish the working class. Above all, the US is demanding that the government impose direct control over the mainly Shia Hashid Shaabi militias, which have long demanded Western forces depart the country entirely.

Just 10 percent of Iraqi jobs provide regular employment, largely in the public sector and allocated on the basis of Iraq’s sectarian political system. The remaining 90 percent are casual day work that require two such “jobs” to put food on the table. All this is in a country where 60 percent of the population is under 24 and most young people are without work.

While the spread of the coronavirus and lockdown measures halted the mass rallies and ended the tent sit-ins in Baghdad’s Tahrir Square, fresh protests have started amid frequent and long electricity outages during a blistering summer when temperatures topped 50 degrees Celsius (122 degrees Fahrenheit). At the end of July, two anti-government protesters were killed and 21 were injured in renewed clashes with the security forces.

Last month, protests broke out in Sulaymaniya and across the KRG over months of unpaid wages and growing hardship, with workers storming the headquarters of the ruling political parties. Scores of people have been injured in street clashes as the KRG’s security forces carried out dozens of arrests. Doctors went on strike for a second time over unpaid wages.

The KRG blamed the non-payment of wages on the federal government in Baghdad, which according to Iraq’s budget law is required to pay the KRG about 12 percent of the federal budget in return for 250,000 barrels of crude oil per day. In April, Baghdad stopped making the $380 million monthly payments, claiming the KRG had not shared oil production with the federal government.

Following the protests, and under pressure from the US with whom the KRG has close links, Baghdad agreed to restore most of the payments in the August-October period in return for 50 percent of the customs revenue from border crossings in areas under the KRG’s control and to discuss other outstanding disagreements.

In recent months, Iraq has seen a wave of assassinations, including the drive-by killing in Baghdad in July of Hisham al Hashimi, a prominent Iraqi security expert. His assassination has been widely attributed to forces allied to Iran as an indirect warning to Washington.

Iraq has for decades been caught in the crosshairs of US imperialism’s increasingly militaristic confrontation with Iran that is bound up with Washington’s build up for “great power” confrontation with China, attempting to use military force to establish a chokehold over the energy resources upon which the Chinese economy depends.

Some Shia factions allied with Iran were unhappy at Kadhimi’s appointment as prime minister in May. Kadhimi, a former head of Iraq’s National Intelligence Service, who spent 20 years in exile in the UK and US, is on good terms with Saudi Crown Prince Mohammed bin Salman and is viewed as a US spy and puppet. But they gave him the nod in the belief that their parliamentary majority would be able to neuter him.

Al-Kadhimi accepted a poisoned chalice. He is under huge popular pressure to bring the killers of peaceful protesters to justice. Around 560 protesters were killed and thousands injured since October, with the government taking no action to identify those in the security forces responsible. His government has pledged to investigate the killings and the imprisonment of hundreds of demonstrators, and to pay compensation of $8,380 to the families of those killed.

Al-Kadhimi has announced the holding of new elections in June next year, another key demand of the protest movement. While the elections will be based upon legislation overturning Iraq’s sectarian political system, voting procedures and constituency boundaries have not been finalised, neither has the role of the election commission in organising the polls, widely believed to be rigged. He has also ordered state institutions to stop classifying Iraqis by religious sect following a social media outcry.

Last month, Kadhimi flew to Washington to try to reach a “Strategic Pact” with the Trump administration aimed at securing increased aid in a bid to reduce Iraq’s dependency on Iran.

The last months have seen increasing attacks on US facilities, following Washington’s assassination on January 3 of Iran’s General Qassem Suleimani and Abu Mahdi al-Muhandis—a prominent member of the Iraqi government and Popular Mobilisation Units (PMU) leader. Parliament called for the immediate withdrawal of all US troops in the country, but the US refused to leave—with President Donald Trump threatening Baghdad with sanctions if it ordered American troops out. In March, Washington set up at least four new batteries of Patriot air defence systems in Iraq as a preparatory move for an attack on Iran.

On Wednesday, Washington agreed to a face-saving reduction in US forces in Iraq, cutting its presence from 5,200 to 3,000 troops this month as part of a wider draw-down in the region. It leaves intact the far larger number of US private military contractors.