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Hospital's recovery signals rising well-being in Iraq

While conditions are improving at the Central Teaching Hospital for Children in Baghdad and elsewhere in Iraq, the country still faces vast humanitarian needs.

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"The impact of sanctions has been horrendous," UN humanitarian chief Denis Halliday said in 1998. He resigned in protest, one of two in that position who took that step. "They have turned Iraq into a ruin."

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Saddam Hussein's name has since been dropped from the hospital. Officials say it now works at 70 to 80 percent capacity, up from 30 to 40 percent a decade ago. It is still recovering from sectarian violence in 2006 and 2007 that caused it to lose nine of 24 doctors. Two were killed; others left Iraq.

"We are trying to reach a new world," says hospital director Kassim Rahi Essa. "I don't think the situation will turn back to that violence. People are fed up with such conditions."

The kind of tentative optimism expressed by Badawi and others pervades the hospital – and can be found in the maternity ward where a black-clad grandmother, Zam-Zam, sat beside the incubator in which slept her sleeping grandson Mustafa, just 6 days old.

His recovery is "up to my God," she says. But staff here say that they, too, are doing what they can to improve every child's chances. For all Iraqis, the health problems that burdened them 10 years ago are less prevalent today.

Still, the 2009 UN Humanitarian Appeal, released Nov. 19, asks for $547.3 million for Iraq and Iraqi refugees in the region. Hundreds of thousands of Iraqi families are "still struggling with acute poverty, displacement, and the continuing effects of conflict," the appeal notes, while the impact of past sanctions, conflict, and neglect are "still extensive and severe."

Corruption and an inability to distribute aid remain key government problems. A 2002 report from the UN Children's Fund (UNICEF), based on government figures, found that mortality of children under 5 years old had increased 2-½ times in the previous decade. More than one-fifth of children, the report noted, "still experience stunted growth."

While those Hussein-era numbers have been questioned, today the government spends $5.9 billion on an outdated ration system created in the 1980s that was once lauded by UN officials as a lifesaver and model of efficiency. But Iraq's needs have changed. That system is an "extremely inefficient way to meet basic needs," says David Shearer, the UN humanitarian coordinator for Iraq.

"We are seeing pockets of fairly intense humanitarian need, and with Iraq, it is such a mosaic of different levels of under-development, both from the early days and the last few years," he says. "Our challenge is to work on those really acute areas."

The system needs reform, experts say, because rations are handed out not according to need, but as an entitlement to every Iraqi. But getting poor Iraqis food is only one area needing improvement.

Figures for 2006, for example, show that 79 percent of Iraqis are connected to water lines, but only 40 percent have regular flow into their homes. Often water lines are tapped into by others along the way and become contaminated – which leads to rising infant mortality rates.

Until now, poor security has limited the types of infrastructure improvements that could better the country's overall health. Until earlier this year, some 600 municipal and public works employees had been killed across Iraq in efforts to fix water and sanitation problems.

"With this focus on security, sometimes I think we are missing it a bit," says Shearer, "missing the deprivation."