Iraqis' mental health suffering, say doctors

More than 1,000 people turned out on May 9 for one of the largest conferences to date on the health effects of the Iraq War. Leading researchers flew in from around the United States to speak at the University of California San Francisco (UCSF). "We have been silent too long," former UCSF chancellor Haile Debas told the gathering. "We have a moral obligation to speak out and try to head off devastating consequences." Speakers at the day-long forum called it a historic event–the first time since the Iraq War began four years ago that medical professionals had come together at such a well-known institution to publicly clarify the health effects of the war on the local population. "In subjects that are hot, it's important to get it right and tell people what you know and what you don't know," said Dr. Richard Garfield, a professor of nursing at Columbia University and coauthor of a report published last year in the British medical journal The Lancet. Garfield's team went door-to-door surveying communities in every province of Iraq and estimated that, as of last October, 655,000 Iraqi civilians had died as a result of the Iraq War. The team found the two main causes of death were sectarian conflict and being killed by US-led occupying forces. "There is more violence and the increase in violence is due to sectarianism and [the breakdown] of authority," he added. "You have both an internal conflict and a conflict between Iraqis and foreigners. It's a complicated situation." But the health impacts go beyond the risk of death from daily violence and include long-term psychological effects on the general population, the researchers said. A survey released last month by the Iraqi Ministry of Health found 70 percent of primary school students in one Baghdad neighborhood suffer symptoms of trauma-related stress disorder. Separately, the International Red Cross reports that many Iraqi children must pass dead bodies on the street as they walk to school in the morning, while others have seen relatives killed or have been injured in mortar or bomb attacks. "They're having extreme fear reactions, they're anxious, they have bed wetting, they're afraid to go out, they're crying easily, they're having difficulty concentrating, they're having flashbacks of traumatic scenes," said Jess Ghannam, a professor of psychiatry at UCSF. "Those are all the classic signs of Post Traumatic Stress Disorder [PTSD]." Providing any kind of treatment will be difficult, Ghannam added. In March, the head of the Iraqi Society of Psychiatrists told CNN that 50 percent of the country's psychiatrists have fled the country or been killed since the war began. "The most logical thing to do would be to have school intervention programs, but schools aren't functioning," Ghannam said. "Even more disturbingly, the teachers have PTSD too. So who's going to do this? You have an entire population that's basically struggling with deep fear, hopelessness and helplessness about their situation right now." "The struggles of daily life are incredibly difficult," added Dr. Dalia Wafsy, an Iraqi-American physician. Wafsy moved to the southern Iraqi city of Basra last year and spent three months there with her family. "Basically you take your life in your hands every time you leave your house," she said in an interview, "but even if you stay home you aren't safe from the daily house raids being conducted by American forces and the Iraqi police." The keynote speaker at the event was syndicated columnist Robert Sheer. He told the gathering he hopes more doctors will speak out about what they see in Iraq. "The fact is that all of this activity is accompanied by a very heavy medical presence," he said. "Medical people know full well the kinds of injuries that are being sustained and the implications for the future, and we're not hearing much of that." Sheer said he hopes the UCSF event will inspire more medical professionals to come forward, though no follow-up events have been planned.