Iraqi doctors have warned that their country's crumbling healthcare infrastructure could collapse completely if the number of coronavirus cases seen in Europe or neighbouring Iran is seen in Iraq.
Wracked by years of war and civil unrest, and with collapsing oil prices squeezing limited resources, there are fears about what the next few weeks could bring for Iraq.
Ghaith Ghaffuri is an internist at the Shahid as-Sadi hospital in the middle of Baghdad's sprawling Sadr City neighbourhood. He told Middle East Eye that despite the best efforts of workers, Iraq's healthcare system would not be able to endure a massive spike in cases.
"If we get numbers like you get in the UK or in Spain or Italy, we will fall down," he said.
"It's all about the numbers - if the number rises up to 10,000, let's say, we won't even have enough beds to put people in and of course we won't have the ventilators for the badly-infected people."
On Monday, the Iraqi health ministry reported 630 cases of the Covid-19 virus and 46 deaths, giving the country the second highest death toll in the region, after Iran.
Waad Alhafiz, a medical student and activist, explained the process for dealing with coronavirus infections.
"We receive suspected cases, put them in a quarantine room, examine them and take a swab for a PCR test," he explained, referring to the polymerase chain reaction test used to detect new infections.
"If they are positive we send them to the quarantine hospital."
Iraq's deputy health minister, Jassim al-Falahi, told Al-Jazeera over the weekend that the country's healthcare system was “resilient”, but the data suggests the country may struggle if numbers keep rising.
The country's healthcare spending, at around $153 per capita annually, is less than half that of neighbouring Iran, which has itself been severely struggling to contain the crisis, while according to the World Health Organisation (WHO), there are 8.2 doctors for every 10,000 people in Iraq.
According to figures compiled by the health ministry in 2018, Iraq had 799 intensive care beds compared to around 4,000 in the United Kingdom, a country less than twice the size of Iraq, and one that has also seen its healthcare system straining.
The WHO has estimated there are, in general, 14 hospital beds in Iraq for every 10,000 people.
Although resources are available to manage the current intake of infections, there are fears that the number of infected could be much higher, as only around 2,000 people have been tested out of Iraq's 40 million-strong population - placing a much greater burden on an already creaking and underfunded system.
Curfews ignored
In order to combat the spread of the virus, the government has imposed a countrywide lockdown until 11 April, closing schools, universities, shopping centres, airports and other large gathering places.
But despite the curfew, there has been scant attention paid in some parts of the country.
Last week, Baghdad Operations Command announced that 1,542 individuals had been arrested and 557 vehicles seized since 17 March.
The most high profile incident took place on 21 March, when tens of thousands of worshippers defied the curfew in order to commemorate Musa al-Kadhim, streaming down the streets of Baghdad to the 8th century Imam's mausoleum.
Alhafiz said the failure of Iraqis to take the recommendations on social distancing seriously was frustrating the efforts to tackle the pandemic.
"When the people are at the hospital they take it seriously, but when they go away from the building they don’t," he told MEE.
"Also most people don’t have protective equipment and they don’t know how to protect themselves. For example, many of them came to the hospital putting their hands on their face thinking that would protect them against the virus."
He said that a major problem was a lack of literacy, meaning many were unable to follow the instructions being produced on how to cope with the virus.
"Since 2003, we have many people that can’t read or write down their names," he said.
"Illiteracy is killing people more than coronavirus."
Ghaffuri said that while much of Baghdad was now observing curfews put in place to prevent the spread of coronavirus, locals where he worked in Sadr City - a suburb that makes up the vast majority of the capital's population - were largely ignoring social distancing advice.
Markets in the densely populated area were still open, people were still gathering in restaraunts and coffee shops and smoking shisha.
On Tuesday, Iraqi media began circulating photos of masked security forces deployed around the holy city of Karbala.
The Al-Sumaria news channel said they had been deployed in anticipation of the religious festival of Mid-Shaban, in order to enforce the curfew and prevent a repeat of the Kadhim incident.
Ghaffuri said health workers were already expecting the fallout from people ignoring the restrictions, and particularly mass commemoration for Kadhim, would be felt soon.
"If those people who were at the shrine visit tested positive, they'll pass it to their neighbours, their families and this could reach around 500 new cases," he explained.
'Just like World War Three'
The coronavirus pandemic has produced an outpouring of support for the world's healthcare workers, who have been putting their lives at risk on the frontline while people have been encouraged to stay home and distance themselves from others.
Despite the risks he and his colleagues were facing, Ghaffuri said that the whole ordeal has been - to a certain extent - "exciting".
“I told my colleagues we have to imagine ourselves as soldiers, and this pandemic thing is just like World War Three. The whole world, everywhere from east to west, is depending on us to stop this and to recover the lives of other people, as much as we can,” he said.
“So I don’t really feel worried as much as I feel excited to face this, to take it away and to finish it, so that one day when it’s over people can point to us and say: 'Those people helped us go back to our normal lives'."
By Alex MacDonald
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