Update

I yet live.

I have updated my profile and need to do other blog maintenance when I find time but not today, I am too busy preparing for Thanksgiving Day tomorrow.

Day by day

I yet live. but congestive heart failure is an aggravation and my energy level is pretty low.

I follow the Mosul news off and on, what there is of it. Every indication is it's still a pretty dangerous place but maybe there are fewer mindless bombs and killings. Perhaps there are simply fewer reports of such but one can hope.

Project Status

I yet live.

Spammers have been dropping pseudocomments on the most recent post, with links back to their own commercial sites, so I have disabled comments for non-members, me being the only member.

I can be reached via the contact info at the top of the page.

The Mosul Chemotherapy Project is inactive until further notice. My contacts at Mosul Oncology and Nuclear Medicine Hospital informed me some time ago that supplies arriving through normal Iraqi channels (Ministry of Health, Kimadia, etc) have improved to the point that costs and risks associated with shipments delivered by this project are no longer justified. I will continue to monitor the situation intermittently as best I can (reading news reports, occaisional phone calls to Mosul, etc.) and attempt to renew my efforts if asked.

I think I have mentioned before that I count as heroes all those who helped in this project. This includes Iraqi doctors, American personnel stationed near Mosul Airport, FedEx people who expedited shipments, pharmacists who dispatched the many difficult shipments, folks who chipped in to help pay for them, etc. In most cases I have not mentioned their names to avoid exposing folks in Mosul to added risk and out of respect for their privacy. One guy, Brad Blauser, a civilian contractor, took the "hero" thing so far in so many ways that others noticed and he wound up on nationwide TV when CNN gave recognition to a "Heroes Top Ten" recently (YouTube CNN video). Check out the big grin on Brad's face in Brad's own video as he helps a disabled Iraqi kid who's just received a fancy pediatric wheelchair due in large part to Brad's efforts. I have never met the folks I've worked with in this project face-to-face, and probably never will, but I've sensed in them the same kind of satisfaction at doing something helpful and worthwhile that you can see on Brad's face. I am enormously grateful to have had the chance to work with them.

Events in April and May

I got confirmation from my contact at the hospital that the latest shipment of drugs from India reached the hospital last week. Again, the shipment contained 50 vials of doxorubicin and 10 vials of carboplatin as before.

When I spoke to my contact, he indicated that oncologists at the hospital have become dubious of the quality of the drugs in recent shipments based on apparent response of patients to treatment. Because of the poor phone connection I was unable to understand all the details and I have asked him for clarification.

The chemotherapy drugs in recent shipments have been produced in India and shipped from there. I was very careful to investigate the competency and quality control program of the supplier in India before deciding to work with them, and I have good reason to believe they are competent and well equipped to properly test and verify the quality of their products. I have asked them to provide analytical reports for the drugs delivered in recent shipments. Hopefully, such data will enable the specialists at the hospital in Mosul to make a well informed assessment of the drugs and decide whether to continue using them.

I am not sure but I suspect there may be a general suspicion of all imported drugs among Iraqi doctors. I think perhaps I need to caution the people at the hospital that there is strong reason to believe that the drugs from the Indian supplier are full strength and exactly as labeled, and that it could be unsafe to assume otherwise when administering them.

On another subject, in April there was an event dubbed a "Global Activism Expo" in Chicago sponsored by Chicago Public Radio. Here is a Link. Mr. Robert Braam attended to represent the Mosul Chemotherapy Project, and several hundred people had an opportunity to look at flyers about the project. There has so far been little that has come of it in email or comments on this blog, but perhaps someone who took home a flyer will pass it along. If you'd like to look at a PDF version of the flyer, you can find a copy by following this Link.

Update - Crediting Kimadia with SOME Improvement

I spoke to my contact at the hospital today about the continuing supply problems, and he indicated that although the shortage of chemotherapy drugs from Kimadia is still critical and near-total, there have in fact been some improvements over the last year in deliveries of other supplies. One example he mentioned was a recent rather large delivery of ostomy supplies. Another was improvement in delivery of surgical supplies including such things as dressings, anesthetics and antibiotics, to the extent that the number of surgeries per week per surgeon which is possible with the available supplies has approximately doubled in the last year.

I asked whether the supply problems seem attributable to corruption or to shortage of funds or some other cause. His feeling seemed to be that it is the general chaos that afflicts Iraq that is the most important problem. He seemed doubtful that highly placed people in the Ministry of Health were diverting supplies to the black market but considered it possible that lower echelon personnel might do so if the opportunity presented itself.

I have never ceased to be impressed by the dedication and courage of Iraq's doctors, and to the extent that the Ministry of Health is staffed by physicians I have no doubt that the welfare of the patients of Iraq is their primary concern.

March Shipment

I got confirmation from the hospital that the latest shipment arrived there OK on March 23, 2008.

The shipment included:

1. Doxorubicin 50 mg vials : 50 vials
2. Carboplatin 450 mg vials : 10 vials

USA Today Article Blames Sadr

A recent USA Today article titled "Sadrists' grip on Iraqis' health care takes toll" indicates that Sadr and his cronies control the Ministry of Health and it's Kimadia agency and use them as a tool to exercise power. The presence of a large portrait of Sadr's relatives outside the Ministry offices is offered as confirming evidence.

In part, the article says:
Al-Sadr's control over Kimadia, the state-run company that is responsible for importing and distributing drugs and supplies to Iraq's hospitals, also poses problems, Ferrati said.

"Kimadia has a stranglehold on the whole medical sector, and that is a source of power through which Sadr can control the health sector and threaten the country," Ferrati said. "If they decide to stop working, then you cut off all the drugs into Iraq."

This is interesting because it suggests a face or group identity to blame for the supply woes afflicting Iraq's hospitals, but I suspect it might be erroneous or oversimplified. If I had to guess I would say not all of the Health Ministry is corrupt although serious corruption would be consistent with the poor job Kimadia seems to be doing; Kimadia's personnel in Mosul seem to have the respect of my contacts there although they are far from satisfied with the job Kimadia is doing. I suspect many Ministry and Kimadia people are honest enough and if there are miscreants they are probably a minority, possibly in management positions if they are in fact Sadr's politically appointed agents. Also, I have seen no indication that the medical supply situation is better in any particular place in Iraq than others, suggesting that rather than withholding medical supplies from some parts of Iraq that don't toe Sadr's line and providing them to other areas that do, necessary supplies are being denied to (or stolen from) all without prejudice. This would be more consistent with diverting medical supplies for profit and using the proceeds to finance criminal/sectarian activities than bartering the supplies for favors. That would match reported profiteering on diverted oil in southern Iraq where militis are reportedly heavily involved it that corrupt trading problem. If medical supplies and drugs are being diverted for profit, it's presumably happening in Baghdad and involves collaboration of militias.

Of course I'm half a world away and have no direct knowledge of any of this, but something pretty outrageous is causing serious problems for Iraq's hospitals.