Baghdad, Iraq – After graduating from the College of Medicine last year, Dr Omar al-Shimmari felt pretty confident and was convinced he would soon take the first step in a long career path.
But the reality was different. Instead, he has become a pharmaceutical sales representative – a job he dislikes but needs for the paycheque.
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Going door-to-door to provide product information to doctors and to persuade them to prescribe the drugs to patients “is not a decent job for a doctor, but I have no other choice to make ends meet”, al-Shimmari said.
However, a lack of government funding has derailed the employment of thousands of graduates of medical universities and other health workers in Iraq at a time when the country’s health institutions are limping along because of decimated infrastructure and a shortage of medical staff.
As a result, pressure has increased on the dwindling number of medical professionals mainly in hospitals with the onslaught of COVID-19 patients, forcing them not to take time off while in some places they work even if they have the symptoms of the disease.
“Fourteen months have passed now since graduation and we are staying at home,” al-Shimmari, 26, told Al Jazeera in a phone interview from the northern city of Kirkuk.
“Without practising medicine, we will forget everything,” he said.
The delay in employing nearly 2,300 graduates has not only affected the efforts to fight coronavirus, but has also delayed the training chain the physicians must go through, as those in service cannot move to the next level, said the head of the Iraqi Medical Association, Abdul-Ameer Muhsin Hussein.
“The employment of these graduates is a good addition to the health system that will bring new energy of youth,” Hussein added.
Protests for jobs
Iraq is one of the countries badly hit by the coronavirus pandemic. On Friday, the confirmed cases surpassed 5,000 for the first time since the outbreak in February, bringing the total to 252,075. Total deaths stand at 7,359.
The health ministry has warned it fears the number of infections “will lead our health institutions to lose control” in the coming days.
The pandemic is only one issue in a long list of woes Iraq is suffering through, however.
Like other oil-producing countries, the war-ravaged nation is taking a massive hit after oil revenues – which make up nearly 95 percent of its income – dropped more than 50 percent.
The months-long unrest – which started in October when Iraqis took to the streets to demand a better life – has delayed the approval of the 2020 budget.
Alarmed by the lack of medical practitioners, the Iraqi government formed a ministerial committee in July to find ways to employ medical graduates, but the finance ministry refused because of the absence of the budget and a lack of funds.
On Tuesday, the cabinet issued an exemption for the newly graduated physicians to be employed, but did not give details on how to pay their salaries.
The decision does not cover nearly 31,000 healthcare graduates, according to Firas al-Mousawi, deputy director of state-run Al-Shafaa Centre for Crises.
Like his colleagues, al-Shimmari is still not convinced the government is serious.
In a bid to stop what they call “procrastination” by the government in implementing the decree, the graduates are planning protests in the capital Baghdad and other cities on Sunday.
“The protests will run for two days,” said al-Shimmari. “If nothing will happen then there will be a partial strike by those in service except emergency wards and intensive care units, and later we’ll start a general strike.”
Ailing health system
Iraq’s health system has suffered in recent years as more than 20,000 doctors fled because of insecurity, threats, and targeted killings, leaving the country with less than 30,000 doctors, according to Iraqi Medical Association.
And 363 doctors were assassinated while hundreds endured kidnappings since the 2003 US-led invasion that toppled Saddam Hussein, an attack that unleashed instability and chaos that persists to this day.
What has further strained the health system, Hussein continued, is the new retirement law that went into effect this year, which mandates the retirement at 60, forcing more than 3,000 senior doctors out of the healthcare system.
“To be honest, there is a huge shortage of mainly doctors as well as health workers,” said Hussein. He added the country has one of the lowest numbers of doctors and nurses per capita, standing at about 0.8 doctors per 1,000 people.
One of the major obstacles for doctors and medical workers “is the absence of a safe environment as they increasingly face harassment and assaults from disgruntled families of patients”, Hussein said. He is pushing authorities to deal with attacks against medical staff using the anti-terrorism law.
Deteriorated health infrastructure and a lack of protective gear while dealing with coronavirus patients have caused infections among doctors, he said. Since the outbreak, 44 doctors have died while more than 1,500 others were infected, a number that could be even higher.
Healthcare graduate from Baghdad, Mayssam Muqdad Mahmoud, 26, describes delaying their employment as “unfair as we are left in the middle of nowhere and we don’t know our fate”.
“We are all disappointed and shocked,” she said. “What is the government waiting for amidst the current crisis of coronavirus and shortage of medical staff?”
She said she is upset at being a “housewife” after studying medicine for six years. In order not to forget what she studied, Mahmoud joined other colleagues in a Facebook group where they review the college curriculum.
Graduates cannot seek jobs in the private sector or outside Iraq as authorities do not issue their certificates before completing seven years in public service, or a person guarantees the graduate will not leave the country.
“We are like prisoners,” said Mahmoud. “They don’t let us start our public service nor issue our certificates so that we can leave the country.”
Protesters will be joined on Sunday by those in service who want protection from assaults, improvements in their work environment, and review benefits offered.
In advance of the protests, the graduates launched an online campaign on social media to martial support and increase pressure on the government.
“A doctor revolution,” said one post on Twitter. Another showed a picture of a group of men pumping their fists in the air while being led by a man holding a banner saying: “Doctors without protection, without jobs.”