Scores more Iraqis than Americans are wounded or killed each day in Iraq. The hospital wards at Ibn Sina reflect this. After the car bombs and ambushes, the raids and street battles, Iraqi police, soldiers, civilians, and enemy insurgents flood into American emergency rooms. The U.S. is obligated to care for anyone injured as a direct consequence of war.
Others, like the boy, are admitted too: children with insect stings, pregnant women, men with sexually transmitted diseases. They get in with the help of sympathetic soldiers and medics. They get in because doctors everywhere swear the same oath. Ibn Sina is an island of hope.
The Americans work hard treating Iraqis, as hard as they would for anyone. Doctors slice charred skin away, neurosurgeons tug chunks of metal out of skulls, nurses stop bleeding in legs blown to hamburger.
But in Iraq, the problem is what happens after. Military hospitals are not prepared to treat Iraqi patients for long periods. At a certain point, doctors must send their Iraqi charges—no matter who they are—back into the Iraqi healthcare system. And the system is ruined. Once upon a time, Iraq's hospitals were the best in the region. But Saddam Hussein's threats and violence eventually drove many doctors from his country. Iraq's hospitals began to rot under the dictator and the sanctions imposed on the nation after the first gulf war. By 2003, when American soldiers charged in, the system was a shell, broken and looted.
In his small office at Ibn Sina, a hospital once used by Saddam and Iraq's ruling elite, Lt. Col. Mark Smith, deputy commander for clinical services, explains that the U.S. is trying to repair the broken system, pay doctors' salaries, provide new equipment. But violence and chaos have blunted the effort. It seems, at times, like scraping a hole in sand.
"We really can't take care of all those Iraqis," says Smith, who must sometimes decide when to send Iraqi patients away. "There's got to be a way to build that medical infrastructure right now." But he knows it can't happen while the country tears itself apart. Someday, Iraq's hospitals may function well, fully staffed and provisioned. But Smith doesn't believe it'll be soon. "I would say we're a generation away from that."