Monday, February 28, 2005

Some thing new

Today I asked my daughter Najma (as she is our computer expert), to teach me how to put the links of other blogs in the side bar of my blog. She did, and I get busy for awhile in copying the links from her list. That take me a very long time, So I don't have enough time to write a new post. But I remember a letter I received from a friend contain a nice joke. I liked it and hope you will.

A new head of a company is elected, and he want to prove him self to the employees, he put out a new rules. He write an announcement includes these rules.

"Please be inform that there are NEW rules and regulations implemented to raise the efficiency of our firm.

TRANSPORTATION:
It is advised that you come to work driving a car according to your salary.

* If we see you driving a Honda, we assume you are doing well financially and therefore you do not need a raise.

* If you drive a 10 year old car or taking public transportation, we assume you must have lots of savings therefore you do not need a raise.

* If you drive a Pickup, you are right where you need to be and therefore you do not need a raise.

ANNUAL LEAVE:
* Each employee will receive 52 Annual Leave days a year (Wow!). They are called Sunday.

LUNCH BREAK:
* Skinny people get 30 minutes for lunch as they need to eat more so that they can look healthy.
* Normal size people get 15 minutes for lunch to get a balanced meal to maintain their average figure.
* Fat people get 5 minutes for lunch, because that's all the time needed to drink a Slim Fast and take a diet pill.

SICK DAYS:
* We will no longer accept a doctor Medical Certificate as proof of sickness.
* If you are able to go to the doctor, you are able to come to work.

TOILET USE:
* Entirely too much time is being spent in the toilets.
* There is now a strict 3-minute time limit in the cubicles. At the end of three minutes, an alarm will sound, the toilet paper roll will retract, the door will open and a picture will be taken.

* After your second offence, your picture will be posted on the company bulletin board under the "Chronic Offenders" category.

* Subsequent pictures will be sold at public auctions to raise money to pay your salary.

SURGERY:
* As long as you are an employee here, you need all your organs.
* You should not consider removing anything. We hired you intact. To have something removed constitutes a breach of employment.

INTERNET USAGE:
* All personal internet usage will be recorded and charges will be deducted from your bonus (if any) .And if we decide not to give you any, charges will be deducted from your salary.

* Just for the record. 73% of the staff will not be entitled to any salary for the next 3 months as their internet charges have exceeded their 3 months salary.

Thank you for your loyalty to our company. We are here to provide a positive employment experience. Therefore, all questions, comments, concerns, complaints, frustrations, irritations, aggravations, insinuations, allegations, accusations, contemplation, consternation and input should be directed elsewhere"

I hope we will not have such rules in our new Iraq.

T.T.

Wednesday, February 23, 2005

The history of my right kidney

Today is a special day for me. It is Tuesday 22 Feb.
Some body may ask why I chose this title for my posts, that is because I decided to write about how a patient suffers in Iraq, when he had a serious or chronic illness.
I personally have some medical problem. Although I am a doctor and know all the excellent doctors in Mosul and always get somehow a special management, I still suffered a lot.
Today I get rid of some (not all of the suffers), I did passed 3 stones with urination, without surgical intervention. Those stone cause me a severe pain over the last 30 days.


The story from the beginning.


In 1982 I was in the military service as medical doctor for some of the military units during the Iraq-Iran war.
It was July and we were in a desert area with no clean water supply, It was Ramadan our fasting season, I was fasting at that time , although it was very difficult but I was still 36 year old and feel strong and youth, our fasting last for one month, we stop from eating and drinking from about an hour before the sun rise to the sunset. At that time the doctors serve in the army as an ordinary soldiers, but as far as I am the only doctor in the camp. I got somewhat a special treatment, this was true specially when there is fight near by us. Our staff consists of one doctor (me), one medical assistant (male nurse), an ambulance and driver.
Our equipments are all brand new, all the drugs and medicine are available, and our ambulance was Chevrolet 1982. There were no other facilities, as laboratory test or x-ray. All what we could offer to the patients is the first aids for the casualties and some medicine for the common illnesses. The more serious condition, we refer them to the military hospital, and this take a complex routine procedure.

At that time I started to have some pain in my right loin, the pain was mild at the start and I was a strong youth man, I have a lot of medicine at my hand. So I treated my self with simple analgesic and antispasmodics. Also the general condition of the whole situation was not encouraged me to consult the military hospital.


Two years later, I still in the military service but this time in the north front, I started to complain of more severe loin pain and occasional renal colic, I was the only doctor in that unit, we have no any facilities as X ray, or lab. exam. But we have almost all type of medicine we need.
when I discharged from the military service at the mid of 1984, I started to check my self. The result was surprising to me, there was a large stone in my right kidney filling all the renal pelvis. I consult the best urology surgeon in Mosul, he decided surgery with possibility of kidney removal if there is a noticeable damage to the kidney. During the operation he decided to preserve the kidney as he found it still in a healthy condition.
The stone was very big and friable it fragmented in his hands during removal, although he made washing to the area but many fragments are left in place, to become multiple new stones afterward.
That mean I started with single big stone, and ended with multiple small stones.
I tried to take some medication to dissolve the stones, both pharmaceutical and traditional drugs that prepared from herbs. The result I get; I ended with three stones in the renal pelvis, there sizes are 8-10 mm. in diameter. These stones continue to enlarged and cause more pain.

The decision come again from the urology surgeon, operation.
In 1986 I had the second operation to remove the renal stones. This time the stones were solid and non friable, but,
this happen only to me, the surgeon remove two stones and lost the third. He couldn't found it. At that time, the facilities in the hospital was too poor, they didn't have portable x-ray machine or an ultra sound devise. So the close the wound when they give up and can't found the stone.
That mean I ended with one large stone in my kidney after two major operations.


At 1988 the date of introduction of a shock wave therapy in Iraq (a procedure of breakdown the stones by supersonic waves) .
I was the first who try this procedure in Iraq. I did it in Baghdad in a private hospital, several sessions one month a part.
The stone breakdown and most of it get out with urine, but little pieces left, built their selves to more stone later on.

That mean I ended with multiple renal stones again.


From 1989 to 1995, I had several shock wave therapy with transient relieve of pain, the stone and pain relapsed within few months to about a year. During this period the sanction against Iraq was started and involved the medical appliances and most of the known drugs.
Our instruments get old and without maintenance.
In 1995, one of the urology surgeon who was worked previously in x ray department, with the help of the medical city (the biggest and best general hospital in Iraq), introduced a recent way of removing renal stones by a method called percutaneous nephrolithotripsy.
what is percutaneous nephrolithotripsy? :

"Percutaneous nephrolithotripsy (PNL): A technique for removing large and/or dense stones and staghorn stones.

PNL is done via a port created by puncturing the kidney through the skin and enlarging the access port to 1 cm (about 3/8 inch) in diameter. There is no surgical incision.

PNL is done under anesthesia and real-time live x-ray control (fluoroscopy). Because x-rays are involved, a super-specialist in radiology (an interventional radiologist) may perform this part of the procedure.

The urologist (an endourologist, another super-specialist) then inserts instruments via this port into the kidney to break up the stone and remove most of the debris from the stone."

I did the PNL in 1995, but it was not as easy as it looks to be, may be that happen to me only, during the procedure I felt a severe pain that made be shout "Aayyee" loudly, by the way this is never happened to me before this time, the surgeon asked the anesthetist," why he feel pain" guess what? She forgot to give the anesthesia before the operation!!. But at the end, this time, I get rid of the stones for very long time! About 8 years of stone free life, thanks God because they were very hard years on all Iraqi peoples.

Two years ago I started to have the same pain again, and the x ray showed multiple stones in the same kidney!

This time I have a decision, "No more operations". I started some diet modification and plenty fluid, no more fasting in summer time.

It was OK till last month when me and the family were in Baghdad for the holiday of the Aid, when I developed a severe renal colic, there were no hospitals, but plenty of relative doctors, they gave me the strongest analgesic available,but with limited response.
The colic lasted for 10 days with no relapse, I managed to returne to Mosul driving all the way back. It was the days before the election, there were curfew for the cars, and also no hospital and no doctors.
At the end of the election days when every thing returned to its ordinary state. I took an x ray, there were three stones in the right ureter in the lower third.
They took about 20 days of suffering and taking different analgesic.
Today the Tuesday 22 after I get back home from the hospital, I passed one stone with the urine, it was 6 mm. in size, at night about 11:30 pm, I passed two stones the larger one about 9 mm the other about 7 mm in diameters.
By the way, all these problems are in my right kidney only. The left kidney is perfectly normal.
I told you it is great day for me.
I hope I didn't make you bored. If I did , let me know.

Monday, February 14, 2005

Health and illness......... Doctor and patient ..... part two !!

Hi folks
In the previous post I talked about the schools and the colleges in Iraq, I should consider more points which may be of interest to some of you.

When the students pass the secondary school successfully , they have to get some average marks to be eligible for colleges.

We have limited places for students in each particular college. If a college have only 90 chairs for the first year students, and 120 have applied to this college, they chose the 90 of higher average marks.

When the students started to apply to the colleges, they got a printed forms contain the names of all the colleges in all the universities in Iraq. They have to write the name of the desired colleges where they want to apply, according to their preference, they should sort the names according to their wishes.

All the filled forms go the "Ministry of High Education and Scientific Researches" where they distribute the names according to the average degrees and the preferences.

The result will be announced all over Iraq at the same time, then every student have to present him self to the administrative office of the college where he has been accepted for interview and to complete the registration to be able to study in that college.

Almost all the colleges are governmental and under direct supervision of the Ministry of High Education and Scientific Researches. We have very little number of private colleges which are usually teach unscientific subjects like history, geography, religions, agriculture and some teaches statistics and accounting .

All the colleges of medicine, pharmacy, engineering, chemistry, physics and so on are governmental. The teaching programs are almost unified in all similar colleges.

The study are free of charge in all the governmental colleges, but not in the private ones.

The study in most branches are for 4 years, except for medical college which is for 6 years. In pharmacy, and dental hygiene it is 5 years.

The sex of the applied student has no effect on the results of acceptance, except in some branches which required special physical fitness.

In short any one who get high degrees can go to the college he want. those who are less fortunate can apply to any private college, but they have to pay for that.

In Saddam times, he gave a privilege to Baath party members and their families, by having 5 degrees added to the average of their marks to enter the competition. So most of them can get the places in the college they want without really deserve it, in addition of taking the place of other candidates.

Salam to every body

Tuesday, February 08, 2005

Health and illness......... Doctor and patient part one!!

Today I am trying to write some thing different. Some thing non political, may be social, or have some thing to do with my ordinary life

I have told you before that I am a medical doctor, I graduated from Iraqi Medical College in 1972, the study in the medical college is six years. I have my post graduate study here in Iraq too.

The study of medicine is in English language for both pre and post graduate. After graduation, we use to have 12 months residency as junior doctor in one of the general hospital, we have to rotate in all branches of medicine to practice clinical application of medicine, now they change the rules and the training period extend to 24 months.

After this, all the males used to go to the military service for a period varied from time to time according to the general situation of our country (We usually have a war every now and then)

After the military service, the doctor must have a second residency period as a senior house officer, usually he choose the branch which he prefer, but this is not always the case. It last for 24 months also. After that the doctor can apply to post graduate study if he want to, or practice medicine as a general practitioner, or as some time called "a family doctor"

Most of the hospitals in Iraq are belonging to the government, and all the doctor are employee for the government, ministry of health

There is no health insurance in Iraq!! The reason for that is; the medical consultations, medical examination, laboratory investigation, surgical operations and the medicine (drugs) are all free of charge. This is really true.

In addition to that, learning in the schools, primary, secondary and the Universities are all free also. The government supplies the student with new books, notebooks, pencils, erasers and even pencil sharpener free of charge every year. Even in the medical college they supply the students with free medical text books.

During the last few years, due to the sanction the books have to recycle, I mean they collected them at the end of the year to give them next year to another students.

To be continued....

Friday, February 04, 2005

More comments........, more answers

Anonymous

First of all I have to tell you that you are write, I am surely Sunni, but definitely you are wrong, I am not belonging to saddam's regime as you guess. You are wrong again in saying that sunni= belonging to sadam's regime.
It is easy to determine that you don't know sadam or his regime. You have to thank Good for that. You are wrong again in saying that i have little to gain from democratic revolution!!!. You should know that there is no democracy under occupation. I can go on enumerating how wrong you are !!. But instead I will tell you some truths i hope it will open a new vision in front of you.
1-Me and most of my friends and relatives are anti sadam, the reason for that not because he is sunni but we believe from the early days he got the control that he is the man of America in the middle east.
The Iraqi - Iran war proved our believed. if you don't believe that , you should reread the history.
2- From the history also. All the governments ruled Iraq from the start of Islam in Iraq till the time of sadam all are sunni, what a coincident.?. I know why. But if you don't know you should reread the history once more again.
3- Most of our brothers, the Kurds are sunni, most of them are anti sadam too.
4- Till few months ago is: before the war, no body think that he is sunni or sheie, we all Moslems.
5- counting the Kurds as sunni, the majority of Iraqis will be sunni.... Did you got why the concentration of Arabic -Kurdish differencing in western media.??
6- Just for the FACT, sadam had killed thousands of Iraqi peoples Arab, Kurd. Moslems, and Christians with out differencing of any kind. the concentration on the event of Halabja city( where several thousand Kurd were killed by chemical weapon is all made by the media. I am sure the CIA and the American government have the write story......... You have to look for another source for history.

the last thing I have to mention here that i read an article about the Iraqi election, written by an American author. the complete text could be found at: http://www.wanniski.com/

"It's almost two years since the invasion of Iraq and the world has not been able to hear from any of the members of Saddam Hussein's regime, because of course they are all under lock and key, waiting to go on trial for hiding weapons of mass destruction they did not have and for colluding with Al Qaeda, which they did not do. I've often wondered what happened to Muhammad al-Douri (as I have spelled his surname). I had been in daily touch with him by e-mail and cellphone when he was Iraq's Ambassador to the United Nations in the last days before the March 2003 invasion, but lost touch with him when he left quickly for Europe on the day Baghdad fell. We'd originally met through his predecessor at the UN, Nizar Hamdoon, who I'd known since I began looking into the allegations of Iraq's misdeeds in 1997. Hamdoon passed away last year, of cancer, and I'd been assured by the Iraqi U.N. Mission that al-Douri was okay. It was nice, though, to see this interview on the Al Jazeera English website this week. I would have missed it in my daily scan, but spotted his frowning visage. He's really a most pleasant fellow, a rather distinguished lawyer who joined the diplomatic corps to represent Iraq at the Human Rights Convention in Geneva. In case you wonder, I agree completely with him in this interview, that the recent elections are meaningless because they were arranged along sectarian, not nationalist lines. President Bush should read this. He would learn a thing or two.

Iraq elections, democratic practice but ...
by Ahmed Janabi

When Baghdad was occupied on 9 April 2003, the last Iraqi ambassador of Saddam Hussein's government to the UN, Muhammad al-Duri, declared that the game was over. A journalist, university professor and statesman who served as an Iraqi delegate to the UN from 1999 to 2003, he left Iraq in 1999 to act as Iraq's ambassador to the UN in Geneva, Switzerland before he was moved to New York where he remained until he resigned after the occupation of Iraq.

Janabi:
How do you feel about the elections?

al-Duri: Despite everything that has been said about its incompetence, it is still a democratic practice. It is part of a well-thought out US plan to implement its strategy in Iraq. But one must be aware that last Sunday's elections establish sectarianism in Iraq. So many Iraqis entered the electoral process whether as candidates or voters on a sectarian and/or ethnic basis and motives. It is very dangerous and Iraqis should reject sectarianism.

Janabi:
But according to many Iraqi voters who talked to reporters on election day, they did so because they wanted to end the state of chaos in their country and restore security and stability. Isn't that the case?

al-Duri: I do not agree with that concept, these elections are not designed to restore security and stability. The US administration has been desperate to legalise its occupation of Iraq, but it has failed so far. This mission has become an obsession for it; especially that the war on Iraq is still protested against by EU and Arab countries. Therefore the US is trying to legitimise its existence in Iraq by bringing in an elected parliament and a government which are fully loyal to it [US], and as such it will be able to conclude long term agreements that secure its interests and influence in Iraq.

Janabi:
As a politician and a professor of politics, do you think that the Iraqi Sunni Arabs boycotting of the elections could put the legitimacy of the process at risk?

al-Duri: It is wrong to say that Sunni Arabs boycotted the elections. It is an attempt to ridicule a national Iraqi position that opposes the division of the country, by labelling it as a sectarian position. The US occupation has encouraged the virtual division of Iraq into three entities. The first one is in the north, it is ethnically motivated and works to separate itself and establish an independent state (Kurdistan). The second in the south plans to split and establish a sectarian entity backed by Iran. The third is central Iraq which for some reason carries a national vision for the future of Iraq. Obviously the US works hard to destroy this entity, which happens to be Sunni and exists in central Iraq. But as a matter of fact, the people of central Iraq are Arab Iraqi Muslims in addition to being Sunnis. This part of the country holds a sense of national identity that rejects the foreign occupation and separation bids.

Janabi:
But boycotting elections would have delayed the formation of a national Iraqi government, parliament and constitution, don't you agree?

al-Duri:
All that you are talking about was approved by the former US administrator in Iraq, Paul Bremer.


Janabi:
And what is wrong with that if it would benefit the country?

al-Duri: A country's constitution must be national, while Iraq's interim constitution which laid the foundation for Iraq's future constitution was put forward by Noah Feldman, a Jewish American university professor. All the documents that rule Iraq today were made in the US, translated to Arabic and forwarded to Iraqis who could not even discuss them properly. How can a country adopt a constitution imposed by a foreign power? Even the elections were set by Feldman's document, and thus the elections have no legitimacy because it is based on illegal documents written by an occupying force.

Janabi:
The interim Iraqi interior minister has said the US could pull out of Iraq in 18 months. What do you think of this statement?

al-Duri:
Initially, I would like to ask why this statement came on the eve of the elections? It was obviously part of the election campaign.
However, this is part of the US' exit strategy. This notion is being widely discussed in the US, not because the US genuinely wants to pull out from Iraq, but because of unexpected urban fighting. They are spending hundreds millions of dollars on Iraqi security forces in order to put them face to face with the resistance. Actually, this money is supposed to be for the reconstruction of Iraq, but I can assure you that nothing has been reconstructed, absolutely nothing, not even in the oil sector. At the end of the day, Iraqi officials do not speak for themselves, they just echo the US' desires and instructions. The real ruler of today's Iraq is not the president of Iraq, nor the interim prime minister; actually it is the US embassy in Baghdad. It is unlikely that the US would voluntarily withdraw from Iraq; it has spent nearly $300 billion up to now, how is it going to get this money back if it withdraws? The US has captured a goose with golden eggs (Iraq), why would it let it go? That cannot be. The US did not go to war with Iraq because of WMD, or links with al-Qaida. I am fully convinced that it has an agenda in my country. It also did not come to establish democracy in the country. On the contrary, if we look at what is in today's Iraq we will find nothing but division, hatred, and sectarianism. If the US were to pull out, it will not do so unless it secures powerful bases in Iraq.

Janabi:
US bases exist in Japan and Germany; I think no one can argue that US bases hindered the development of those two countries in the post-second world war era?

al-Duri: It is very strange that some Iraqis accept this idea. US bases in Germany and Japan were set up in different international conditions! It came after a world war involving Germany and Japan who waged an aggressive war and occupied foreign countries, and the US and its allies fought to drive out German forces from occupied Europe. That was not the case with Iraq. There were no Iraqi forces out of Iraqi soil, and the war took place on its soil with forces which came from overseas to occupy it. How can we compare what has happened in Iraq with Nazi Germany?!

Janabi:
Regardless, why don't anti-US Iraqis wait and see?

al-Duri: You have to choose either bread with dignity or bread without dignity. Why should we wait? What does Iraq need from the US? It is a country rich in resources, located in a strategic position, and with a highly educated people. If the US really wants to help, there are dozens of poor and undeveloped countries out there, let it help them instead of helping a country which possesses the world's second largest oil reserve and which has achieved high rates of development before it occupied it.

Janabi:
When Baghdad fell to US forces on 9 April 2003, you said the "game is over". What did you mean by that?

al-Duri:
Many people interpreted my words that what happened was a game between Saddam Hussein and the US; actually I meant that during the 13 years of UN sanctions on Iraq, the UN was acting like a theatre.
All players were not sincere in finding a way to end the sanctions that killed millions of Iraqis. The proof for that is when the US decided to attack Iraq, everyone backed off and the US did what it wanted.

Janabi
: But there were protests around the world, and many countries did oppose the war.
al-Duri: That was not enough."