In the 1980s, almost all medical facilities continued to be controlled by the government, and most physicians were Ministry of Health officials. Curative and preventive services in the government-controlled hospitals and dispensaries and the services of government physicians were free of charge. The ministry included the directorates of health, preventive medicine, medical supplies, rural health services, and medical services. The inspector general of health, under the ministry, was charged with the enforcement of health laws and regulations. Private medical practice and private hospitals and clinics were subject to government supervision. In each province Ministry of Health functions were carried out by a chief medical officer who, before the war, frequently had a private practice to supplement his government salary. Provincial medical officers were occupied mainly with administrative duties in hospitals, clinics, and dispensaries. The work of medical officers in the rural areas before the war was seriously curtailed by lack of transportation.
One of the most serious problems facing the Ministry of Health in the prewar period was its shortage of trained personnel. The shortage was accentuated by the fact that most medical personnel tended to be concentrated in the major cities, such as Baghdad and Basra. Physicians trained at government expense were required to spend four years in the public health service, but they strongly resisted appointments to posts outside the cities and made every effort to return to Baghdad.
In 1983, the latest year for which statistics were available in early 1988, Baghdad Governorate, which had about 29 percent of the population, had nearly 37 percent of the country's hospital beds, 42 percent of the government clinics, and 38 percent of the paramedical personnel. The increasing number of clinics in the provinces, however, brought some rudimentary health care within reach of the rural population. At the same time, given the unsettled conditions in the Kurdish areas, it was likely that health care in the northern provinces had deteriorated since the start of the war.
Published information concerning sanitation and endemic diseases was scanty. Reportedly in the mid-1980s Iraq had a high incidence of trachoma, influenza, measles, whooping cough, and tuberculosis. Prior to the war, poor sanitation and polluted water sources were principal factors in the spread of disease. A large percentage of the population lived in villages and towns that have been along irrigation canals and rivers polluted with human and animal wastes. These waterways, along with the stagnant pools of water that sometimes constitute the village reservoir, were the major sources of drinking water and of water for bathing, laundering, and washing food. The periodic flooding of rivers contaminated water supplies and spread waterborne diseases.
The Tigris and Euphrates rivers and their tributaries serve as water sources for Baghdad and some of the major provincial towns. Irbil and As Sulaymaniyah, located in the northern mountains, have adequate supplies of spring water. In Basra, Mosul, and Kirkuk the water is stored in elevated tanks and chemically treated before distribution. In Baghdad the water is filtered, chlorinated, and piped into homes or to communal fountains located throughout the city. In the smaller towns, however, the water supply is unprotected and is only rarely tested for potability.
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