BASRA, IRAQ & — BASRA, Iraq -- In the worst days of the war, some Iraqi doctors here and around the country say that they performed surgery by the light of kerosene lanterns. They boiled dressings from one patient to use on another. They collected water from the streets and backed-up sewers for straining and boiling. And at times they buried their patients in the garden when the morgues overflowed.
Western-trained Iraqi physicians and surgeons, who a year ago diagnosed ailments with multimillion-dollar CT scan systems, the latest X-ray machines and lab facilities, have reverted to basic medical tools: the stethoscope, the thermometer, the probing hand and their gut instincts.
The combination of allied bombing, postwar rebellion and the trade embargo against Iraq has left many parts of the country's medical establishment in ruins and its doctors beleaguered by the overload of casualties, destruction and disease.
Many physicians said in interviews that they were coping by improvisation. Some doctors, who asked not to be identified, severely criticized the government of President Saddam Hussein for what one characterized as his "criminality" in inviting the devastation of Iraq.
Dr. Walid Rawi, showing a reporter and a visiting U.S. physician around the grounds of the bomb-damaged Basra teaching hospital, where he is administrator, shooed away a pack of snarling dogs.
"Since the war, they have become more aggressive because they ate human bodies," he said.
Across town, the Tahrir Hospital in Basra's old port district lost most of its windows when a bomb struck near its outpatient clinic. Ten miles away in Az Zubair, allied bombs struck the only hospital, medical officials here said, making it unusable.
At Basra General Hospital, Dr. Rajha Thamer, who was recently named director general of the city's health authority, said that during the war he was serving in An Nasiriya, where he witnessed the aftermath of a bridge bombing on Feb. 4.
"I was in my office" at 3 p.m., he said, just as thousands of civilians were walking home, many of them crossing the bomb-cratered Euphrates River bridge because it would no longer support vehicles, when the bomb struck. "By the time I got there, there were hundreds of people in the river," Dr. Thamer said. "By the end of the day, more than 180 casualties were brought into the hospital, and we recorded 100 deaths."
At the Basra teaching hospital, Dr. Rawi, 42, considered himself somewhat lucky that after the out break of war in January he was able to supply electricity and clean water to his 435-bed institution after allied bombers knocked out the national electric power grid serving the rest of this city.
But a week after the allied bombing in and around Basra began, Dr. Rawi discovered that war has a way of intruding.
On Jan. 17, after the opening blackout of the war, the diesel motors of four big generators installed just for such an emergency kicked in to provide current and heat to the operating rooms, intensive-care unit and wards. For drinking water, the hospital's engineers took a pump down to the Shatt-al-Arab waterway, which flows in front of the hospital, and began pumping river water contaminated by sewage from upstream into a holding tank.
After consulting his bacteriologist, Dr. Rawi ordered a liter of laundry bleach poured into every 15,000 liters of river water in the tank. The chlorine-laden bleach went to work on the bacteria from the river. It seemed to do the job, he said.
In Baghdad at the Yarmuk teaching hospital, the chief of the surgery department, Dr. Mohsen Ani, recalled Feb. 13, when 52 burn cases came in after U.S. F-117 stealth planes bombed an air-raid shelter in the Baghdad suburb of al-Amerieh, where hundreds of civilians had taken refuge during a night of attacks.
"We had to use the open method of burn treatment" because of the shortage of bandages and dressings, the doctor said, "and this calls for the patient to lie completely naked without cover."
"There was no electricity or water on the wards," he said, "and we lost a lot of burn cases because there was no heating and they died of the cold and shock."
Nearby, at the 400-bed Saddam Pediatric Hospital, Dr. Qasm Ismail, the director, said that on the first night of the allied bombing campaign, his 400-bed installation was nearly full when the electricity failed and the explosions sent panic through the wards.
"Mothers grabbed their children out of incubators, took intravenous tubes out of their arms," he said. "Others were removed from oxygen tents, and they ran to the basement, where there was no heat. I lost more than 40 prematures in the first 12 hours of the bombing."
In Karbala, scene of a rebellion by Shiite Muslims, the Husseini Hospital itself became a target, and its upper floors today are riddled with holes from tank artillery rounds fired into the building.
The hospital's young surgical chief, who refused to be identified by name, said that at the height of the rebellion, "all of the people we operated on died."
"There was no postoperative care," he said. "We were seven doctors, three times in the operating theater per day. At one time, we had 65 bodies in the garden, and still today we have 15 cadavers buried there."
Far to the north in Erbil, a Kurdish center, Dr. Khurshid Dizaye, 56, is in charge of Ward No. 3 at the pediatric hospital. "This hospital was running on kerosene lanterns during the war. Can you imagine doing a Caesarean section in this situation?"
The doctor, who in 1975 joined a Kurdish rebellion against Baghdad only to see it fail, has devoted the years since to his pediatric practice among the Kurds of the Erbil area.
"You can't imagine how much we have suffered from this war," he said, "and although I speak English, I am not able to express all of my feelings about it."