From Iraq to Afghanistan: An Italian Doctor Talks About Treating the Civilian Victims of the War on Terror

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The founder of the humanitarian group Emergency, Dr. Gino Strada, discusses the impact of sanctions on Iraq’s medical system and the U.S. use of landmines and cluster bombs. [includes transcript]

The website is estimating that up to 9,800 Iraqi civilians have died since the U.S. invasion began in March.

We will likely never know the final death toll or the number of Iraqi civilians injured.

Today speak with an Italian surgeon has spent considerable time in Iraqi hospitals both before the invasion and since.

His name is Gino Strada. He is the founder of the Milan-based medical organization Emergency which has been providing medical care to civilians in Iraq and Afghanistan.

  • Gino Strada, founder of the Milan-based medical organization Emergency.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!. I’m Amy Goodman with Juan Gonzalez.

VIDEO EXERPT FROM DESERT RAINBOW: Jose was in a man’s world. He was playing in the street when they found a funny looking piece of pipe on the ground and started throwing it back and forth. The pipe flared up as if in Elle’s hands. Many women are victims of accidents at home. Tackia is 20 years old and has five children. She’s pregnant with her sixth baby. While she was firing up her old kerosene stove to cook a meal, it blazed up and burned her. Alda, 17, has lost his sight in both eyes. He went behind the lines of his father in search of scrap metal, and anything he could use at home. He picked up a wooden ball that set off a mine trap. Christani, 12, said he found something in the hills where he was helping his father and brother tend their animals. He picked up the cluster bomb, and in a matter of seconds lost his eyesight and both hands.

AMY GOODMAN: An excerpt of Desert Rainbow, about the Milan based medical organization, Emergency. We are joined by its founder, Dr. Gino Strada, who has just returned from Afghanistan and before that, Iraq. The website,, is estimating that 9800 Iraqi civilians have died since the Iraqi invasion began in March. We’ll likely never know what that final death toll is. Thank you for being with us.

GINO STRADA: You’re welcome.

AMY GOODMAN: Tell us about your work.

GINO STRADA: Our work is to provide the surgical assistance to the victims of war. I like to say that in every conflict that I have been working, and in Iraq and Afghanistan are no exception and over 90% of the victims are civilians. 30 of the victims are children below 14, so, we are dealing with a big health problem, public health problem, which is caused by the war.

AMY GOODMAN: Tell us what you saw in Iraq. Tell us about the people we just saw in this video.

GINO STRADA: Well, in Iraq, you know, we have been there since 1995, and we have been through different phases of the conflict, including the civil war. What you see is always the same story. I mean, you see people who have no medical care, hospitals which were not working anymore — before, because of the embargo, or after that, because of outbreak of war. And, in the city of Karbala, we are building our third hospital. We had dozens and dozens of wounded, particularly children, wounded by cluster bombs and there was no facility to look after them. So, we had to transfer them to our hospitals up in the north of Iraq to be looked after surgically.

JUAN GONZALEZ: In terms of what you — how the conditions, the medical conditions are since the war and vs. during the period of the embargo and before President Bush declared war, has there been a qualitative change in the character of the medical treatment that most Iraqis can receive?

GINO STRADA: Well, I was in Baghdad in February, and I was discussing with the head of the Baghdad University Medical Center, and at that time due to this long-standing embargo, they said they had virtually nothing, no disinfectants, no suture materials, even because, you know, suture materials were considered dual use materials so import was forbidden. They had virtually no means to provide surgery for the wounded. After the — after March, the situation got even worse. I remember that not one hospital in Baghdad has been working for over a month simply because hospitals have been looted. In other cases, there was no fuel to run the generators so that we could run operating rooms and et cetera. We had to bring 40,000 liters of fuel from the north of Iraq to activate the generators at Baghdad hospitals.

AMY GOODMAN: Can you talk about how Iraq compares to Afghanistan? Where you have just returned from?

GINO STRADA: Well, I think there are —

AMY GOODMAN: …the health care system.

GINO STRADA: In terms of the health system basically what we see in all of the so-called third world countries, although Iraq was not a third world country, it has been made a third world country, but what we see is basically the same. The so-called public health system is in fact a private system. Patients have to pay for everything because hospitals don’t have medicines, don’t have consumable materials. Doctors spend most of their time in their small private practices and therefore, you have this nonsense where the public health is private and when you go there as private organization and you in fact do public health.

AMY GOODMAN: Now, in both cases, and in Iraq we have certainly been focusing on this, the U.S. government has been pouring in billions of dollars. Where is it going?

GINO STRADA: Well, I’m not in the condition to answer this question. All I can say is that for instance, in Afghanistan where several millions of dollars have been poured, basically the living conditions and the health conditions of the population did not change. What we can see now is that there is a new aristocracy coming up in the city of Kabul to rent a house in Kabul will cost you between $4,000 and $5,000 U.S. dollars a month, which is ridiculous, and that money comes from the money of the international aid. In fact, it doesn’t go to the people. It doesn’t go to improve the living conditions of the population.

JUAN GONZALEZ: Now, you’re Italian and working in at least these two countries, in Afghanistan and Iraq, where certainly the conflicts of the last few years have made many Europeans not welcome. Not just Americans. What kind of relations did you have with the Afghani people and medical folks as well as the Iraqis?

GINO STRADA: Well, in Afghanistan, I think we do not have any security problem. I mean, we have been working in Afghanistan since many years. We were there in the Taliban time. I was in Kabul myself when Kabul was taken over by the Northern Alliance forces. The problem is that you know, we have been looking after people, regarded their political affiliation or ideology or ethnic groups. If you do that, people will respect you. I would say that in Iraq the situation is a bit different, because everybody claims to be in Iraq to do humanitarian work. The population doesn’t understand anymore who is whom. When you know from politicians to army people, to health organizations, they all say we are here to do humanitarian work: It’s a big mess. That makes our job much, much more dangerous.

AMY GOODMAN: What about land mines?

GINO STRADA: Well, that is a tragedy. I mean, it’s a tragedy that it persists–land mines and now even cluster bombs that behave like land mines when they stay unexploded in the ground. We have every day, every day, civilians maimed or killed by these weapons. I think these weapons are a form of terrorism in slow motion. They have no target. They just hit civilians. I mean, I have done myself surgery on more than 3,000 mine victims and I did not operate on any soldiers.

AMY GOODMAN: Explain exactly what happens. How — what is a cluster bomb, and how does it hurt someone?

GINO STRADA: Well, a cluster bomb, when it does not explode, performs like a land mine. We are talking about small objects, about the size of a pack of cigarettes or slightly bigger than that. Obviously, after a while, they are hidden in the ground. They are covered by the sand, and by grass. I mean, they are not visible, actually. And they move. They move with the water flow and et cetera. If this is a persistent danger for the population and the population must live in those areas to get the food. So, every day, you have new victims.

AMY GOODMAN: A report out of the Independent newspaper in Britain says that more than 1,000 civilians have been killed or wounded by cluster bombs in Iraq. And they are continuing to go off.

GINO STRADA: Well, it’s not difficult to believe. I mean, we have a few hundred for sure during the period of March, April.

AMY GOODMAN: What kind of warning is put out to the people now? I mean, the U.S. Is in charge. What are people told what are children told? What exactly do they look like? What color are they on the ground?

GINO STRADA: You have about 400 models, and you cannot say they are this color. There are mine awareness programs, but I don’t think they’re effective. The people, they do know about the mine danger. The problem is that that’s where they live. So, I mean, you cannot avoid the danger.

AMY GOODMAN: You have not only worked in Iraq and Afghanistan, you have also worked in Sierra Leone.


AMY GOODMAN: Can you describe the situation there?

GINO STRADA: In Sierra Leone now, at least there’s no war. There’s still a big poverty. The social infrastructure, the and health infrastructure is very, very weak. But the at the moment, there’s no fighting, so, we are dealing mostly with normal emergencies, not with the war surgery. And this is very good. This is a good sign.

JUAN GONZALEZ: In terms of the doctors who are native to these countries, what kind of — can you talk a little bit about their ability to continue to function and their persistence. Are people just giving up and leaving who are doctors in these countries, or are they managing to continue to move forward and do treatment in the best way they can?

GINO STRADA: Unfortunately, there are many doctors left. If you take from Iraq, this has happened over the last ten years. I mean, even because the public administration has no money to pay the salaries or doesn’t want to pay salary, so people are forced either to leave or to go into private practice.

AMY GOODMAN: Can you talk about why you began Emergency? Why you spend your life in perhaps the most dangerous places in the world?

GINO STRADA: Well, just because it’s needed. I mean, there are huge needs, and there are — there is very little help. So, I mean, for a surgeon, I think it’s a good option to make the best out of your role, out of your study, of your university.

AMY GOODMAN: What kind of a team do you have with you?

GINO STRADA: We have surgeons and anesthesiologists, nurses, physical therapists, some logisticians a normal medical team. We tend to provide a high standard level of surgery, so it is not just field hospitals or emergency surgery, first aid. We do comprehensive surgery, because there’s nowhere we can refer to patients to.

JUAN GONZALEZ: How do you recruit doctors, from all over the world, or largely from Italy?

GINO STRADA: Yeah, from all over the world. At the moment we have in Kabul also a U.S. Surgeon. We are very happy to have personnel from different countries. And we recruit them purely on the basis of their professional skills.

AMY GOODMAN: Where do you get your support?

GINO STRADA: From Italian citizens. Private donations from Italian citizens.

AMY GOODMAN: How are you treated in Iraq both by Iraqis and by the U.S. occupying force?

GINO STRADA: Well, by the Iraqis, I think we have good relations, good relations with all of the Shiite authorities that we are working with in the city of Karbala. We have no relations with the occupation forces.

AMY GOODMAN: I want to thank you very much for being with us, Dr. Gino Strada, founder of the Milan based medical organization, Emergency.

GINO STRADA: Thank you.

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