Wednesday, October 01, 2008
Dubai dispatch: The Iraqi doctor diaspora
Most doctors in the Gulf countries are expatriates, rather than locals. Until recently, the majority of these expat physicians came from India and Pakistan, but according to our main distributor in the Gulf countries the picture has changed entirely in the last two years. Since early 2006 there has been a huge influx of Iraqi doctors, many of whom are apparently better than the expats they have displaced. Iraq's loss has been a gain for medical practice in the rest of the region, including in highly-specialized disciplines.
That bit of scuttlebut led me to hunt around for corroborating news. According to this August story in the Khaleej Times, small numbers of Iraqi doctors are returning now, as against a huge number who have left.
Some 650 of the 8,000 Iraqi physicians who fled the country since 2003 due to violence have returned to their jobs in the past two months because of improved security, a Health Ministry official said Monday.
Adel Muhsin, the ministry's inspector general, said the doctors have gone back to hospitals across Iraq.
The country's medical system is woefully understaffed because of workers fleeing, and several weeks ago the government appealed to doctors to come home.
As it happens I had dinner last night with an Iraqi surgeon, "Ali" in this post, who came to Dubai from Iraq a few years ago. Ali had trained in the West many years before, and was old enough that he had grown up in Iraq before Saddam. I believe from his comments that he is Sunni, but I did not ask and he did not say. He spoke at length about the war in Iraq, the American occupation, the role of the various players in the region, and the prospects for improvements.
Ali said that the Iraqi professionals who had fled in the last few years were almost universally eager to go back to Iraq. When old friends in the diaspora get together they say they will meet "next year in Baghdad," but most do not yet believe that the country at large is safe enough. The Iraqis who have returned in recent months are generally those who could not get good jobs outside Iraq. Many of these people are not necessarily incompetent, but may simply be too old to secure a good position elsewhere. That makes sense. A foreign hospital, university, or business might hire a 45 year-old Iraqi, but would be less likely to hire somebody in their sixties.
Ali did say that his friends in Iraq were reporting that Baghdad was safer today than it had been in years, perhaps even more than during Saddam's time. Even before the war, the Shiite slums -- Sadr City, as it is known today -- were off-limits to affluent Iraqis. He illustrated his point with a story. During the war with Iran he had driven a Shiite army surgeon up to Baghdad from the south in his new car. When they reached the edge of Sadr City his colleague asked to be dropped off, saying that he would take the bus the rest of the way. The friend said that anybody driving a new car through that part of the city would be attacked.
This fear of the Shiites pervaded the Sunni elites, who were probably the only people who could have taken out Saddam from the inside. Ali said that years ago he had quietly argued with a friend that "Saddam had to go," but the friend had objected, saying that without Saddam the poor Shiites would rise up and tear the city apart. In Ali's view, this fear of the Shiites was validated by the looting of Baghdad following the fall of Saddam.
That has changed, though, with decision of David Petraeus to invade Sadr City and destroy the Shiite militias. From Ali's point of view, this is but one of several very smart things that Petraeus has done.
For Ali, Petraeus is the great hero of the American war, and Paul Bremer is the great fool. Ali knew Petraeus back in 2003, when Petraeus was in command of the 82nd Airborne in Mosul. Apparently Petraeus made a point of dining regularly with Iraqis, listening to their suggestions, and responding to their requests. Ali said that he had a meal or tea with Petraeus roughly every two weeks for several months, and that the general was deeply curious about Iraq and understood the folly of Bremer's aggressive de-Baathization program. Petraeus listened.
Paul Bremer, according to Ali, made a point of not listening, at least to the Sunni professional class. Ali met with Bremer once, at Petraeus' invitation, to talk about simple and inexpensive things that might be done in Mosul to build support among the population -- providing funds to replace the broken windows in the government buildings, for example. Bremer essentially told him to go back to practicing medicine. Not long after, Ali took his family and left the country.
Bremer's greatest error, in Ali's telling, was disbanding the Iraqi army without giving the officers and their men new work to do. Many of these people joined the insurgency to earn a living that could have as easily been provided by the United States. Indeed, Petraeus has effectively reversed the decision, calling some of the best professional officers back from exile abroad and paying thousands of Sunnis $200 per month to hunt al Qaeda. The same decision might have been taken in 2003.
Ali is also outraged about the influence of Iran in his homeland. He condemns the British for their passive occupation of Basra. The authorities in the south, he says, have issued many thousands of Iraqi passports to Iranians, who exert tremendous influence there and in the national government. "We fought Iran for eight years, and now they run Iraq without firing a shot."
Still, in spite of all of this Ali is both optimistic that Iraq will improve over the next few years and, in the end, happy that Saddam is gone. One of the other guests asked him whether it was a mistake to get rid of Saddam, and Ali said without any hesitation that "Saddam had to go" -- the economic sanctions were killing the country -- but not this way. He did not come out and say it exactly, but it was fairly clear that he believes that the years since the invasion would have gone very differently if the American occupation authority had not disenfranchised the Sunni professional, governmental, and military establishment so comprehensively. I know far too little to know whether Ali is correct in this, but I do know (and have long argued) that our failure to plan for and deal with the problem of unemployed soldiers was, as a matter of history, an inexcusable mistake.
15 Comments:
By 
, at
Wed Oct 01, 08:46:00 AM:
General Petraeus commanded the 101st Airborne in Mosul. Just a small point.
Otherwise, very interesting.
There is now a pretty good consensus that Bremer was a mistake of the first magnitude.
-David
By 
D.E. Cloutier, at
Wed Oct 01, 08:59:00 AM:
Outstanding post, TH. You just did the kind of work professional journalists should do every day.
By , at
Wed Oct 01, 09:50:00 AM:
By , at
Wed Oct 01, 11:36:00 AM:
What Tigerhawk is blogging will not be in the news because it would not support the crisis management that we need to keep the American public at a low boil.
Today's politicians need a crisis to manage. They have been running plays right out of Karl Marx's play book for years and the American public doesn't bat an eye.
Dave
By davod, at
Wed Oct 01, 01:30:00 PM:
Karl Marx?
Don't you mean the Saul Alynsky(sp) playbook. The whole government will playing by these rules after Janur 20, 2009.
By , at
Wed Oct 01, 01:44:00 PM:
Sadly, the canard how the US was wrong to disband the Saddam Army is still given credence even among the most sensible people.
To start with a basic fact, Saddam Army was not at all like the US Army. Saddam Army was a brutal institution based on consription. That simple fact should give immediate pause to anyone capable to think clearly. How was the US supposed to preserve Saddam Army? Should the US have continued to press people into military service, just like Saddam has done?
Of course it goes much deeper than that. What we call conscription, in the Middle East amounts to the very old institution of military slavery, unknown in the West for centuries. Saddam Army had a lot in common with Janissaries and Mamluks from the days of Sultans and Khalifs. There was simply no way the US could possibly took control of such army.
Further, it is simply not true that no attempt was made to use services of top Iraqi commanders. I remember reading about some Saddam generals cooperating with the US since 2003. Also, recruitment centers for the new Iraqi Army opened almost immediately after the invasion and attracted numerous volunteers. In fact, most of the high casualty attacks by the insurgents took place at those recruitment centers and yet people kept coming to sign up.
By Dawnfire82, at
Wed Oct 01, 02:31:00 PM:
I think that Candide has the right of it.
Footage was broadcast on CNN of mass desertions of Iraqi soldiers during and immediately following the war. Thousands and thousands just decided among themselves that they were going home. Some waved at the Americans as the tanks went by.
'Disbanding' the Iraqi Army was simply the acknowledgment of a fact.
By TigerHawk, at
Wed Oct 01, 02:44:00 PM:
Candide and Dawnfire82,
I respectfully submit that you are not responding to the point I made a year ago (accessible through the link at the end of this post). Whether or not the Iraqi army was "disbanded" affirmatively or "melted away," the presence of so many unemployed soldiers represented a fundamental social problem that would prove to be catastrophic. My argument, which I believe is stronger than many I make, is that (i) history clearly teaches that unemployed soldiers need to be hired or killed, and (ii) that we should have known this and hired Iraqi soldiers from the get-go. We did not need to give them weapons, only put the word out that any Iraqi soldier would be treated fairly and paid $200 per month (as we are doing now) and given three squares as long as they show up for parade twice a day and do constructive work when ordered to do so. We did not need to arm them, but we could have used them to multiply our force in other ways (such as in the doing of public works). As they proved their reliability over months or years they could have formed the nucleus of the rebuilt army.
Finally, on the question of Iraqi commanders, I believe that we kept the Sunnis substantially out of it for a long time. I am sure we felt that we were necessarily appeasing the Shiites, so I understand not putting these guys back in positions of authority. They still could have been put on the payroll and given "advisory" roles and other jobs that would maintain their income and some prestige.
By Dawnfire82, at
Wed Oct 01, 03:27:00 PM:
"My argument, which I believe is stronger than many I make, is that (i) history clearly teaches that unemployed soldiers need to be hired or killed, and (ii) that we should have known this and hired Iraqi soldiers from the get-go. We did not need to give them weapons, only put the word out that any Iraqi soldier would be treated fairly and paid $200 per month (as we are doing now) and given three squares as long as they show up for parade twice a day and do constructive work when ordered to do so."
I thought that we (the US) did address that, as Candide referenced.
"Also, recruitment centers for the new Iraqi Army opened almost immediately after the invasion and attracted numerous volunteers. In fact, most of the high casualty attacks by the insurgents took place at those recruitment centers and yet people kept coming to sign up."
Simply declaring that you'll hand out free money to former soldiers if they promise to behave is no way to run an occupation. It is a recipe for chaos if these soldiers do not operate in a disciplined manner. Once the formations dissolved and they all scattered to their homes, there was no hope of reforming the same army in any functional form. Especially since most of the officers were Sunni nationalists anyway.
Even if they came with their own equipment, (doubtful at best) it was a multi-layered problem of logistics, identity, and discipline. Namely, there wasn't any. There was hardly any before the invasion.
Rather, we moved to begin building a new, professional army and recruitment began very soon after the end of hostilities.
I'll buy the idea that rebuilding the Iraqi Army wasn't done very well. I suspect it that it could have been done faster and we'd have reaped benefits sooner. But it was done.
By Cassandra, at
Wed Oct 01, 03:55:00 PM:
Another point that isn't often made is that leaving the Sunnis in place would have contributed to the distrust with which both the so-called "American occupation" and the fledgling Iraqi government itself were viewed by Shiites who had been suffering beneath Saddam's jackboots for too long.
I am not saying your doctor doesn't have a point. He does.
What I am saying is that Dawnfire and Candide also make valid points: it's not enough to just hire people. You have to supervise them too and that is expensive in both time and effort. If you leave the Old Guard in place, you do risk fostering an 'in-place insurgency' (so instead of having Shiite militias terrorizing the populace under dubious color of law, you might well have had Sunni ones doing the same thing).
The thing is, it's hard to know. I think under the insurgency and al Qaeda made the average Iraqi well and truly miserable, there just wasn't the incentive to unite and get beyond some very deep seated hatreds.
By Cassandra, at
Wed Oct 01, 03:56:00 PM:
However, great post! I didn't have time to read it earlier. Glad I finally got a moment.
By Escort81, at
Wed Oct 01, 07:29:00 PM:
Yup, that was the nice thing about warfare in the old days -- so many of the opposition's soldiers were already dead at the end of a war that the remaining army posed little threat. Think Germany 1945-46. Of course, there was plenty of collateral damage associated with the uniformed KIAs, which is why that scenario isn't likely to be repeated. Admittedly, I have oversimplified!
But TH makes a legitimate point, almost Huntingdonian in nature, that you never want to have large groups of young men hanging around with nothing to do (Huntingdon makes this point in terms of demographics and population growth in his Clash book). Idle hands are the devil's tools, etc.
By , at
Wed Oct 01, 07:41:00 PM:
"(i) history clearly teaches that unemployed soldiers need to be
hired or killed, "
Since we had not the political will (or means) to kill them all,
we effectively hired those who would turn to our side as the Awaking councils. It would have been a mistake to allow Saddam's army to continue to function in any form, NO MATTER THE TEMPORARY CHAOS.
Can you imagine, or prefer that we deal with those Baathist murderering dead-enders, instead?
It was almost fatal that didnt follow thru and stopped short in 1992.
By , at
Thu Oct 02, 09:14:00 AM:
Just as a different sort of comparison, the German Army after WWI was very bitter, and some of the former soldiers formed a political core that lent itself to revolutionary activity.
Example: Adolf Schicklegruber (Hitler)
Between the wars (I and II), there were groups such as the "Frei Corps", former soldiers fighting Bolsheviks, the Poles, anybody that they could pick a fight with to advance Germanic nationalism and interests. Many of the Frei Corps became members of the SA druing the rise of the Nazi party, and after the Nazi party came to power became part of the SS and Gestapo.
The collapse of the Iraqi army was no different. Some went home, some re-enlisted, some fought for the other side. A lot of them ended up dead.
The fate of the Iraqi Army may actually be less important than Bremer's unwillingness to work through the different family 'tribes' to create effective government and a political peace. Bremer's "New Iraq" was to be totally secular, and ignore the past. Petraeus was much more pragmatic and realistic about what could be accomplished, recognizing the long term cultural realities of Iraq. But he's just some dumb soldier, I guess.
Talk about hubris.
-David
By , at
Thu Oct 02, 11:30:00 AM:
Tellingly, the people who insist that disbanding Saddam Army was a mistake never use any facts and numbers.
Two basic facts are:
1. Saddam Army was 350,000 strong, and
2. Term of conscription was 2 years.
That simply means 175,000 soldiers were due to go home in 2003 and another 175,000 were due to go home in 2004. After that, there would be no Army to speak of. Bremer had no authority and no right to keep soldiers in the barraks past the day of release and press the new Iraqi conscripts into the old army. What, the US was supposed to keep Saddam draft boards going? The whole idea is absolutely preposterous.
So we are basically talking about keeping 175,000 young soldiers (18 year olds) in barraks for 1 year. That is supposed to make a whole difference in the course of events in Iraq! Btw, it wouldn't be an army but concentration camps, no matter how you sweeten it verbally.
This canard is a relic of the days when Bush opponents were grasping for anything to damage him. Among other bright ideas they concocted the notion that everything would be much better if we managed to keep the enemy army intact! They never bothered to learn what Saddam Army was and how it really operated. They picked a slogan and they keep shouting. Look at specifics, look at logic, look at arithmetics: does it make even a single iota of sense?
