End of WHO's Absence From Iraq Good News for MH System

The World Health Organization (WHO) will again post international staff members in Baghdad, five years after the organization's non-Iraqi employees left Iraq.

The new team of six to eight people will address mental health issues as well as communicable disease monitoring and health infrastructure questions, WHO country representative Dr. Naeema al-Gasseer said at a news conference. WHO will expand its presence not only in Baghdad but also in Arbil, Basrah, Hillah, and Kirkuk, she said.

The WHO and other United Nations representatives left Iraq in August 2003 after a terrorist bomb destroyed the United Nations' headquarters there and killed 22 staff members, including the chief envoy, Sergio Vieira de Mello. In the interim, WHO personnel based in Amman, Jordan, have undertaken missions to Iraq to control disease outbreaks and advise on health system reform.

“WHO's return is a very significant step,” said Winnie Mitchell, M.P.A., an international officer at the Substance Abuse and Mental Health Services Administration, in an interview. “It is another indication of increasing stability in Iraq.”

In recent years, Iraqi WHO personnel have focused on responding to humanitarian needs and controlling threats to public health. The organization will not provide services directly but will offer technical guidance and policy assistance to the Iraqi Ministry of Health, as well as to other public and private health entities in the country as it reforms its health system.

Immediately after the U.S.-led invasion in 2003, WHO took part in the process of changing Iraq's mental health system from one focused on large psychiatric hospitals to a community-based approach, said Mitchell. WHO also took part in mental health planning conferences for Iraq held in Amman and Cairo, and has played a role in coping with the plight of the millions of traumatized Iraqi refugees in Jordan and Syria.

The organization also helped train nurses in mental health care and sought to increase the number of women nurses in what is a male-dominated profession in Iraq. WHO helped introduce mental health concepts to nonpsychiatric physicians.

“WHO has been, and will continue to be, strongly involved in developing and revising policies and standards of care for mental health, integrating mental health services into an overall primary health care plan, training Iraqi mental health staff of different levels, and advising on substance abuse prevention, psychological counseling services, advocacy, and other activities,” WHO communications officer Paul Garwood told Psychiatric News.

Funding may be a problem, however, said WHO officials. International donors promised $19 million for health-sector work in February, but none of the money has been received yet, said Eric Laroche, assistant director general for the WHO's Health Action in Crisis Cluster. An appeal in September 2007 for $85 million to help displaced Iraqis in neighboring countries has garnered only $7.4 million so far.

More information on WHO's role in Iraq is posted at<www.emro.who.int/Iraq>.▪