Saturday, February 16, 2008

The Doctor, The Patient and the Terrorist

Imagine this scene in Baghdad. Having just ended a lengthy phone conversation, the acting medical director of a mental establishment asks a nurse to bring two female patients into his office. The purpose is not a therapeutic intervention or a change in medication but the start of a process that will lead to two suicide bombings in a busy street market. The director is subsequently arrested and confesses to having been convinced by Al-Qaeda operatives of the use of mentally ill and vulnerable patients in terrorist attacks.

Obviously mental disability comes in different shapes and forms but on one extreme the possibility remains that these two ladies were either not given a choice or did not have the mental capacity to make the choice of martyrdom. Having committed their act under coercion, it cannot be reasonably recognized as holy even by the most reactionary religious expert and its only symbolic value resides in the level of desperation reached by those behind the attacks.

They say that the degree of civilization of a society is recognized at the way it treats its weakest elements. I fully agree with this statement and as a doctor feel strongly that the medical profession is in a privileged position to uphold this principle. According to the following report at least one Iraqi doctor failed at the universal duty of care embodied in the Hippocratic Oath while another paid with his life the price of safeguarding human dignity.

Joseph El-Khoury

From the Times February 12th 2008.

Hospital boss arrested over al-Qaeda attack by human boobytraps

Martin Fletcher in Baghdad

The acting director of a Baghdad psychiatric hospital has been arrested on suspicion of supplying al-Qaeda in Iraq with the mentally impaired women that it used to blow up two crowded animal markets in the city on February 1, killing about 100 people.

Iraqi security forces and US soldiers arrested the man at al-Rashad hospital in east Baghdad on Sunday. They then spent three hours searching his office and removing records. Sources told The Times that the two women bombers had been treated at the hospital in the past.

“They [the security forces] arrested the acting director, accusing him of working with al-Qaeda and recruiting mentally ill women and using them in suicide bombing operations,” a hospital official said.

Ibrahim Muhammad Agel, director of the hospital, was killed in the Mansour district of Baghdad on December 11 by gunmen on motorbikes. Colleagues suspect that he was shot for refusing to cooperate with al-Qaeda. Even before Sunday’s arrest, US officials believed that al-Qaeda was scouring Iraq’s hospitals for mentally impaired patients whom it could dupe into acting as suicide bombers. They said that al-Qaeda had used the mentally impaired as unwitting bombers before. “We have fairly good reason to believe this is not the first time they have recruited mentally handicapped individuals,” said one senior officer, though he did not think there had been more than half a dozen cases.

The attraction of mentally impaired women to al-Qaeda was obvious, he said. Being women they could get close to targets with less chance of being stopped or searched; being mentally impaired, they were “less likely to make a rational judgment about what they are being asked to do”.

The February 1 attacks were the deadliest – and most chilling – to hit the Iraqi capital in months. One of the women was given a backpack full of explosives and ballbearings, the other a suicide vest laden with explosives. They were sent into the middle of al-Ghazl and New Baghdad markets, which were packed with people. Their explosives were then detonated by remote control.

The Times was shown photographs of the two young women’s severed heads, which were recovered from the wreckage. One very obviously had Down’s syndrome. The other had the round face, high forehead and other features often associated with Down’s syndrome, but her symptoms were less pronounced.

An insight into the way al-Qaeda thinks came in a letter written by one of its leaders in Anbar province that the US military seized in November and released in part on Sunday. “It is possible to use doctors working in private hospitals and where the infidels/ apostates are treated who have serious conditions to be injected with [air bubbles] that will kill them,” it said.

The US military believes that al-Qaeda is adopting these extreme tactics because the prevalence of check-points and concrete barriers is making car bombings harder, and fewer foreign suicide bombers are reaching Iraq. The number of car bombs has fallen steadily from a peak of 112 last March to 27 last month. Conversely, there were 16 pedestrian suicide bombs in January – the second-highest total in 13 months.

Foreign jihadists – invariably male – used to carry out 90 per cent of the suicide bombings in Iraq, but the US military believes that tighter controls have halved the influx to 50 or 60 a month. The officer conceded that protecting public places against individual suicide bombers was almost impossible. “You really can’t stop a determined bomber from blowing themselves up,” he said. “The key is continuing to take down the terrorist network that conducts these operations.”

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