Country Policy and Information Note Iraq: Medical and healthcare provision Version 2.0 January 2021 Preface Purpose This note provides country of origin information (COI) and analysis of COI for use by Home Office decision makers handling particular types of protection and human rights claims (as set out in the Introduction section). It is not intended to be an exhaustive survey of a particular subject or theme. It is split into two main sections: (1) analysis and assessment of COI and other evidence; and (2) COI. These are explained in more detail below. Country of origin information The country information in this note has been carefully selected in accordance with the general principles of COI research as set out in the Common EU [European Union] Guidelines for Processing Country of Origin Information (COI), dated April 2008, and the Austrian Centre for Country of Origin and Asylum Research and Documentation’s (ACCORD), Researching Country Origin Information – Training Manual, 2013. Namely, taking into account the COI’s relevance, reliability, accuracy, balance, currency, transparency and traceability. The structure and content of the country information section follows a terms of reference which sets out the general and specific topics relevant to this note. All information included in the note was published or made publicly available on or before the ‘cut-off’ date(s) in the country information section. Any event taking place or report/article published after these date(s) is not included. All information is publicly accessible or can be made publicly available, and is from generally reliable sources. Sources and the information they provide are carefully considered before inclusion. Factors relevant to the assessment of the reliability of sources and information include: x the motivation, purpose, knowledge and experience of the source x how the information was obtained, including specific methodologies used x the currency and detail of information, and x whether the COI is consistent with and/or corroborated by other sources. Multiple sourcing is used to ensure that the information is accurate, balanced and corroborated, so that a comprehensive and up-to-date picture at the time of publication is provided of the issues relevant to this note. Information is compared and contrasted, whenever possible, to provide a range of views and opinions. The inclusion of a source, however, is not an endorsement of it or any view(s) expressed. Each piece of information is referenced in a brief footnote; full details of all sources cited and consulted in compiling the note are listed alphabetically in the bibliography. Page 2 of 76 MedCOI Project MedCOI is an Asylum and Migration Integration Fund (AMIF) financed project to obtain medical country of origin information. The project currently allows 11 European Union member states plus the UK, Norway and Switzerland to make use of the services of the ‘MedCOI’ team in the Netherlands and Belgium. The MedCOI team makes enquiries with qualified doctors and other experts working in countries of origin. The information obtained is reviewed by the MedCOI team, which includes medical doctors, before it is forwarded to the relevant COI Service. The Belgian Desk on Accessibility (BDA) of the Immigration Office in Belgium forms part of Project MedCOI. Feedback Our goal is to continuously improve our material. Therefore, if you would like to comment on this note, please email the Country Policy and Information Team. Page 3 of 76 Contents Information ............................................................................................................... 5 Country information ................................................................................................. 6 1. Structure of the healthcare system .................................................................. 6 2. Statistics .......................................................................................................... 7 3. Cancer (oncology) ........................................................................................... 9 4. Cardiology (heart conditions) ......................................................................... 13 5. COVID-19 ...................................................................................................... 23 6. Dental treatment ............................................................................................ 24 7. Diabetes ........................................................................................................ 24 8. Eye conditions (including ophthalmology) ...................................................... 30 9. Geriatrics ....................................................................................................... 35 10. Haematology.................................................................................................. 35 11. Hepatitis ......................................................................................................... 38 12. HIV/AIDs ........................................................................................................ 39 13. Mental health ................................................................................................. 41 14. Nephrology (kidney diseases)........................................................................ 50 15. Neurological conditions .................................................................................. 53 16. Obstetrics and reproductive health ................................................................ 60 17. Paediatrics ..................................................................................................... 63 18. Palliative care ................................................................................................ 65 19. Tuberculosis (TB) and other lung diseases ................................................... 66 19.1 Tuberculosis ........................................................................................... 66 19.2 Other pulmonology conditions ................................................................ 67 Terms of Reference ................................................................................................ 72 Bibliography ........................................................................................................... 74 Sources cited ........................................................................................................ 74 Sources consulted but not cited ............................................................................ 75 Version control ....................................................................................................... 76 Page 4 of 76 Information Updated: 12 January 2021 Guidance on medical claims For general guidance on considering cases where a person claims that to remove them from the UK would be a breach Articles 3 and / or 8 of the European Convention on Human Rights (ECHR) because of an ongoing health condition, see the instruction on Human rights claims on medical grounds. Back to Contents Page 5 of 76 Country information Section 1 updated: 12 January 2021 1. Structure of the healthcare system 1.1.1 The Australian Government’s Department of Foreign Affairs and Trade (DFAT) Iraq country information report published on 17 August 2020 stated: ‘Article 31 (1) of the Constitution guarantees citizens the right to health care. It commits the State to maintaining public health, and providing the means of prevention and treatment by building different types of hospitals and health institutions. Article 31 (2) guarantees individuals and entities the right to build hospitals, clinics or private health care centres under State supervision. The Ministry of Health (MoH) is the primary health care provider.’1 1.1.2 A report produced by the World Bank Group (WBG) in February 2017 (the most recent of its kind to date) entitled ‘Iraq – Systematic Country Diagnostic’ stated: ‘Access to health services is limited, and geographical disparities are significant. In the public sector, health services are provided through a network of primary health care centers (PHCC) and public hospitals at very low charges. The PHCCs provide preventive and basic curative services. The main centers are located in urban areas with smaller centers in rural areas. Poor organization and shortages of staff and medications are significant impediments to delivering adequate services in the PHCCs. Despite this, the PHCCs are recognized as very important sources of health care provision, particularly for the poor. ‘For secondary and tertiary care, patients are referred from PHCCs to hospitals, although it is estimated that only about 40 percent of Iraqis have access to these referral services because of the inadequate number and uneven distribution of public hospitals. Secondary and tertiary care are also provided by small private hospitals. Since there are no health insurance schemes in Iraq, the costs of private health care must be met out-of-pocket, which is well beyond the reach of many Iraqis… Most of the health sector in Iraq is financed by the government with a small but growing private sector financed by out-of-pocket payments from patients.’2 1.1.3 In May 2019 the United Nations High Commissioner for Refugees (UNHCR) published a report entitled ‘International Protection Considerations with Regard to People Fleeing the Republic of Iraq’. The report, citing various sources, stated: ‘Over the past decades, Iraq’s public health