AMMAN, 27 March 2008 (IRIN) - The high cost of drugs and medical care in Jordan is a major problem for impoverished Iraqi asylum-seekers, according to a survey by the International Medical Corps (IMC) and the US Johns Hopkins Bloomberg School of Public Health (JHSPH) released on 26 March.

Only four percent of respondents said they could afford medical assistance, according to the survey conducted among an undisclosed number of Iraqi patients in health clinics run by non-governmental organisations (NGOs) in Amman.

Since the US-led invasion of Iraq in 2003, over half a million Iraqis have settled in Jordan, most from the middle class, but many have used up their savings and are now relying on basic medical help offered by NGOs.

Nearly 50 percent of respondents said they spent at least one quarter of their income on health bills, while 14 percent said over half their income went on medical care, particularly for specialised services. Free medical centres often provide basic tests, but in many cases patients need specialist treatment or care not available at these centres.

Adam Sirois, the IMC country director in Jordan, said most Iraqi medical spending was on drugs to manage chronic diseases, specialist diagnostic tests and surgery. "More attention needs to be paid to these services which most Iraqis in Jordan cannot afford," he said.

The survey found that 83 percent of patients seeking free care at NGO-run clinics were unemployed.

Public hospitals

Jordan had previously barred Iraqis from receiving subsidised treatment in public hospitals, but late last year, the government changed its policy under international pressure and allowed migrant Iraqis to obtain health care in public hospitals. But this has not helped those who have to pay fees for long-term treatment and medication.

Radhi Jwarneh Radwan, a Ministry of Health spokesman, confirmed the new policy, adding that children received free vaccinations.

Adel Abdul Rahma, a former university professor in Baghdad, said he had tried to get medical help in public hospitals but found it impossible. "Public hospitals are overwhelmed with patients. Doctors often advise patients to turn to the private sector for fast treatment, if their medical condition is urgent," said the 62-year-old Iraqi asylum-seeker.

To be examined by a specialist in a public hospital, patients sometimes have to wait two to three months, consultations cost US$15-30, and medical drugs are considered among the most expensive in the region.

Mental health

The survey also revealed that half of the respondents said they needed mental health and psychosocial services but only 5 percent had access to help in this field.

At least 64 percent of interviewed patients said they felt stressed, and 22 percent had witnessed violence or were generally affected by displacement.

"Concrete steps must be taken to prevent Iraqi families in Jordan from falling into poverty or becoming more vulnerable due to out-of-pocket health payments," the survey said, adding: "Iraqi society needs more NGO-supported maternal-child health and family planning services, more affordable secondary and tertiary care, and mental health and psychosocial support."

During a recent meeting of countries hosting Iraqi asylum-seekers, Jordan said it needed JD 176 million ($248 million) to build clinics and renovate hospitals in Amman, Irbid and Zarqa to be better able to provide medical help to the Iraqis.

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