BAGHDAD
The narrow, gloomy room is no place for a grandmother to live. But Noura Jassem Mohammed, who at 71 stays here without a toilet or running water, has no choice. She has run out of relatives willing to care for her.
Widowed four years ago, Mrs. Mohammed no longer can make ends meet on her husband’s modest pension, so she must beg from neighbors, friends and distant relatives. She uses a neighbor’s bathroom and is too poor to afford all her blood pressure and heart medicine.
“The day my husband died was the worst day of my life,” said Mrs. Mohammed, wiping away tears with the hem of her long black robe, known as an abaya. “I’ve had nothing but problems since.”
Investment in health and geriatric care suffered under Saddam Hussein, who steered government revenues to the security forces and his own pockets even as the country labored under more than a decade of harsh international sanctions.
Already teetering when Saddam was ousted in 2003, Iraq’s health care system has had no chance to recover in the face of a violent insurgency, the collapse of basic services and the weakness of the new central government.
According to the World Health Organization (WHO), Iraq, potentially among the richest countries in the region, has fallen behind peer nations such as Egypt and Jordan on basic health indicators. Per capita spending on health care in Iraq is $23 a year, less than half that in Egypt and one-seventh of the figure for Jordan.
With health professionals fleeing the insecurity in huge numbers, Iraq has 6.6 doctors for every 100,000 people, compared with nearly 25 doctors in neighboring Jordan.
Traditionally dependent upon relatives and extended family to care for them, Baghdad’s elderly are being abandoned in greater numbers as relatives flee the violence and chaos of Iraq, government officials said.
“The elderly in Iraq have been dealt a very bad hand and short of a miracle very little can be done to help them,” said Dr. Akif Alousi, a physician and representative of the Iraqi Medical Association. “Sometimes they just close the door of the house and wait to die slowly.”
The most vulnerable senior citizens are in frail health with little or no income and cannot live independently. Many have no children to support them or have never married.
Adding to their misery, Iraq’s devastated health care system makes it nearly impossible for Baghdad’s elderly residents to receive adequate medical treatment. The lack of potable water and electricity here further threatens their welfare during the sweltering summer months.
Demographers at WHO said 2.8 percent of Iraq’s 28 million people were 65 and older in 2005, the most recent year for which figures were available. By contrast, 12.6 percent of the U.S. population and 17 percent in Japan are 65 or older.
For Iraqis like 87-year-old Mariam Ansari, who have beaten the odds and endured, self-preservation these days is a daily struggle.
Mrs. Ansari lives in a single room with cement walls. A fluorescent light illuminates a twin bed and a patchwork of threadbare Persian rugs covering a dirt floor. The room, provided by a neighbor as charity, is among the many donations from the community on which Mrs. Ansari depends to meet her basic needs.
But these contributions are not enough to save Mrs. Ansari the indignation of begging at a local marketplace.
“What can I do?” she asked. “I accept my life for good or bad. This is God’s will.”
For Iraqi seniors suffering from short-term memory loss or the onset of dementia, the desertion of family members can be especially disturbing and treacherous.
Maysoon Mustafa, who said she is not certain of her age, slept on the streets for two nights in January near her Ghazaliya neighborhood in western Baghdad after her three grown children and their families fled with her husband to northern Iraq to live with her in-laws.
Left alone in her house with the deafening sound of mortars exploding around her, Mrs. Mustafa panicked and fled. An Iraqi policeman, who found her days later exhausted and filthy, arranged to place her in the Anya retirement home, a privately run Christian facility in central Baghdad.
Today, Mrs. Mustafa is secure but without the comforts of her family or her house of 12 years.
“I want to go back home, but I’m not certain what has happened to my house,” she said.
Officials say elderly Iraqis without children are particularly vulnerable because they often cannot leave dangerous neighborhoods.
Rosa William, who thinks she is in her 70s, moved into Anya in August when her sister and brother-in-law fled north to live with his family in Mosul.
Faced with the prospect of living with strangers in a new city, Mrs. William realized she was destined to remain in Baghdad.
“They’re not my people,” Mrs. Will- iam said, referring to her brother-in-law’s family. “Believe me, I have no one.”
Yaseen Shakir, a 75-year-old lifelong bachelor, is confined to his house in Saidiya, a neighborhood in southwestern Baghdad where insurgents often control the streets and clash with U.S. and Iraqi government forces.
“I can’t even step outside,” Mr. Shakir said. “It’s just too dangerous for me here.”
Adding to his suffering, the retired impressionist painter is losing sight in his right eye despite two recent operations. Mr. Shakir lost his monthly stipend from Iraq’s artists union after the Saddam regime dissolved. Now his income depends on donations from colleagues and admirers.
Mr. Shakir’s 68-year-old brother, Basil, handles the pair’s errands, including hazardous excursions to the market. But the fighting has exacted its toll on him. “I am very, very, tired,” Basil Shakir said.
Margaret Hannah Achou, 81, who never wed, lives in the house in which she was raised with her seven siblings in Baghdad. She uses a walker after a fall earlier this year. Unable to find medical services to rehabilitate her legs, Miss Achou is stranded in her home.
Her primary nurse, Ahmra Mowad Dowoud, 32, lives in a gatehouse with her husband and four children on Miss Achou’s property. The Dowouds provide Miss Achou with a sense of well-being and companionship within the house, but they can do little to assuage her fears about the violence outside.
“It feels better than living alone, but I’m still frightened at times,” Miss Achou said.
Like many elderly Iraqis, the ongoing war has intensified the pain and frustration of aging for Miss Achou.
“It gets worse and worse every day,” she said, “and nobody can save me.”
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