MEHRPI. The project provided probono assistance for selected cases requiring specialized resource intensive treatment not available in Iraq.

The overview.
IOM initiated and started the MEHRPI programme in 2003, following the conflict in Iraq. Based on a two-pronged approach, the project provided probono assistance for selected cases requiring specialized resource intensive treatment not available in Iraq. It also contributed to the in country capacity for the rehabilitation of the national health infrastructure through training and rehabilitation of projects that address identified gaps in health service delivery. The two components of the programme ran concurrently, with the medical evacuations helping to relieve the pressure on the local health care facilities while they were being rehabilitated.

The evacuation component
IOM set up offices in Baghdad, Basrah, Amman (Jordan) and Kuwait, and liaised closely with national medical personnel, United Nations organizations, NGOs and other international organizations present in Iraq and surrounding nations. The cases were reviewed for eligibility based on the following general criteria for medical treatment abroad. Patients were initially referred to MEHRPI by local doctors-in-charge, health staff of various international organizations/ NGO's and/or specialized UN agencies, and medical officers of the Coalition Forces. The recommended cases were then referred to the International Medical Selection Team (IMST), who then selected and confirmed cases eligible for medical evacuation. These were then forwarded to IOM for placement abroad.

IOM collaborated with NGOs, government authorities, and IOM field offices in participating countries in order to relay the medical documentation to hospitals which had been approached, and had volunteered, to accept patients. Following acceptance for pro-bono treatment, IOM arranged visas and travel documents for the patients and escorts. The principle criteria in choosing a specific country were based on the availability of the offer from the donor, and to a lesser extent on the travel distance or the administrative procedure.

Upon completion of treatment, the MEHRPI staff repatriated patients and escorts to Iraq, The costs of treatment, housing and transports costs from Amman to the host countries were borne by receiving hospitals, governments and NGOs, while funding from the European Humanitarian Aid Office (ECHO) and the Kuwaiti Government covered transportation, IOM staff and office costs. In addition, the Coalition Forces covered the transportation contribution in kind, offering the use of aircrafts and skilled medical personnel.

The rehabilitation component
The rehabilitation of major Iraqi health institutions has been one of the key objectives during the establishment and implementation of IOM's MEHRPI programme in Iraq. Set up to run simultaneously with the medical evacuations, the rehabilitation component aims to increase the local capacity to provide medical services for people requiring specialized treatment.

IOM supported this plan through two components:

1. The physical rehabilitation, refurbishment and expansion of the old burn ward in Basrah, establishing a new operating theatre, and redesigning 2 Intensive Care Units. This was completed in September 2003.
   
   
2. Capacity Building and Training Component - in coordination with Kuwaiti Health Authorities two Iraqi doctors and 2 specialist nurses received 4 weeks training at Al-Babtain Burns and Plastic Surgery Hospital (Kuwait).
   
   

Other training initiatives were supported including assisting doctors to upgrade their skills in orthopedic and reconstructive surgery and in the treatment of children with scoliosis. Participation in international medical conferences was also seen as an important element, and IOM facilitated Iraqi specialists to attend several conferences held in Kuwait.

By the close of the programme 250 patients had returned after successful treatment.