/ 19 February 2008

Iraq’s last brain surgeon refuses to budge

While many Iraqi professionals take advantage of the “brain drain” robbing the war-ravaged country of its best talent, one man has vowed to stand his ground and care for the brains that remain.

With little money but a great deal of passion, Munir Faraj (40) is the last remaining neurosurgeon still working amid the chaos and sectarian barbarism that grips modern-day Iraq.

“It is a matter of challenge,” explains the diminutive surgeon, his sharp eyes half-hidden behind his glasses. “We are the only team in the world that works in these conditions.”

Since the March 2003 United States-led invasion, Faraj, who studied in Baghdad, has battled to get the ransacked Neurology Hospital back on track.

He has never been afraid to get his hands dirty and has done whatever it took to keep the facility running: clearing away debris, repairing broken machinery, even exercising his diplomatic skills to secure the necessary support to keep the project running.

He has been subjected to anonymous threats and was even forced to flee to Syria for four months with his wife and two children, before returning a year ago to continue his work.

The doctors who make up his team are considered highly prized targets for insurgents, keen to deprive communities of the key figures needed to keep a society turning over.

In the hospital tucked away in the midst of the sprawling countryside north of Baghdad, the doctor knows that he and his little team could secure lucrative salaries if they were to leave their war-torn homeland.

“I love my job and I feel that if I go abroad, I will not have the chance to perform these kinds of operations,” he says.

“I want to stay in Iraq and I am proud to be an Iraqi,” he adds as he prepares for a delicate, 10-hour operation to implant two tiny electrodes in the brain of a man suffering from Parkinson’s disease.

Dressed in green overalls, his face hidden by a mask, the surgeon, who divides his time between the Neurology Hospital and his private surgery in the heart of the capital, carefully explains the procedure to his patient.

Ather Shalam (46) sits in a wheelchair, wearing blue striped pyjamas and listening intently, his hands shaking uncontrollably due to his condition. Frail and with his face looking tired and drawn beneath his shaven scalp, he is not ashamed to admit he is nervous ahead of the operation. He whispers simply: “I am frightened.”

The surgeon’s voice is soft but his gestures are firm, almost brutal, as he screws his patient’s head into a frame that will keep it still during the first stage of the operation — an MRI brain scan.

The apparatus uses a very weak resolution and Faraj struggles trying to improve the results. “Iraqi resourcefulness,” he laughs.

He dreams of one day managing to scrape together the $3-million needed to upgrade the machine. That would allow him to use a specially designed scalpel, bought in 2003, which uses gamma rays to treat brain tumours.

After the affected cells in Ather’s brain are identified, the operation begins in earnest, with Faraj drilling a hole in the side of his patient’s skull. Ather, having been given a local anaesthetic, is awake throughout most of the operation.

“The brain is senseless. The brain is responsible for sensation in all the body, except for the brain itself,” explains the surgeon.

Millimetre by millimetre, five micro electrodes are placed on each side of the brain to mark as accurately as possible the location of the final implants.

“It is a very complicated procedure, highly technical. Few places in the region offer this service,” he says, adding that at his hospital, the treatment is free.

“Once the electrodes are planted, they will be connected to a device in the patient’s chest,” he adds.

Then, “We are ready,” he tells Ather, whose eyes are brimming with fear.

Despite his initial nerves, Ather appears to relax during the mammoth operation, at one stage asking staff if someone could fetch him a Pepsi.

The day after the operation, Faraj contacts to explain how the treatment went. “Thank goodness the operation was completed successfully on the same day. It took 10 hours to finish,” he says. — AFP