Abdallah Qassim, a local nurse, confirms the practice. “It’s not just doctors setting up a new practice that do this,” Qassim told NIQASH. “Even well-established doctors use brokers.”
If a patient pays the doctor, say, IQD25,000 (about US$21) for a consultation, then the doctor will keep IQD15,000 and the broker will get IQD10,000, Qassim explains. Some doctors will give all of the fee to the broker and then make money from the patient in other ways.
“Most of the people who fall victim to the brokers are poorer people who live out in the country and have come into Basra to go to the doctor,” says another Basra doctor, Abdul-Hamid Abdul-Majid. “Sometimes the doctors make use of the ignorance of their patients and they convince them they are suffering from illness they don’t have so that they will pay extra for X-rays or other tests. The doctors have agreements with the companies providing those services and they get a kick back from them. That’s how they make back the money they pay to the brokers,” he concludes.
Part of the reason that doctors are using the brokers is because of the rising cost of doing business in Basra, suggests Shawqi Sadiq, a local pharmacist. Work has halved and taxes and rents are rising.
Thanks to an increasing number of security checkpoints as well as the roads being closed to vehicles for security reasons, there are fewer potential patients coming to the area. But there are still more than a hundred medical service providers – including pharmacies, clinics, laboratories and specialists for things like X-rays – in the area.