The question of health is significant as it impacts a variety of users that could include us or our loved ones. It is accountable for triggering many emotions, and highlights a range of themes such as dignity. The experience could be related to a dream, where one is cured through pain-less channels with a dignified recovery, or alternatively a nightmare due to lack of resources and skill-base causing more harm than good.

As a British-Kurd Patriot, I felt I was bounded ethically to offer something back to my ancestral roots of Iraqi-Kurdistan, being my education and skills within the healthcare arena. Armed with an optimistic smile and faith as my ammunition I visited different hospitals in the region alongside the medical universities as a would-be patient to assess the patient experience. The image I portrayed was of an individual that knows no-one therefore probably taken as a poor disadvantaged individual. Following the signs and speaking to other patients, then went on to try and seek medical assistance, with a plan to be giving symptoms that I knew required further examinations. To my surprise, in a mouse house room filled with an aroma of dried blood and bleach the medical team would be consulting with ten patients at a time, with little regard to confidentiality. Sitting with fellow patients with a claustrophobic itch somebody would come who was known to have strong networks or ‘connections' and be seen to almost immediately even if the doctor was with a life threatening patient who required critical care.

However, the interesting aspect of my ultimate observations and findings were that it varied on who was on shift and on different days and times it would generate a different outcome. Thus, it could be that at certain times the service exceeded expectations and at times went below standard. Working within policy and strategy, this tells me that firstly there is a lack of infrastructure with standardised guidelines, and secondly the ‘policy' in place is flexible and lacks accountability. The general blame as with every other problem that arises in Kurdistan is pointed to the Kurdistan Regional Government. However, I disagree as I feel that as professionals we have a social and moral responsibility to ensure compliance and there is a limit to government intervention. To target this problem, a root cause analysis must be performed, that would identify exactly where the issue is. The Kurdistan Regional Government is partially responsible in that funding is centralised and perhaps it would be more efficient and effective if hospitals had autonomy on budget but then on the other hand, with the current resources it depends if the hospitals have utilised the channels and created a regulatory framework.

It is off beam to label the healthcare system as a disaster as the NHS in the United Kingdom is not labelled as perfect either, neither is the quality of care standardised within all trusts. But, there are frameworks and regulatory boards to enforce compliance. In order for the Kurdistan Healthcare to progress, the professionals must be challenged, and held accountable for there actions rather than frequently using the Kurdistan Regional Government as a scapegoat. Perhaps it would be ideal if British expertise guided our local professionals in order to establish dialogue and share best practice by reflecting on different cases.

Another issue is the wide distribution of expired medication within the region. One of the methods to target this epidemic is by developing information systems that record and classifies all drugs that are imported within the region to be able to have a national database. Most importantly, the medical professionals must uphold the medical practice ethical code and oath and refuse to give any expired medication to patients that would force the intervention of the Ministry to take action. The role of the Ministry is to educate and inform the public on healthcare issues but most significantly to devise national guidelines and policy, this can only be done by the input of local professionals through public consultations and the region must start devising such routes of communications.

Iraqi-Kurdistan is known as the Other Iraq, and quite rightly prides itself on its booming economy and infrastructures but one of the fundamental pillars that determines whether we live or die, is the pillar of health, and until a professional, expert-led policy think-tank and unit is devised than there will be only a few that will label the healthcare delivery as a dream.