Operational Challenges for Medical Services Provision in the Oil and Gas industry in Iraq- the Risks, Consequences, and Mitigating Steps
Authors: Moen Rikard 
Published: April 2012

Abstract
The paper will discuss the challenges for the Oil and Gas industry in Southern Iraq in establishing health care provision, service delivery, medical emergency preparation and creating a fully integrated medical evacuation process from the field. It will also outline the risks and potential consequences and provide guidance on how to mitigate these risks. The paper will be applicable to all organizations currently operating or considering to operate in Iraq.
The paper will add to the technical knowledge base by discussing the requirement for healthcare for the Iraqi employees, medical transport issues and difficulties in the supply chain from procurement to importation.
The conclusions will assist organizations establishing operations in Iraq to comply with their medical risk assessment and to ensure that they provide safe and effective health care provision to all of their employees.

Situation Analysis:
Iraq is probably the most challenging arena in the world for the Oil and Gas sector to provide safe, effective and fit-for-purpose medical services. This is exacerbated by the security situation (terrorism, explosive/ballistic incidents and kidnapping), political instability, remote/hostile environment, Iraq procurement law, and the difficulties with cost recovery. The local medical infrastructure in Iraq is not capable of providing international standard medical care and foreign companies are required to establish their own services or contract private health providers. The US Military were previously able to provide life/limb/eyesight saving emergency care to the Oil and Gas industry, but since their withdrawal from Iraq in December 2011 the only facility able to provide advanced emergency care in Southern Iraq is a private western medical clinic located in Energy City, Basra. Medical evacuations out of Iraq are occurring on a weekly basis and are increasing in frequency, this situation has been made significantly more difficult with the loss of rotary wing support from the US Military. The risk profile for medical evacuations will only increase as Oil and Gas operations continue to ramp up over the next 3–4 years.
Security is the number one major issue for any company conducting operations within Iraq. A complex array of groups has waged an insurgency against US-led coalition forces and the Iraqi government since the end of the full scale military conflict in Iraq. Armed opposition groups and trans-national terrorist networks have also targeted diplomatic, commercial and humanitarian personnel and assets, as well as civilians. The security situation has improved since mid-2007; however, foreign personnel continue to face threats from suicide attacks, roadside bombings, shootings and kidnapping. Violent crime is widespread and includes carjacking, robbery, rape and murder. Although the majority of the multinational companies have strict security procedures and protocols in place to protect their employees from such risks, foreign nationals are still an attractive target for insurgents. Transferring personnel around the country continues to require significant logistical planning and security resources.