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Dr Fradd moves to real war zone

The flak GPC joint-deputy chair

Dr Simon Fradd endured during new contract negotiations will pale into insignificance when he starts his new job in wartorn Iraq, as he explains to Nerys Hairon

Many comparisons have been made between the flak GPC joint-deputy chair Dr Simon Fradd took over contract negotiations and his recent decision to take up a post in Iraq as a medical adviser. But to Dr Fradd this is no matter for levity ­ he takes the risk to his life seriously.

Dr Fradd left for Iraq at 4am on Saturday, March 27, from RAF Brise Norton in Oxfordshire, equipped with a weighty flak jacket and helmet for protection.

The flak jacket weighs more than 10 kilos. He said when he was fitted with it at the Foreign Office it was very difficult to walk or run in it, but he added: 'I expect I could run all right if the adrenaline was flowing.'

While Dr Fradd will be accompanied by four armed guards and two armed vehicles at all times, he admitted: 'No one can pretend this is much less than a war zone.

'The military can't do anything more to protect me, but the truth of it is, if your name is on the bullet, then your name is on the bullet.'

But he said it was important not to dwell on the risks and to concentrate on the job in hand, namely rebuilding the country's health service.

'In terms of the risk all you can do is try to minimise that risk and then look at it statistically ­ it must be one in 1,000 or so. Having gone through training and having learned to be a bit aware, then the thing to do is get on with the job,' he said.

The decision to swap GP contract negotiations for a war zone was not a sudden one ­ Dr Fradd said

he was realising a long-held ambition to do overseas aid work of some kind, and since the declaration of war on Iraq he had wanted to help rebuild the country's health system.

'I also did an elective in Johannesburg in 1976, and since then I felt there were other parts of the world that had much greater needs than Britain,' he said.

The project came about after the GP negotiator applied for the job, which was advertised on an NHS website earlier this year. The application

process was a fast one, as Dr Fradd was told he had been successful just three weeks before he was scheduled to leave the UK.

Before leaving he had to fit in training with the SAS on the Herefordshire border to prepare him for what he might face in Iraq. 'It was

extremely useful. The SAS men know all the details about weaponry ­ they know what weapons are lying around in Iraq,' he said.

Dr Fradd will be working with three other medical advisers ­ one nurse and two NHS managers ­ to rebuild a health service that 'is going to last'.

He said: 'No one can pretend that we are going to solve all the problems of Iraq's health care, but the important thing is that we create something

that continues to develop after we have left.'

The main tasks will be to liaise with the non-governmental organisations, government institutions and with Iraq's own department of health.

While the posting is meant to last for six months, the political instability in the country and imminent change of government could mean the four medical advisers being expelled from the country.

'They could sling us out on June 30 when the government changes to the Iraqi one,' Dr Fradd said. 'It's not our place to say they must have us, it's up to the Iraqis to say who they want.'

Just before he left, Dr Fradd did not know whether he would be based in Basra or one of the four governorates in southern Iraq.

Press reports that he would

be living in one of Saddam Hussain's former palaces have proved unfounded as Dr

Fradd said he would not now be posted to Baghdad.

In Basra, however, there is a special 'compound' for the Coalition Provisional Authority, where Dr Fradd may be living.

'I might be in a very small hut with an en suite shower or I might be living as part of a unit with four huts sharing a shower.'

Life in Iraq is expected to be tough. Dr Fradd said he would be living and working in the compound, working 12-14-hour days with little time off and 'not much to do socially'.

Language would also present a challenge. Dr Fradd said he would

have to learn a few words of Arabic to 'show respect' but he admitted: 'I don't speak any Arabic at the moment and there is no pretence that I am going to get fluent.'

While in Iraq, Dr Fradd is renting his London flat out and receiving financial compensation from the NHS, as he is officially on secondment to the Coalition Provisional Authority.

'I will be quite significantly out of pocket,' he said. 'It's not something you do for the money.'

He confessed that leaving family and friends to spend six months in a war zone had had 'a slight edge', as he was aware of the possibility that this might be the last time he saw them. 'It's nothing too severe but it's like when people go and have an operation ­ you trust that everything's going to be okay, but it's not like seeing someone off on holiday.'

Just before leaving, Dr Fradd said his sister and an old friend had helped him clear out the larder and freezer in his flat.

'It was quite bizarre,' he said. 'It was a bit like when my mother and grandmother died. Now, it was as if I had already died myself.'

'I would rather be killed than be injured,' he said matter-of-factly. 'I don't fancy having to crawl out of a minefield with one leg missing and I'm not too keen on being taken hostage or tortured.

'I would rather go on living, but a clean death would be better than terrible injury.'

On his eventual return to the UK, Dr Fradd said he would not remain on the GPC negotiating team but hoped to stay a GPC member and chair of the BMA's superannuation committee.

He planned to carry on as chair of the charity Developing Patient Partnerships.

And he also hoped to increase his time commitment to general practice, by doing up to six sessions a week at his practice in Nottingham, instead of the current three, which he has completed in one day during the hectic contract negotiations.

The transition from medical adviser in Iraq to part-time GP would not be as difficult as his return to the UK after working in South Africa and experiencing a different perspective, Dr Fradd said.

But he did expect the experience to change his values.

'I've met up with a few people who have been in Iraq ­ they all say it changes you and you revalue things in a different way.

'Just think of the health care they are getting in Iraq­ the health service budget has dropped by 90 per cent. They have got the buildings but they have got nothing in them.

'That must be quite salutary, to see people trying to manage without anaesthetics and sterilisation equipment.'

The experience of working in a country ravaged by war would also make him value human life more, Dr Fradd said.

'One thing I found was, watching the news, in a few seconds they talk about hundreds of people dying. Already my values are changing.

We pay too little attention to so many people dying in the world, he said.

'These are human beings who suffer horribly. I don't think it's a bad thing for a doctor to go into a situation where you value life more highly.'

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