BAGHDAD — In a country where most people believe that God will protect them but their government won’t, it has taken a popular Shiite cleric to give Iraq’s stumbling vaccination program a boost.
Iraq has been bracing for a dangerous summer, with widespread skepticism over coronavirus precautions, a limited vaccine supply and a troubled health care system.
But last week, Moktada al-Sadr, whose lineage from a revered Shiite family commands respect among millions of Iraqis, was shown on video rolling down his robe and baring his arm for a Chinese Sinopharm vaccine in the holy city of Najaf.
Vaccination clinics throughout Najaf Province had until then recorded only around 300 vaccinations a day. Two days after the video was released, that number climbed to almost 2,000 a day until clinics ran out of vaccines on Wednesday. They expect to receive more in two weeks.
But the boost in numbers from Mr. Sadr’s followers might not be enough to deliver Iraq from devastatingly high infection rates.
Vaccines began to arrive in the country only in late March. So far only one percent of the population — about 400,000 people — have been vaccinated, a long way from the 30 percent the government aims for by the end of the year.
Even if millions more Iraqis are persuaded to get vaccinated, it is not clear whether those doses will be available in the midst of a global shortage. Covax, the global vaccine-sharing partnership, has allocated 1.7 million doses for the country of 40 million people.
Last month, coronavirus cases in Iraq officially topped more than one million since the pandemic began, a figure public health officials believe significantly underrepresents infections since many people are never formally diagnosed.
But millions of people are staying away from the vaccine anyway, most of them citing conspiracy theories of side effects or the belief that God will protect them from the virus.
“We Iraqis rely on God and the Prophet’s house,” said Mustafa Wael, one of hundreds of riot police deployed at Baghdad’s Tahrir Square. “Maybe God will save me from the coronavirus. Maybe God is testing my patience.”
Mr. Wael, a law school graduate, said he had been told by a doctor he knew that the vaccine could cause sterility and cancer. He said he thought the pandemic had been exaggerated and he has not followed health ministry instructions.
After more than a decade of U.S.-led sanctions hollowed out Iraq’s health care system, the years of corruption, mismanagement and government dysfunction that followed the 2003 toppling of Saddam Hussein have left hospitals unable to cope.
Iraq, an upper middle-income country suffering a severe financial crisis, has stitched together a vaccination program using AstraZeneca vaccines from Covax, Chinese donations of Sinopharm, and purchases of the Pfizer-BioNTech vaccine funded through a $100 million World Bank loan.
The vaccination program was meant to start with the elderly, health care workers, those with chronic conditions and security forces. Yet a significant number of Iraq’s roughly 200,000 health care workers are refusing vaccines, according to officials.
In Tahrir Square, where hundreds of police officers have been deployed since anti-government protests were crushed more than a year ago, almost none of the officers wore masks and few said they were willing to be vaccinated.
Across the street a group of police officers took shelter from the sun, sitting near their plastic shields in the entrance to an apartment building. Of the five officers in the group, all in their 20s, only one said he planned to take the vaccine.
A building guard there, Raheem Ali Kadhim said he was not shaking hands anymore, going to large gatherings or allowing non-relatives inside the family home. But Mr. Kadhim, 79, said he did not trust Iraqi hospitals and would not go to one if he became ill. He said he would not get the vaccine.
“God created me and you,” he said. “Worship God and God will save you.”
Across the square, Ahmed, a police officer who did not want his last name used because he was not authorized to speak to media, said he had concerns about side effects.
“There is information I need to confirm that says a vaccinated individual must not have sex with or marry a non-vaccinated individual because it could lead to deformed children,” he said, citing false rumors that have circulated. “Especially on social media there are people who say they are doctors speaking about such things, which scare people.”
Ahmed, 28, said he had contracted Covid-19 despite wearing masks and disinfecting his hands. He said he quarantined himself at home with an oxygen tank until he recovered. And as for social distancing, he said, “We were ordered to wear masks here but we sleep in barracks with 28 people to a room. How can we stay distanced?”
With official infection rates topping 6,000 per day, the health care system is struggling to cope with both prevention and treatment for Covid patients.
“It’s a system that over the last 20 years has been crumbling,” said Omar Ebeid, the Covid response project coordinator in Baghdad for the international medical aid group Doctors Without Borders.
Since 2003, he said, frequent changes in government and political appointments in the health ministry have taken a heavy toll.
“You can see it has resulted in a health system that struggles to function,” he said. “But it is also the case that with Covid everywhere it’s kind of like a stress test where you get to see where the cracks in the system are.”
Last month a fire swept through a Baghdad hospital for Covid patients after an oxygen canister exploded, killing more than 100 people, most of them patients and their relatives. The hospital lacked smoke detectors or sprinkler systems.
The health minister was forced to resign and other officials were arrested. Iraqi ministries are divvied up among powerful political parties with the health ministry under the control of the Sadr political bloc.
Mr. Sadr, who has tried to portray himself as above politics while still playing a key role in Iraq’s political system, has said any officials convicted of wrongdoing should be punished.
The health ministry has struggled to get its message across.
“Some people still do not believe in the existence of the virus and they do not believe in the effectiveness of the vaccine,” said Dr. Ruba Falah Hassan, in the ministry’s media office.
At many vaccination clinics outside the Sadr strongholds, there has been so little demand that any Iraqi with ID or foreigner with a passport can be vaccinated after a few minutes wait.
Near central Baghdad’s Palestine Street, about 30 people waited for a Sinopharm vaccine on plastic chairs in the Al Edreesi health care center on Thursday. In this middle-class neighborhood most of those waiting appeared to be professionals or university students.
“We ask anyone who took the vaccine to send a message of reassurance in their groups. ” said Afraa al-Mullah, from the health center’s media department. “Anyone who took the vaccine must speak and say, ‘Here I am. I’m fine, get vaccinated.’”
The more that word spreads that vaccines are not harmful, she hopes, the more Iraqis would agree to be vaccinated.
“Iraq’s population is 40 million, 20 million must get vaccinated,” she said, calling the 400,000 who have been inoculated “a drop in the ocean.” She added: “We have people that do not believe in coronavirus. How can we convince them to vaccinate?”
Falih Hassan and Nermeen al-Mufti contributed reporting.