A Digital Magazine by American University's Kogod School of Business
Inadequate medical facilities in Tikrit
Business Remedy for Health Care

    Almost 100 miles from Baghdad, Iraq, a town lies surrounded by desert, interrupted only in the East by the Tigris River.

    Tikrit was the birthplace of Saddam Hussein and the last major Iraqi municipality to fall to U.S. forces in 2003. Now, a different kind of legacy is beginning there.

    Students in Kogod’s Peace Through Commerce practicum are conquering real-life funding dilemmas faced by entrepreneurs in high-conflict, impoverished zones, such as Dr. Hatem Mukhlis’s medical project in Tikrit.

    Mukhlis, an Iraqi-American, worked as an emergency room doctor in Ithaca, New York, before leaving behind a comfortable life in the States to return to his native Iraq after the fall of Baghdad in 2003. He hopes to build an urgent care facility and medical lab in Tikrit, complete with a burn treatment facility and a mammography unit.

    “People are dying every day in those hospitals [in Iraq] because of the lack of good lab facilities,” Mukhlis said. “Others are misdiagnosed because of the absence of such necessary services. Women are dying because of late diagnoses of cancer.”

    Mukhlis hopes the project will bring much-needed care to Tikrit’s 200,000 residents and more than 1.5 million people in the Salah Al-Din province. Now, diagnostic tests are often sent 100 miles to Baghdad for processing and many burn victims die from dehydration before receiving treatment.

    Even those many miles from Tikrit to Baghdad, which crisscross riverbanks and desert terrain, are a short journey compared to how long Mukhlis’s project has grown, travelled, and changed.

    From one consulting group to another and one business plan to the next, the project has been snipped, split, and stitched back together.

    Despite Mukhlis’s passion and wealth of professional contacts in the region, he is a medical doctor, not a businessman; acquiring funding isn’t his strong suit. Mukhlis had consulted with another university through a State Department program to no avail when Executive-in-Residence Bob Sicina and his 2010 Peace Through Commerce class stepped in.

    An international finance expert, Sicina draws on 30 years’ experience as a senior executive with Citibank and American Express. Associate Professor Heather Elms joined Sicina this past fall, bringing her expertise in international business strategy and corporate social responsibility to the class.

    Sicina, Elms, and their students from multiple disciplines create high-quality business plans and seek out sources of funding for the projects.

    No project is a quick fix. The Tikrit project is three years in the making and recently completed its one-year anniversary with the Kogod student team.

    “I’ve learned that the race for dollars is often a marathon, not a sprint,” said Aisha Brown, Masters in International Service ’11, who participated in the practicum in fall 2010. “And the entrepreneurs have to adapt and adhere to the wishes of their donors and investors.”

    The Tikrit project proposal was initially too large to realistically find backing from grants, foundations, or corporations, so the Kogod team reshaped it into three phases and built a database of potential funders.

    The students researched regional medical labs, healthcare providers and equipment suppliers to develop the proposal. During Snowmagedon in February 2010, a group of 12 students even held a Skype conference call with Mukhlis until 12:30 a.m. to circumvent the eight-hour time difference.

    The project caught the eye of LabCorp, a multi-billion dollar multinational company, but plans for possible funding fell through.

    After LabCorp “went radio silent,” as Sicina put it, he and the Fall 2010 student team proposed splitting the project into two parts: a for-profit laboratory and a non-profit urgent care center. The urgent care is more likely to attract funding from grants, while the medical lab appeals more to private investors, Sicina explained. Dr. Mukhlis agreed to the revised approach.

    The split makes the urgent care facility eligible for more grants as a non-profit, and helps the medical lab get funding since Mukhlis can now seek investment for the lab as a strictly for-profit venture, said Anna Wiinberg, BS in Business, Language, Culture ’12, who worked on the Tikrit grant team that helped devise the split.

    The project’s division requires revising business plans and crafting grant proposals full of “detail, detail, detail,” Sicina said.

    “Splitting the lab has meant coming up with a new operational strategy that includes a new equipment list and specifics of day-to-day operations for the urgent care facility,” Wiinberg said.

    The urgent care center will ideally attract grant funding from private, philanthropic foundations, Sicina said. The grant will help get the center off the ground, and then all revenue made will sustain it after the grant ends. All profits will return to the urgent care center.

    “Considering the lack of health insurance in Iraq, the urgent care center is a great humanitarian endeavor that will provide basic health care to a population in dire need,” Brown said.

    The lab, on the other hand, is more likely to achieve strong levels of profitability and therefore will be more attractive to private investors. It will also quickly generate healthy cash flow and has excellent growth potential, Sicina said. Upcoming practicum teams will pitch funding proposals to sources of private patient capital and corporations like lab equipment manufacturers and Qwest Diagnostics. The team will also consider returning to LabCorp to see if the split changes the company’s position.

    “The laboratory will be the first in Iraq operating at the same standards as the world’s best facilities,” Brown said. “Consequently, we foresee the laboratory as an attractive and lucrative investment.”

    Mukhlis’s Tikrit project is one of the many projects the students have taken on in the Peace Through Commerce practicum, a course now in its third semester. Others include proposals for a poultry farm in Afghanistan, a rice plantation in the Philippines, and a business-training center in Basra, Iraq.

    As Wiinberg said, “Working in a conflict zone is of course challenging in itself, but it is also a challenge in that many investors shy away from risk-averse areas.”

    If the journey of Mukhlis’s project is an indication, the practicum is determined to help entrepreneurs turn their dream into reality, despite the many challenges they face.

    “These guys [entrepreneurs] put their projects in our hands after they’ve failed in their initial efforts,” Sicina said. “It’s a Hail Mary pass. We throw Hail Mary passes.”


    The pictures above are of the inadequate and unsanitary conditions of existing medical facilities in Tikrit. Photos courtesy of Dr. Hatem Mukhilis.



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