BAGHDAD (Reuters) - Ear, nose and throat specialist Abu Samir laments that he has only one colleague left to call after an exodus that has robbed Iraq of about 70 percent of its most qualified doctors.
"My phone book became empty. Out of 50 numbers, I find one name left from the specialists I know," said the 66-year-old, who asked not to give his full name.
Specialist doctors have fled Baghdad and other cities in scores since the 2003 invasion that toppled Saddam Hussein, with most going abroad or to the relative safety of Kurdistan in the north.
Once the elite of Baghdad society, medical specialists quickly became a target for insurgents, militias and kidnappers in search of rich ransoms.
Of the 2,327 doctors with 15-20 years experience registered as specialists, 60-70 percent have left Iraq, said Nadhim Abdul-Hameed Qassim, head of the official Iraqi Doctors' Syndicate.
Among senior consultants with even more experience, as many as 80 percent have fled, he said.
"These are people who are really the pillars of the medical system of Iraq," he said. "The replacements are new graduates whom I really cannot trust."
Even during Saddam's era, with poor salaries being paid to doctors in government hospitals, specialists still earned good money in private clinics.
In the 1980s and 1990s patients from Iraqi Kurdistan would come to Baghdad for treatment by one of the capital's many specialists.
Now the picture is reversed, with Baghdadis joining streams of Iraqis from other volatile cities heading to Kurdistan or abroad to seek specialist treatment in safety and comfort.
The only other options are to go without treatment or try to find a doctor with the right qualifications among those who remain.
"The ophthalmology board department is now closed because there are no professors," said an emotional Qassim as he sat behind a wide desk in his office in the syndicate building.
Abu Farah, an oculist who works in Ibn al-Haitham hospital for ophthalmology, said that newly graduated specialists could not fill the vacuum left by older, more experienced doctors. Of 25 specialists in the hospital before 2003, two or three remain.
Abu Farah said the flow of specialist doctors had slowed to a trickle recently because most had left in 2004 and 2005.
"There is no replacement. Many hospitals suffer from the lack of specialist care," said Abu Farah, who also did not want to use his full name.
"The new cadre is now running the hospitals. They have good certifications but they lack the experience which plays an important role in diagnosing diseases and making important decisions concerning the health of the patient," he said.
Faced with the danger of kidnapping or worse, crumbling public services and poor wages, few senior doctors hesitate when the chance of a well-paid job abroad comes up.
Um Nabil, 55, from the holy Shi'ite city of Kerbala south of Baghdad, went to Amman last month looking for care because she could not find a suitable gynecologist in Baghdad.
"I was visiting a doctor in Baghdad, then he left. I visited more than one doctor but whenever I started visiting a doctor for two or three months I would hear that he left," she said.
Looking for a good specialist can also be risky. While violence has fallen sharply in the past few months, the risk of attack remains high. On Wednesday, 15 people were killed by a car bomb in central Baghdad's busy Karrada district.
Um Aqil, a 56-year-old retired engineer, has chronic arthritis. She consulted a general practitioner after going to north Baghdad's al-Maghreb Street, once crowded with specialists, only to find it nearly deserted.
"If you need a specialist, you have to search," she said.
"It is difficult for me, so I found it easier to go to a doctor nearby. I know he is not a specialist but he is better than no one at all."
Qassim said he would prefer doctors stayed abroad rather than returned home and put themselves at risk.
"I know five of my friends who were killed," he said.
"It is worth a fortune for Iraq to keep them safe. In the future they may come back."
Writing by Paul Tait; Editing by Giles Elgood