In the stores and buses of Iraq masks are rare even as Covid-19 spreads widely, vaccines are viewed with suspicion and the sick see hospitals as a last resort.
At Al-Shifaa Hospital in the capital Baghdad, the ramifications are clear.
"More than 95 percent of those sick with Covid-19 in intensive care are unvaccinated," said Ali Abdel Hussein Kazem, assistant director of the facility.
Half of the 40 intensive care beds are occupied in the department, where irregular beeping from monitors and IV machines is constantly heard.