July 05, 2017

MOSUL, IRAQ/NEW YORK, JULY 5, 2017—Extreme levels of conflict and violence in the Iraqi city of Mosul—including airstrikes, bombardment, suicide attacks, and gunshots—are taking a devastating toll on residents trapped in the embattled Old City, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today.

MSF has treated more than 100 patients for war-related injuries since officially opening a hospital in western Mosul less than two weeks ago. These patients included more than 25 children and 20 women. Yet MSF fears that only a small fraction of the residents of the Old City who require medical attention are receiving it, and many are dying on the battlefield.

"Every day, our teams are treating patients from the Old City, many of whom are women and children," said Stephanie Remion, MSF emergency coordinator for western Mosul. "We see patients with war-related injuries ranging from shrapnel wounds, gunshots and blast injuries to burns and broken bones from collapsing structures. Despite the tremendous efforts by staff in front-line trauma stabilization points and by ambulance drivers, the numbers of patients we are receiving are low relative to the unknown thousands of residents thought to be trapped in the conflict zone. Our greatest fear is that many of the most urgent cases are dying in the battlefield, unable to access life-saving medical assistance."

The hospital, located a few miles from the front line, is one of only two hospitals serving this area of Mosul. When it officially opened on June 23, MSF teams treated 18 patients in a mass casualty incident. On July 1, teams responded to another influx of more than 20 war-wounded patients, most of whom were women and children. Of the more than 100 patients MSF has treated for war injuries in western Mosul, 13 had immediately life-threatening injuries and more than 50 were at risk of dying without medical treatment.

Life has become a daily struggle for survival for the unknown thousands of residents still trapped in the Old City, according to patient testimonies received by MSF.

"I Buried Them In The Garden"

Covered in dust, four-year-old Ahmed (named changed) sat on his father's lap outside the MSF hospital in western Mosul on July 2. The boy devoured a biscuit that had just been handed to him, covering his face in chocolate. For the moment, he seemed distracted from the horrors he had survived, including the death of his two siblings. The boy's father comforted the child's grandmother who sat beside them, helping her drink water through parched lips. Her face was a visceral portrait of the family's hardship.

Just a few hours earlier, the family escaped through a deadly gantlet of conflict and violence from the few blocks of Mosul's Old City which are still under siege. The home they sheltered in was right on the edge of the battle between Iraqi forces and the Islamic State group, which is marked by intense bombardments, airstrikes, suicide attacks, improvised land mines, and sniper fire. That morning, the house they were in was retaken by advancing forces. But the relief came too late.

"My wife was holding our other son when a mortar fell," Ahmed's father said, describing the fighting three days earlier. "The wall collapsed in the room next door where my wife and sister were. At first I couldn't enter the room; there was so much dust I could not breathe. When the dust settled, I went in and began digging through the bricks. I heard my wife screaming and I uncovered them. I picked them up and carried them out. When I removed all the bricks I discovered my son was dead. He was one month and five days old."

As Ahmed's father spoke, the boy's mother lay on a hospital bed in a neck brace and his aunt was being treated in another ward. The boy's grandmother alternated between mournful exclamations and filling in the background of the story through her tears. "My granddaughter died of starvation and I also had to put my grandson in the grave. Two of them: one starved to death and the other was hit by a mortar . . . I buried them in the garden. We have gone three days without water. Even the water we drank was not good, we had diarrhea whenever we drank it. During Ramadan we were starving . . . we were not even allowed to eat scraps from the trash."

Ambulance After Ambulance 

As medical staff prepared for more patients, the sound of explosions could be heard from the front lines. The previous day, July 1, was the busiest day since the hospital opened. Ambulance after ambulance arrived with war-wounded patients: a little boy with burns covering his arms and legs; a woman appearing to be in shock, her face obscured by blood; a little girl in a flower-patterned dress, her right leg lacerated by shrapnel and left leg blown off at the knee.

The emergency room turned into a brutal testament to the horrors this battle has inflicted on residents. A little girl told a staff member how she watched her brother die right in front of her. The air filled with the sound of sobbing, wailing, cries of pain and shock, and guttural exclamations of relief. Family members accompanying the injured showed clear signs of hardship, sunken cheeks, blank stares and bodies covered in blood and dirt. One woman sobbing in the waiting room paused only to drain a juice box, before the tears resumed.

"Hunger and suffering," an elderly woman said from her emergency room bed, repeating the words over and over. She is 74 years old and had just escaped the battle zone hours earlier. "We tried to convince the children to eat tomato paste," she said, recounting her family's struggles to survive. "We would boil flour in water . . . the rice we had was so dirty even animals could not eat it. Every day we were dying because of the shelling and airstrikes. We don't know where it was coming from. I lost half of my weight. We were barely having showers . . . our skin had all kinds of diseases."

MSF's facility is one of only two functioning hospitals in this area, and the first priority is life-saving assistance. Medics work urgently to clear beds for new arrivals by referring patients to other hospitals for follow-up treatment as soon as they are stabilized. MSF runs two projects providing post-operative and rehabilitative care but can only help a small proportion of those who require assistance.

The surviving members of Ahmed's family were soon referred to another hospital, traveling in an ambulance with nothing but the clothes on their backs. It would not be long before the ambulance was back again, with another patient fresh from the battleground.

Read More: Medical Care in Mosul: “There are No Heroes in This Story, Only Victims”

Since opening the hospital in western Mosul, MSF has provided medical assistance to more than 200 patients for trauma injuries and other medical issues. The hospital provides surgery for war-wounded patients and emergency cesarean sections, short-term post-operative care, maternity care, an emergency room, and a mass casualty intake room for triage. In total, MSF is providing medical assistance for people affected by the Mosul crisis in eight locations in and around the city.

MSF offers neutral and impartial medical assistance regardless of race, religion, gender or political affiliation. In order to ensure its independence, MSF does not accept funding from any government or international agency for its programs in Iraq, relying solely on private donations from the general public around the world to carry out its work.

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