Why are we there?
- Armed conflict
This is an excerpt from MSF-USA's 2013 Annual Report:
Thousands of Iraqis endure a lack of basic healthcare services, and access is further hampered by chronic insecurity. War has affected medical infrastructure in some areas.
There was a dramatic increase in violence in Iraq in 2013, and this further undermined the capacity of health facilities to respond adequately to medical needs. MSF is focusing on filling some of the gaps in care, training staff and sharing knowledge at several hospitals.
Child and maternal health
In January, MSF began working with the neonatal care unit at Kirkuk general hospital, providing training and supervision to ensure basic standards of care for newborns and their mothers.
The Al-Zahra hospital is the main referral hospital for obstetrics, gynecology, and pediatrics in Najaf governorate. An MSF team trained doctors and nurses, implemented treatment protocols, and introduced documentation and analysis methods. Support was also provided in hospital management, infection control, structure rehabilitation, and maintenance. MSF trained hospital staff in case management in order to try and reduce the number of neonatal deaths. Along with training and supervision, MSF placed an emphasis on infection control, pharmacy standardization, sterilization procedures, and data collection. In 2013, 23,627 deliveries were registered at the hospital, with more than 6,000 infants requiring intensive care.
More than 300 emergency surgical procedures were performed each month at the hospital in Hawijah, the only facility offering specialist services in the entire district. In addition to providing hands-on emergency surgical services around the clock, an MSF team conducted training in the management of emergency cases and infection control intervention. MSF also carried out assessments of health centers in Hawijah district to ascertain whether basic healthcare was available for the rural communities, and this information will be used as a reference to develop new activities.
Caring for Syrians in refugee camps
The Syrian crisis has resulted in a massive flow of refugees into Iraq. According to the UN refugee agency, more than 200,000 Syrians had crossed into the Kurdish region of Iraq by the latter half of 2013. Borders are opened only intermittently and more than 50,000 refugees arrived within just a few days in mid-August. MSF opened a health clinic offering basic and mental healthcare in September at the Kawargosk camp in Erbil province, which hosts 12,500 refugees. A mobile clinic that ran from late September in the smaller Qushtapa camp (3,000 refugees), also in Erbil province, was handed over to the Department of Health in December 2013.
More than 18,900 consultations were conducted with refugees, and 30 percent of these were for children under five. Respiratory infections were the main cause for consultations across all age groups.
MSF is also the main healthcare provider in Domiz camp. Initially designed to host 1,000 families, the camp population has swollen to 45,000 people. Despite the efforts of the local authorities, camp services cannot keep pace with needs and overcrowding and poor living conditions have led to a deterioration in people’s health. Each week MSF carries out some 2,400 medical consultations. Many patients suffer from upper respiratory tract infections and acute watery diarrhea, but MSF also provides treatment for chronic diseases, reproductive health, and mental health. Targeted distributions of washing kits and water and sanitation activities to ensure minimum standards of hygiene were completed in the first half of the year.
Referring victims of violence for reconstructive surgery
Many patients suffering from burns and other traumatic injuries cannot access the specialized care they need within the country. MSF runs a network of medical liaison officers (MLOs) located in Baghdad, An-Najaf, Kirkuk, Ninewa, Erbil, Al-Qadissiyah, Al-Anbar, Salah ad-Din, Al-Basrah, and Diyala. They identify and refer patients to MSF’s reconstructive surgery program in Amman, Jordan. Patients receive orthopedic, maxillofacial, and plastic reconstructive surgery, along with physiotherapy and psychosocial support. The MLOs, together with administrative support based in Baghdad, managed the admission and discharge of 185 patients, and provided follow-up for almost 400 patients in Iraq in 2013.
Reducing the stigma of mental illness
Mental illness is not openly discussed or treated in Iraq. MSF had been providing mental healthcare in Baghdad and Fallujah since 2009, responding to needs and aiming to reduce stigma. Individual counseling and a telephone helpline were offered. In 2013, psychologists treated 775 people in 2,027 counseling sessions, before the program was handed over to the Ministry of Health in June.
Sharing expertise in health services
MSF supported the national Poisoning Control Center (PCC) in Baghdad through the donations of antidotes and the exchange of scientific knowledge. MSF also responded to a request from the health ministry’s Department of Medical Rehabilitation for a possible collaboration concerning physiotherapy. Visits were made to various rehabilitative departments in Baghdad, and training for inpatient physiotherapy is being organized.
At the end of 2013, MSF had 526 staff in Iraq. MSF first worked in the country in 2003.
Syrian refugee, Domeez camp
I arrived with two of my children, but had to leave my husband and my two other daughters behind. We walked for more than six hours to cross the border. We don’t have our own tent yet, so we must share with another family.
I have a kidney stone and it is very painful. Since we arrived here I have been lying down all the time because of the pain. I need surgery to remove the stone. Here, we Syrians suffer from sickness, but also from the difficult situation we have gone through.