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Iraq: Latest MSF Updates

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The following is an excerpt from the 2014 in Review update. Click here to download the document.

2014 Activity Highlights

MSF’s Care for Displaced Populations

Since IS launched its offensive in Iraq in late 2013/early 2014, MSF has been responding to the humanitarian needs of displaced people who fled en masse from Anbar, Salah–ad-Din, and later Ninawa governorates. MSF teams first supported four referral hospitals in the towns of Tikrit, Hawija, and later Sinjar to ensure a 24-hour emergency service. In June, MSF also began to assist Heet hospital, and in July, several mobile clinics offering basic health care were established in Kirkuk.

In August, following a massive influx of people from Sinjar and Ninawa, MSF teams provided urgent medical care on both side of the Syrian Iraqi border. Entire communities had fled the violence, and MSF teams ran mobile clinics to offer primary health care and water and sanitation services to thousands seeking refuge.

As the conflict spread across Anbar governorate in October, triggering more displacement, MSF mobile teams provided health care in the cities Al-Qadisiyyah, Kerbala, and Babil Governorates.

Working on the Frontlines

In Dohuk, many displaced have been resettled in new camps, so MSF is now focusing on the sizable population still living outside the tented facilities. Simultaneously, MSF medical teams are spreading their reach across buffer areas in Ninawa governorate, where and when security allows, offering much-needed medical care to the local populations in places where most of the medical infrastructure has been destroyed.

Last July, in spite of the very volatile security environment, MSF started deploying mobile clinics in Kirkuk governorate, Salah ad Din, and Diyala governorates to provide health care to the displaced. Our medical services focus on primary health care, with an important emphasis on non-communicable diseases, reproductive health, and mental health care.

Medical Facilities Under Fire

Throughout MSF’s response to the current crisis, teams have had to adapt or close several projects at different times because security worsened and risks increased, health structures were damaged, or staff no longer felt safe working in certain locations. Projects in Hawijah and Tikrit were abruptly shut down due to the deteriorating security situation. In June, the day after MSF completed its primary health care unit in Tikrit, the city was overrun by rebel forces and MSF’s clinic was destroyed by an explosion. MSF medical staff had to be evacuated.

A few weeks later, MSF offices in the hospital compound of Hawija, where MSF had been working since 2010, were severely damaged during fighting, prompting the closure of the project.

Medical staff fled Sinjar hospital in August when IS militants seized the town; some staff later joined our teams in Dohuk and are still working to provide medical services to their communities. In October, MSF withdrew from Heet hospital after IS took control of the city, forcing thousands from Al-Anbar who had already fled their homes once to take flight again.

NFI Distributions for Vulnerable Populations

In addition to health services, MSF teams also distributed medicines, non-food items, blankets, and construction kits to the most vulnerable and difficult-to-reach populations across Kurdistan and in Ninawa, Al-Anbar, Salah ad Din, Diyala, Kirkuk, Baghdad, Kerbala, Najaf, Babil, Wassit, and Al Qadiyiah governorates. In total, MSF teams distributed 37,183 relief items and 46,772 blankets in 2014.

Health Care in Syrian Refugee Camps

In August 2014, MSF opened a maternity unit in Domeez, the largest Syrian refugee camp in Iraq. As the population swelled to 60,000 and more and more pregnant women needed proper assistance, MSF augmented its primary health care center to include a delivery room for safe delivery and gynecological services.

Teams had also been providing general health services and mental health care in the Kawargosk and Darashakran refugee camps, until handing over activities (aside from mental health care) at the end of 2014.

Secondary Health Care

MSF has had a network of doctors across Iraq since 2007 and currently works with 8 doctors to refer patients in need of specialized reconstructive surgery to MSF’s hospital in Amman, which offers orthopedic, maxillofacial and plastic surgery, along with physiotherapy and psychosocial support.

MSF had also provided assistance to Al-Zaharaa hospital in Najaf since 2010, helping to improve the quality of the neonatal and obstetric care, until it ceased working there in October 2014.

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.

A physiotherapy session for a patient with a hand injury, Amman, Jordan. © Philippe Conti

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. 

Hawijah hospital

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.

Patient story

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.

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