Due to the resurgence of violence in Iraq and the ongoing fighting between armed groups and the Iraqi army, hundreds of thousands of people have fled the cities of Mosul, Fallujah, and Tikrit in the past month. Most have fled to Iraqi Kurdistan, Al Tameem governorate, or other cities considered relatively safe. Some civilians, however, remain trapped amidst heavy fighting.
Providing emergency medical care in these circumstances is proving immensely challenging. On June 11, for instance, deteriorating security drove a Doctors Without Borders/Médecins Sans Frontières (MSF) team to withdraw from a clinic it was about to open in Tikrit. Two days later, the facility was damaged by aerial bombing.
In recent weeks, however, MSF has been able to provide support in the form of staff, medicine, and equipment to a number of hospitals in Tikrit, Hawija, and Hit. Emergency and surgical services are being maintained in these hospitals despite very difficult working conditions and irregular support from the central health authorities.
“The level of dedication of the Iraqi health staff in these hospitals is really impressive,” says Fabio Forgione, MSF’s head of mission in Iraq. “Doctors, nurses, and support staff keep on working despite the extremely difficult conditions. It’s a desperate situation, with increasing numbers of patients requiring emergency care and with dwindling supplies. They have to deal with a lack of drugs and medical supplies, with shortages of water and electricity, and with a high level of insecurity that makes moving around very difficult.”
In Hit, for example, which has absorbed some 82,000 people displaced from other areas, local medical teams are managing to provide basic and emergency services along with orthopedic and gynecological surgery. Iraqi doctors and nurses have also started providing maternal health care and care for chronic diseases, with remote support from MSF.
At the same time, MSF teams are assessing and treating the health needs of displaced people living in camps, as well as the largely overlooked population of people trapped in areas where fighting continues or camped out in unused buildings such as schools, churches, and mosques.
MSF teams are also running mobile clinics in areas to the south of Kirkuk and in the region between Dohuk governorate and Erbil, where the majority of displaced people have gathered. Mobile teams are carrying out an average of 50 consultations per day at each location, mainly for communicable diseases in children, such as chicken pox and diarrhea, and for chronic diseases in adults, such as hypertension and diabetes. They also provide care for pregnant women.
At present, the main challenge for MSF is the security situation in contested areas and areas under the control of armed groups. “Providing the most basic assistance and medical care is extremely challenging for humanitarian organizations on the ground, given the security situation,” says Forgione. “Today the greatest medical needs in Iraq remain in areas that are extremely difficult and dangerous to reach. The only certainties are that people who are fleeing or are trapped by fighting find themselves in increasingly risky health situations, and that whatever aid we can provide remains insufficient.”
MSF has worked continuously in Iraq since 2006. In order to ensure its independence, MSF does not accept funding from any government, religious committee, or international agency for its programs in Iraq, and relies solely on private donations from the general public around the world to carry out its work. In Iraq, MSF currently employs over 300 staff.