April 14, 2003
Doctors Without Borders Responding to Humanitarian Needs in Iraq

Doctors Without Borders/Médecins Sans Frontières (MSF) now has 44 international aid workers based in Iraq and surrounding countries. In the coming days, MSF will begin to address the needs MSF encounters in their initial assessments.

In Baghdad, following the release on April 11 of Ibrahim Younis and Francois Calas, MSF aid workers who had gone missing in Baghdad for 9 days, MSF began assessing the immediate health needs of people in Baghdad. Hospital visits and security assessments will continue in the coming days following the arrival of three additional MSF volunteers.

"There could be surgical needs for weeks," said Koen Henckaerts, MD, Director of Operations for MSF and one of the newly arrived aid workers. He explained how shrapnel or bullet wounds would need to be closed once the risk of infection subsides and how broken bones will need to be reset. People suffering from chronic conditions are also at risk in this vacuum of care. Diabetics without insulin can slip easily into diabetic comas, while not receiving dialysis can quickly lead to kidney failure.

The recent spate of chaos and looting left hospitals short of staff and supplies. MSF has assessed al Kindi hospital in northeast Baghdad, al Qadashia hospital in Saddam City, and al Zafaranya hospital in southeast Baghdad, and will determine where MSF will be most effective in providing assistance.

MSF will also address the shortage of medicines and supplies by sending a shipment of anesthetic drugs like ketamine, fentanyl, and diazepam, and strong painkillers like tramadol, morphine, and diclofenac, in addition to surgical equipment such as external fixation devices, a surgical kit for 300 surgeries, a kit for treating 150 wounded, and supplies for blood transfusions.

MSF has now visited the southern Iraqi city of Basra twice in the past two days. It is still wracked by sporadic looting, and initial assessments of Toheer Hospitals showed a shortage of medicines for chronic conditions as well as a lack of oxygen for medical use. MSF presented the health center at Um Khailil a basic medical kit with drugs and medical supplies, and will follow the situation in both locations closely.

In the coming days, the Basra assessment team may go north to investigate the needs in Nasaryah, Karballah, or Najaf, depending on the security situation. They will be joined by a second MSF assessment team from Jordan.

MSF sent an assessment team from Iran to al Qut, Iraq to assess the health situation and to Badrah near the border for an estimated ten thousand displaced people .

Iran is still hosting 200,000 Iraqi refugees from the 1991 Gulf War, and has said it will only accept refugees if their lives are in danger. Iran has established 10 camps at border points, capable of housing 400,000 refugees.

MSF has materials to support 80,000 possible refugees for 3 months in Khouzistan, Iran from the Basra area or in Kermanshah, Iran from the Baghdad area. There is also the possibility for cross-border operations into Iraq.

In Syria, MSF teams will be based in the cities of Hassaké and Qamishli.

A surgical team with medical supplies is prepared to enter Northern Iraq from Qamishli to assess the health needs of people in Mosul and the surrounding areas after three weeks of intense bombings. There are reports that water and electricity have been cut in Mosul, and conflicting reports about how well the health structures are coping in Mosul and the surrounding areas.

MSF is prepared to offer support of health structures at the al Hol refugee camp near Hassaké. MSF health personnel can supply clinical assistance as well as medicines, therapeutic food, water and sanitation equipment, and shelter for up to 20,000 people for three months. Currently, 143 third country nationals receive care at al Hol, and it is still not known whether there will be a large influx of refugees in Syria.

In Jordan, MSF has agreements and supplies in place to attend to the health needs of any possible refugees at the Ar Ruwayshid camp in eastern Jordan. An MSF doctor and nurse will remain there, in addition to enough health-related materials to care for 10,000 refugees for three months. But for the moment there has not been a large refugee flow to Jordan.

MSF is also using Amman as a base to offer logistical support to the teams in Baghdad.

In Kuwait, MSF has a good deal of surgical and medical supplies in place, including a kit with materials to treat 150 wounded, dressings for 200 burn victims, general dressings for 250, and surgical drugs. This is in addition to nutritional and water/sanitation supplies like high energy biscuits, therapeutic milk, water purifying systems that provide water for 10,000 people per week, blankets, tents, and sheeting.