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Iraq Operational Overview
January 31, 2011
An overview of Doctors Without Borders/Médecins Sans Frontières (MSF) activities in Iraq, as of January 25, 2011:
Going into 2011, nearly eight years after the start of the war, Iraqis continue to be affected by insecurity, violence, and uncertainty about the future. In the areas most affected by violence these days, people run the risk of being directly targeted or caught in the middle of a violent incident. Bombings and assassinations continue to occur in many regions of Iraq, killing or wounding dozens of people every month. The fear of violence has driven many people from their homes, forcing them to relocate elsewhere inside or outside the country. Others have stayed, but are too scared to go outside, which limits mobility and affects the social structure of their lives, something that has significant physical and psychological consequences. Independent humanitarian organizations still have only limited access to victims of the violence in the major population centers.
Although many health facilities inside Iraq are still functioning, the quality of care they provide has been undermined by a shortage of specialized staff and a lack of training—both consequences of the ongoing violence and the international sanctions that predated the war. According to the Iraqi Ministry of Health, hundreds of medical staff have been killed in the course of the conflict, and large numbers of skilled personnel have left the country. Iraq is struggling with shortages of both nurses and specialist doctors, including psychiatrists and psychologists. Iraq’s doctors once provided some of the best and most advanced medical services in the region, but now the quality of some medical services is seriously impaired.
MSF has been running a range of medical programs in Iraq and in neighboring countries since 2006 to assist Iraqis in the current conflict. MSF currently coordinates its medical activities in Iraq from Amman, Jordan, where the organization also holds routine training sessions for Iraqi medical staff.
Medical Assistance in Northern Iraq
Despite the highly volatile context, an MSF surgical team composed of Iraqi doctors is working in the General Hospital in Hawijah, allowing the operating theater to function around-the-clock. More than 300 emergency surgical procedures are performed each month in the town, which is located 80 kilometers (48 miles) from Kirkuk, for both conflict and non-conflict related pathologies.
In the General Hospital in Kirkuk, MSF is supporting the dialysis unit with a team made up of both Iraqi and international medical staff. The objective is to provide a high quality of dialysis to some 80 patients with renal failure.
MSF is providing more general support to four hospitals in the city of Kirkuk and the surrounding Ninewa Governorate by providing medical supplies and supporting emergency response and health education campaigns. MSF has carried out training in on-the-spot triage, and a functioning triage system has been implemented in all four emergency departments.
Counseling the Traumatized in Baghdad and Fallujah
Iraq is facing critical shortages of certain medical specialists, psychiatrists and psychologists among them. As a result, there is an almost complete lack of psychological care and counseling available for patients suffering from mental trauma. In September 2009, MSF opened a mental health counseling unit in Baghdad’s Imam Ali Hospital, followed by a similar unit in the hospital in Fallujah in December 2009. In June 2010, MSF opened another unit in Baghdad’s Yarmouk Hospital. Working in collaboration with the Ministry of Health, MSF aims to provide psychological counseling to alleviate the mental trauma many Iraqis continue to experience as a result of exposure to ongoing violence and the restrictions that the violence imposes on them. The mental health units are located within Ministry of Health hospitals, and hospital staff seconded from the Ministry of Health have been selected and trained to provide counseling services. In 2010, the teams treated 2,371 patients in 5,062 counseling sessions. The teams also carry out community awareness activities to introduce and explain MSFs services to the general public.
Improving Mother and Child Health Care in Najaf
In Najaf, MSF started a medical program to improve the quality of obstetric and perinatal health care in Al Zahra District Hospital, the main referral hospital for obstetrics, gynecology and pediatrics in Najaf Governorate. According the World Health Organization’s health profile for Iraq, obstetrical emergencies and neonatal care are both among the greatest medical needs in the country. Iraqi health authorities do not have the capacity to respond to these needs, which has contributed to rising maternal and infant mortality rates.
MSF staff will work in close collaboration with existing hospital staff, training them to use and respect control measures and sterilization procedures in order to help improve the quality of maternal and child health care and to reduce maternal and child mortality in the region.
Medical Assistance in Southern Iraq
In Basra, MSF is supporting the emergency services of Basra General Hospital, where as many as 20,000 people seek emergency medical care every month. MSF is supporting the hospital in a variety of ways, including training staff in the management of emergency cases and mass casualties. After supporting the rehabilitation of the emergency room’s operating theater, where more than 300 surgeries are carried out each month, MSF is also training hospital staff in peri- and post-operative care. MSF is also providing support for elective surgeries in the operating theater, where MSF teams worked in 2008 and 2009 to improve the quality of anesthesia, post-operative care, hygiene, asepsis, and sterilization.
Health Care for Iraqi Refugees in Syria
An estimated 1.7 million Iraqis have sought refuge outside their country. In neighboring Syria, there are 215,000 registered Iraqi refugees, according to figures from the United Nations High Commission on Refugees, while many thousands more remain unregistered. Most live in precarious conditions and cannot afford to pay for medical care.
In August 2009, MSF started a health care project in Damascus, Syria’s capital, in partnership with a local organization known as the Migrants’ Office. The aim is to provide free health care and mental health support to the unregistered refugees and migrants, as well as to the underprivileged residents of the city.
The clinic provides primary health care, prenatal consultations, and mental health services. In the first six months, more than 2,800 patients received medical care, including 400 pregnant women, and 280 people were given psychological support.
As an international medical emergency organization, MSF strives to provide free medical assistance to communities affected by natural disasters, armed conflicts, and disease outbreaks, as well as those suffering from a lack of access to health care. MSF offers neutral and impartial assistance to patients regardless of their race, religion, gender or political affiliation.
MSF is an independent, non-profit organization founded in 1971. Today, it is a worldwide movement working in more than 60 countries around the world. In order to ensure its independence, MSF does not accept funding from any government, religious committee 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.