April 23, 2004
For Ibrahim Younis, logistics coordinator for Doctors Without Borders/Médecins Sans Frontières' (MSF) emergency pool, having to accept a US military escort into the besieged city of Fallujah one Sunday in April proved to be "the scariest day in my life." He first stayed in Baghdad with the MSF team before, during, and after the US-led bombing campaign last year, a time in which he also spent two weeks in various jails following his arrest by Iraqi security forces. None of these experiences, though, compared to traveling down the road to Fallujah.
"The Coalition forces are a target in Iraq," Younis said after recently returning to Brussels. "Along the road I saw the carcasses of military vehicles destroyed by mortars or rocket-propelled grenades. The Americans told us they needed to escort us, but I would have felt much safer without them."
While nearly 100 Iraqi staff members continue to perform close to 3,000 consultations per week work in three MSF clinics in Sadr City and actively support the reference hospital on the outskirts of Baghdad, MSF's international staff has temporarily withdrawn to Amman.
The 32-year old Younis determined that the risks for international aid workers were unacceptably high. Dozens of foreigners have been kidnapped recently and the distinction between civilians and those aligned with the military coalition has almost completely eroded.
Even getting humanitarian supplies to Baghdad is proving difficult.
"Since fighting rapidly intensified in March – particularly in parts of Baghdad and Fallujah – we had been donating emergency supplies to hospitals and to the Ministry of Health," Younis said. "Our cargo of medical materials and high-protein biscuits arrived in Baghdad, but nobody was keen on transporting it from the airport because convoys are routinely attacked on the road into the city. In the end we did manage to get the materials to our warehouse, but the experience shows how complicated it has become to do anything significant in Iraq today."
When Younis arrived in Baghdad just weeks after his previous stay, he immediately sensed a change for the worse. The city had become more tense and violent. US troops were noticeably absent from the streets, staying in their own quarters and leaving general security to poorly prepared Iraqi police. A cemetery manager said he was hosting nearly 16 funerals every day – mostly for people cut down in the fighting.
Through local contacts, Younis heard that the public hospital in Fallujah was not functioning because it had been taken over by Coalition forces. Local medical staff had set up a field hospital to meet people's needs and the Iraqi Red Crescent negotiated a humanitarian convoy to supply Fallujah, to which MSF contributed 1.5 tons of emergency medical and surgical materials. But Younis wanted to assess the situation firsthand to judge whether MSF could provide more active assistance.
Younis went with the Iraqi Red Crescent through various checkpoints until they were forced to accept the US escort. Over the past year, Younis has invested much effort in explaining MSF's independence to Iraqi leaders, so such an escort could do much damage. When he arrived in Fallujah, he quickly spoke with community leaders to avoid any misunderstandings.
Younis felt much safer inside the city. Though the atmosphere was tense, the respect for the Red Crescent meant he was welcomed at the field hospital. He could not move about the city because snipers considered everything a target, so Younis could not make it to the public hospital.
"It is absolutely unacceptable for hospitals to be militarized," Younis said. "Hospitals have to be respected by all parties in a conflict as neutral territory. Otherwise sick or injured civilians will be too afraid to seek treatment. We have heard stories from various sources about soldiers entering hospitals and taking suspected opponents from their beds. We did not see this with our own eyes, but if these stories are true it is a very serious breach of the neutrality of medical structures."
The medical staff in the improvised field hospital did an impressive job under difficult conditions. When Younis was there, they were caring for ten wounded people with hardly any working equipment in two small impromptu operating theaters. MSF now hopes to bring in more surgical materials for a third operating theater.
A couple of miles outside the city, the Red Crescent planned to set up a camp for displaced families fleeing the siege. While host families take in many people – a year ago, families in Fallujah hosted many people who fled the bombing of Baghdad – others sleep outside or stay in public buildings. The camp, situated next to a river to guarantee water supply, was to hold 200-300 families. But when US troops moved to within a half-mile of the site, it became too insecure. A second location further down the river actually came under fire after the Red Crescent had already set up tents.
The security risks are too great for aid workers, human rights researchers and journalists to perform independent and comprehensive assessments in many parts of Iraq.
"There is a whole string of actions that make it virtually impossible to work independently in Iraq," Younis said in stressing the role the Coalition has played in this climate of insecurity. "Soldiers driving around in cars that look exactly like cars from aid agencies, which makes every aid agency suspect. Forced military escorts like the one I had to take on the road to Fallujah. Embedded non-governmental organizations that choose to always be accompanied by soldiers. No matter how hard we try, we can hardly show our independence from the warring parties. Every Westerner is automatically seen as affiliated with the Coalition."
Such confusion is a major reason why Iraq has become too insecure for aid workers. At the end of the day, civilians in Iraq bear the consequences of continued warfare, particularly the absence of assistance in times of urgent need.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)