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MSF in Iraq, 2008
Field Staff: 489
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In its sixth year of war, Iraq's overall level of violence has decreased. Nevertheless, bombings and killings continue in many regions, causing dozens of deaths and injuries every week. Owing to security constraints, Doctors Without Borders/Médecins Sans Frontières (MSF) cannot give direct assistance in the worst-affected areas. Aid to the Iraqi population is therefore delivered mostly from more secure parts of the country or from outside the border.
Access to health care is problematic, especially after bomb blasts, when it is difficult for the wounded to reach hospitals. Patients with chronic diseases suffer from a general lack of medicines and proper follow-up care.
Large numbers of doctors and medical staff have fled the country since the beginning of the war in 2003. Those who stayed face enormous hardships, even threats to their lives. According to the Iraqi Ministry of Health, more than 600 medical employees, including 132 doctors, have been killed in the course of the war. Humanitarian organizations have also been targeted.
MSF has struggled for years to gain access to the people. "The dilemma we face in Iraq is symptomatic of many conflicts today," says Gustavo Fernandez, head of mission for the programs in Ninewa and Tameen governorates. "Reaching civilians caught in midst of conflict and violence has become a huge challenge."
For the first time since the change of regime in 2003, MSF was able to establish an international team in southern Iraq in 2008. In October, a training project was started in Basra general hospital in the south of the country. The project intends to improve pre- and post-operative care.
Since 2006 medical programs have been set up in neighboring countries. MSF has been providing orthopedic, maxillo-facial, and plastic surgery for Iraqi war-wounded in Amman, Jordan, since August 2006. Almost 600 patients who needed treatment too complex to be provided in wartime Iraq were treated in this program. The program was developed in partnership with the Jordanian Red Crescent hospital and the Iraqi Medical Association.
In the Kurdish governorates of northern Iraq, MSF provided surgical assistance to the wounded in hospitals in Sulaymaniyah, Erbil, and Dohuk, focusing on prosthetic and orthopedic reconstructive surgery and care for burn victims.
Reconstructive surgery for war-wounded Iraqis was also provided in Mehran, Iran. MSF had intended to establish a referral system for patients from the war zone to these hospitals, but attempts proved unsuccessful for a number of reasons. MSF decided to stop some of these programs in the course of 2008 to concentrate reconstructive surgery activities in the hospital in Amman, Jordan, and to give more specific support to hospitals within the conflict zone. The program for burn victims in Sulaymaniyah continues, and deals with an average of 80 admissions per month. The injuries are caused mostly by accidents or in failed suicide attempts.
In Baghdad, central and south Iraq, MSF supports eight hospitals by providing medical material, equipment, and training. Emergency psychological counseling has been introduced for victims of violence in four of these hospitals. In the northern governorates of Tameen and Ninewa, MSF supports five hospitals by providing medical supplies and emergency care in response to violent incidents.
While the situation in Iraq remains violent and highly volatile, MSF hopes to seize the opportunity presented by some relative improvements in security to extend medical humanitarian assistance in 2009.
MSF has worked in Iraq since 2006.