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MSF in Iraq, 2004
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After having been blocked from entering Iraq between 1992 and the very end of 2002, MSF was given permission by the former government to start providing care to civilians in Baghdad shortly before the war began in March 2003.
Weeks later after the most active combat between Iraqi forces and the US-led coalition had ended, MSF visited more than 70 health facilities in 25 cities, assessing the most urgent medical needs and donating medical equipment and drugs as necessary. In some hospitals that were facing staff shortages, MSF also offered the help of its own medical volunteers. While many civilians could not get care amid the chaos that followed the conflict, the country's civilians did not suffer from disease epidemics or huge refugee movements as had been predicted by some.
MSF staff quickly concluded that the most pressing medical problem facing Iraq in the days following the fighting was a lack of leadership within the country's centralized health care system. MSF called on the members of the US-led coalition, as occupying powers, to assume their responsibility as stipulated under the Geneva Conventions and provide basic services, including health care, to the Iraqi people.
Humanitarian aid workers targeted
Although heavy fighting ended in April 2003, the country's security situation deteriorated sharply in mid-2003, and humanitarian aid workers began to be viewed by some as a component of the Western military effort. On 19 August, a bomb attack on the UN compound in Baghdad killed many international and Iraqi humanitarian workers, including UN Special Representative for Iraq Sergio Vieira de Mello. Later, in October, an explosives-packed ambulance slammed into the Baghdad headquarters of the International Committee of the Red Cross, killing 12 Iraqi staff members and injuring 15 others. MSF condemned both of these violent actions as heinous assaults on innocent civilians and on the principle of independent humanitarian aid work. In a statement, MSF emphasized that recent actions and statements made by Western officials attempting to incorporate aid into their political plans were contributing to humanitarian groups' vulnerability to attacks.
Providing care for those trapped by violence
While MSF had withdrawn many of its international volunteers by September 2003 due to both unacceptable risks and reduced emergency health needs, teams continued to provide assistance in a number of ways. MSF began helping civilians in Sadr City, one of Baghdad's poorest areas, where the slum's two million residents had little ability to access clean drinking water, sanitation facilities or basic health care. By mid-2004, MSF teams were providing basic and prenatal care as well as treatment for malnourished children in three of the area's health clinics, each of which includes a first-aid post. More than 3,000 medical consultations were provided each week in these clinics. MSF staff trained medical and paramedical personnel, supervised nurses and rehabilitated the pediatric unit in the hospital in Sadr City's Al Thawra district. When Sadr City underwent a siege in mid-2004, the team treated 40 to 50 people wounded during the stand off. In August, MSF began an ambulance service, in cooperation with other NGOs, to transport the injured to local hospitals.
In August 2004, MSF distributed 1.5 tons of medicine and material to Najaf Hospital and nearby clinics during heavy fighting between US forces and Shia militants around the city's holy shrine. Although the area had an adequate drug supply, MSF found that civilians had trouble entering local hospitals and clinics that were guarded by military forces.
In September 2003, MSF ended the distribution of medicines to treat people with the deadly disease, kala azar (visceral leishmaniasis) which is endemic in the southern part of the country. The project was started because supply deliveries had been interrupted by the war. The materials were distributed among pediatric hospitals and other facilities in Ramadi, Karbala, Falluja, Hindiyah, Najaf, Diwaniyah, Afaq, Samawah, Baghdad (Sheikh-Zaid Hospital) and Nasiriyah. Another organization will now supply the drugs. MSF also donated equipment, reagents and material to help diagnostic-testing facilities resume operations in the public health laboratories of Baghdad and nine other governates in the upper southern region of Iraq.
MSF worked in Iraq from 2002 until 2004.