The Hawija military offensive launched by Iraqi forces to oust the Islamic State group from its last major urban stronghold has forcibly displaced nearly 14,000 people to towns in neighboring districts of Kirkuk governorate. They are arriving in vulnerable condition and in urgent need of care, according to the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).
People arriving at so-called entry points around 15 miles north and 25 miles east of Hawija’s center are in urgent need of shelter, medical care, and food. From the start of the offensive on September 21 to October 5, an estimated 14,000 internally displaced people have arrived at Debis checkpoint, Daquq camps for displaced people, and Maktab Khalid entry point.
Over the course of the offensive, MSF teams in Kirkuk governorate have provided 3,201 medical consultations for people arriving from Hawija. Patients included six war-wounded people, among them an 8-year-old boy, all suffering from blast injuries due to air strikes and land mines.
Tatiana Kotova, MSF Kirkuk Project Coordinator said: “By the time people decide to flee Hawija, most are already incredibly vulnerable, and then you add to that the physical and mental drain of the journey. We receive patients in really critical condition.”
A 37-year-old-man who fled from the south of Hawija described the harrowing journey. “Fleeing Hawija was so dangerous that people call it the road of death," he said. "We had to pass a narrow road between a mountain and a valley. Many people died on this road. Some of them fell in the valley. It took us 15–16 hours to escape the besieged town.”
Daquq camp is currently the only camp in Kirkuk governorate receiving people who fled the Hawija offensive, explained Kotova. “It hosts around 11,000 people who fled Hawija district since October 2016. The MSF team in the camp has been providing medical care since January 2017, through an outpatient department for general medical consultations, treatment for non-communicable diseases like diabetes and high blood pressure, and mental health,” she said.
People living in the district have been living under siege for almost three years. They have been deprived of basic services like medical care, as local infrastructure and facilities in the district were not functioning properly and humanitarian aid was not available.
“Due to the siege, MSF teams have not been able to enter the district,” said Kotova. “But we positioned our activities as close as possible to the front lines to provide health care services to those who need it, including urgent medical [aid] for the war-wounded.”
Since the start of the offensive, MSF teams in Qayyarah hospital have received a total of 56 people with war wounds. MSF medical teams in Kirkuk, Tikrit, and Qayyarah remain on standby with a triage and stabilization point ready for deployment if needed.
“The health situation in Hawija is terrible," said a 40-year-old man from the district. "We couldn’t find medicine, or it’s incredibly expensive and we couldn’t afford it. My mother suffers from high blood pressure, we couldn’t find her medicine and we decided to leave.”
Through mobile clinics, MSF teams are providing medical and trauma care at Debis screening site and Maktab Khalid entry point to people arriving from Hawija.
Teams started providing medical assistance at these locations in November 2016, mainly through the outpatient department. Teams also provided support for non-communicable diseases such as diabetes and high blood pressure.
During the months leading up to the offensive, MSF began supporting the emergency rooms in the two main Kirkuk hospitals with supplies and training to doctors and nurses working with the Iraqi Department of Health to help prepare them to manage war-wounded trauma cases. In Qayyarah hospital, MSF is also providing surgical and emergency medical care to war-wounded arriving from Hawija. The facility has 62 medical beds, including an intermediate care unit, observational beds, and two resuscitation beds. The teams assigned to the Qayyarah camps are visiting the camps for displaced people to monitor the nutrition status of new arrivals from Hawija and assess the need for a possible intervention.
To the south of Hawija, MSF launched medical activities through medical mobile clinics in Salah al-Din governorate in August 2016. Currently primary health care services are available in Al Alam camp, where 9,000 people displaced from Hawija and Shirwat are living.