IRAQ 2014: More War for a Country that’s seen too much

MSF in Numbers

Médecins Sans Frontières (MSF) was among the first international non-governmental organisations to respond to this most recent emergency in Iraq by providing health care in different areas of the country, along with water and sanitation services and blanket and non-food item (NFI) distributions.

Iraq experienced a dramatic surge in violence in 2014 that triggered successive large-scale waves of displacement. More than 2.6 million people are said to have fled war-torn the central and northern areas of Iraq, particularly Al-Anbar, Ninawa, Salah Al-Din, Kirkuk and Diyala governorates.

211,410 46,078 571Iraq total number of

consultations

8,672Mental health consultations

Consultations for Syrian refugees

41,055Consultations for IDPs and

local population

Number of deliveries

Sexual and reproductive health consultations

13,557

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37,183NFI kits distributed

Blanket distributed

46,772tents and

contruction kits

290

Number of staff

523

Iraq experienced a dramatic surge in violence in 2014 that triggered successive large-scale waves of displacement. More than 2.6 million people are said to have fled war-torn the central and northern areas of Iraq, particularly Al-Anbar, Ninawa, Salah Al-Din, Kirkuk and Diyala governorates.

Médecins Sans Frontières (MSF) was among the first international non-governmental organisations to respond to this most recent emergency in Iraq by providing health care in different areas of the country, along with water and sanitation services and blanket and non-food item (NFI) distributions.

In 2014, MSF teams provided a total of 211,410 medical consultations. Most patients were suffering from respiratory tract infections and skin infections related to poor living conditions. Others were suffering from chronic diseases, particularly hypertension and diabetes, but had seen their treatments interrupted due to the security situation and/or displacement.

The most vulnerable populations, however, were those who remain trapped in areas affected by conflict, their movement and access to safe havens severely restricted. Having fled their homes and lost everything—perhaps not for the first time—they struggle to endure amidst harsh living conditions, pervasive uncertainty, and little access to medical care.

Months of relentless fighting have destroyed much of the infrastructure of the region, medical facilities included. Medical staff had fled and drugs are increasingly in short supply to this day. People have to travel great distances and possibly risk their lives to access medical assistance, and organizations like MSF are unable to reach them because of the very volatile security environment.

2014 Activity highlightsMSF’s care for displaced populations

Since IS launched its offensive in Iraq in late 2013/early 2014, MSF has been responding to the humanitarian needs of displaced people who fled en masse from Anbar, Salah–ad-Din and later Ninawa governorates. MSF teams first supported four referral hospitals in the towns of Tikrit, Hawija, and later Sinjar to ensure a 24-hour emergency service. In June, MSF also began to assist Heet hospital, and in July, several mobile clinics offering basic health care were established in Kirkuk.

In August, following a massive influx of people from Sinjar and Ninawa, MSF teams provided urgent medical care on both side of the Syrian Iraqi border. Entire communities had fled the violence, and MSF teams ran mobile clinics to offer primary health care and water and sanitation services to thousands seeking refuge.

As the conflict spread across Anbar governorate in October, triggering more displacement, MSF mobile teams provided health care in the cities Al-Qadisiyyah, Kerbala and Babil Governorates.

Working on the frontlines

In Dohuk, many displaced have been resettled in new camps, so MSF is now focusing on the sizeable population still living outside the tented facilities. Simultaneously, MSF medical teams are spreading their reach across buffer areas in Ninawa governorate, where and when security allows, offering much-needed medical care to the local populations in places where most of the medical infrastructure has been destroyed.

2014 in review: More War for a Country that’s seen too much

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Last July, in spite of the very volatile security environment, MSF started deploying mobile clinics in Kirkuk governorate, Salah ad Din, and Diyala governorates to provide health care to the displaced. Our medical services focus on primary health care, with an important emphasis on non-communicable diseases, reproductive health, and mental health care.

Medical facilities under fire

Throughout MSF’s response to the current crisis, teams have had to adapt or close several projects at different times because security worsened and risks increased, health structures were damaged, or staff no longer felt safe working in certain locations. Projects in Hawijah and Tikrit were abruptly shut down due to the deteriorating security situation. In June, the day after MSF completed its primary health care unit in Tikrit, the city was overrun by rebel forces and MSF’s clinic was destroyed by an explosion. MSF medical staff had to be evacuated.

A few weeks later, MSF offices in the hospital compound of Hawija, where MSF had been working since 2010, were severely damaged during fighting, prompting the closure of the project.

Medical staff fled Sinjar hospital in August when IS militants seized the town; some staff later joined our teams in Dohuk and are still working to provide medical services to their communities. In October, MSF withdrew from Heet hospital after IS took control of the city, forcing thousands from Al-Anbar who had already fled their homes once to take flight again.a

NFI distributions for vulnerable populationsIn addition to health services, MSF teams also distributed medicines, non-food items, blankets and construction kits to the most vulnerable and difficult-to-reach populations across Kurdistan and in Ninawa, Al-Anbar, Salah ad Din, Diyala, Kirkuk, Baghdad, Kerbala, Najaf, Babil, Wassit and Al Qadiyiah governorates. In total, MSF teams distributed 37,183 relief items and 46,772 blankets in 2014.

Health care in Syrian refugee camps

In August 2014, MSF opened a maternity unit in Domeez, the largest Syrian refugee camp in Iraq. As the population swelled to 60,000 and more and more pregnant women needed proper assistance, MSF augmented its primary health care centre to include a delivery room for safe delivery and gynaecological services.

Teams had also been providing general health services and mental health care in the Kawargosk and Darashakran refugee camps, until handing over activities (aside from mental health care) at the end of 2014.

Secondary health care

MSF has had a network of doctors across Iraq since 2007 and currently works with 8 doctors to refer patients in need of specialized reconstructive surgery to MSF’s hospital in Amman, which offers orthopaedic, maxillofacial and plastic surgery, along with physiotherapy and psychosocial support.

MSF had also provided assistance to Al-Zaharaa hospital in Najaf since 2010, helping to improve the quality of the neonatal and obstetric care, until it ceased working there in October 2014.

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Nazha, 26, is the mother of five children, the eldest of whom is 8. They were all displaced from their home in a village near Dakuk, and she was visiting the MSF mobile clinic near Tuz Kharmatu with two of her children.

I came here today because the kids are ill. They have a skin disease. This place is not clean and the kids are always dirty. We are thankful to you for coming here: no doctor has been here in eight months. We are also thankful to the Mayor for allowing us to stay in this village.

The kids were all vaccinated in Dakuk [and] I have treated them with some medicine I was given in Dakuk—I don’t know what it is. It was expensive to get there, 25,000 Iraqi Dinars (about 20 dollars) just for the taxi fare and then another 200,000 IQD (160 USD) for the visit to a private doctor. But they still itch, especially at night, when they scratch and scream in pain.

We came here eight months ago. I was already pregnant. Previously I had given birth in the hospital but this time I gave birth at home. I had gone out to gather some wood that we needed to cook; it was early in the morning. When I came back my water broke and the pain started. My mother-in-law helped me. She’s experienced and has carried out many deliveries in the village where we use to live. I was in pain most of the day, and later in the afternoon I finally gave birth. My sister-in-law was there to help, too. They used gloves and a sterilized knife to cut the cord. It was hard work but all went well.

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Patient testimony