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Iraq, the impact of the war



    Decades of armed conflict and the instability of disruptions in health services in Iraq, even when millions of people are affected by the fighting and urgently need medical assistance. In Iraq, more than three million people had to flee their homes because of the fighting which started in 2014 in several regions. Although many have found refuge in camps, others live in schools, mosques and unfinished buildings.

    Throughout the year 2016, there has been a constant movement of people fleeing from fighting zones or returning to newly recovered areas. The offensive launched in October to regain Mosul continues to cause population movements. About 250,000 people fled the city and surrounding area. All of these people, living in unstable areas, often close to the front line, faced many challenges, including insecurity and lack of access to basic services and health care.

    In order to help the displaced persons and to take care of the wounded, MSF continues to expand its activities. Our teams open hospitals and stabilization stations for the wounded, support health facilities and deploy mobile teams that provide free access to medical care and mental health care.


    The battle of Mosul

    On October 17th, 2016, the Iraqi armed forces and an international coalition led by the United States launched an offensive to retake the Mosul city from the Islamic State group. At the end of January, they took over the eastern part of the city of Mosul and on February 19th, 2017, they launched the assault on West-Mosul. According to the United Nations, 250,000 people have already fled the city and its surroundings.

    In early December 2016, MSF opened a 32-bed hospital in Qayara, 70 km south of Mosul, with an emergency room and an operating theater. The MSF team provides medical and surgical emergencies. MSF receives an average of 1,150 patients per month.

    In early March, teams began to see children, especially babies under six months old, suffering from severe malnutrition, coming from Mosul-West. A rapid detection of malnutrition in 486 children, conducted in early March in the Hammam Al-Alil IDP camp, showed rates of 1,2% of severe acute malnutrition and 2,2% moderate acute malnutrition. Another screening that took place in one of Qayara's camp revealed similar rates. These rates are certainly lower than the emergency thresholds but it reflects a situation of food shortages in Mosul-West. To treat malnourished children, MSF has set up a therapeutic feeding center with 10 beds in the Qayara hospital.

    In addition, mental health care is being provided to displaced persons and neighboring residents in the Qayara Hospital.

    At the end of December, MSF opened a medical clinic in the eastern suburbs of Mosul to stabilize the wounded. In two months, 919 patients were treated, of which more than 57% were trauma. The activity then sharply declined when Iraqi forces regained control of East Mosul. To meet the medical needs of the general population, in March, MSF opened a 16-bed maternity in East Mosul as well as a center for medical and surgical emergencies.

    Since February 19th, MSF has been treating the wounded in a structure equipped with surgical capacity located 25 km south of Mosul. In a little more than three months, 1 296 wounded were treated, 21% of the patients were "red cases", that is to say patients who need urgent care.

    Further away from the front lines, mobile teams have been providing medical and mental health care since the beginning of December in Khazir, Hassansham and Chamakor camps housing displaced people in the west of Erbil. These teams also provide care in Debaga camp, housing displaced persons since 2014, as well as internally displaced persons who have sought refuge within the local population. By December 2016, they had provided more than 2,500 medical consultations and more than 1,800 psychological consultations on 14 sites.

    In northern Iraq

    To provide basic obstetric and neonatal care , MSF opened a maternity clinic in Tal Maraq, in the province of Nineveh. More severe cases are referred to hospitals in Zakho and Dohuk.

    In Kirkouk governorate

    MSF launched new activities in October 2016 to respond to the great number of displaced and injured people following the Hawija offensive. MSF supports emergency rooms at Kirkuk General Hospital and Azadi Hospital and provides primary and psychiatric health care at Daquq IDP camp. MSF mobile teams also provide care for people fleeing Hawija.

    In Souleymanieh, MSF works with the health authorities in the hospital, managing emergencies and providing training for intensive care and emergency trauma care. Since 2015, MSF has been working in camps of displaced persons, through psychological care, psychosocial support and health promotion activities.

    The center of Iraq

    People also seek refuge in the governorate of Salaheddin, in the center of the country. In June 2016, MSF deployed mobile teams in and around Tikrit. These teams offer primary and psychological health care. In January 2017, the teams set up a primary health care center in one of the IDP camps.

    MSF has been working in Diyala governorate since 2015, to support displaced populations in three camps in the Khanaqin district. MSF provides medical and psychological care, and also conducts health promotion activities in the camps. MSF is also working in the newly regained cities of Djalawla and Sadyia, offering health care for chronic diseases, maternal and reproductive health, maternity and mental health to displaced communities and those hosting them.

    In Anbar governorate, MSF started mobile clinics in June 2016 to help the people who fled Fallujah and Ramadi. MSF has also set up a health center in the Amariyat camp, home to 60,000 people, providing primary health care, emergency care, mental health care, and a stabilization and rehabilitation service.

    In the capital city, Bagdad

    In the capital, Baghdad, MSF provides medical care and mental health care to people from the provinces of Anbar, Salaheddine and Diyala who have settled in the disused areas of the Abu Ghraib region in the last two years. A team is also based in a clinic in the Al Shouhada II area.

    Help to Syrian refugees

    In order to help the Syrian refugees, MSF runs a maternity in the Domiz camp. Since January 2016, the teams have attended more than 1,000 deliveries.

    Reconstructive surgery in Jordan

    A network of Iraqi doctors refers victims of violence in Iraq to the reconstructive surgery hospital in Amman, in Jordan, for extremely complex surgical operations.