A rapid escalation in conflict in Iraq caused massive internal displacement in 2014. Nearly two million people have fled their homes in search of safety.
Continual fighting hampered the delivery of humanitarian assistance to displaced people in northern and central Iraq. Médecins Sans Frontières (MSF) launched emergency interventions and found that most of the health problems were related to poor sanitary conditions, particularly the lack of latrines and clean water. Staff routinely treated people with respiratory and urinary tract infections, gastrointestinal problems, and skin and chronic diseases.
Emergency relief for displaced people
The Islamic State (IS) group and allies launched major offensives in Samarra and Mosul in June, and around Sinjar, near the border with Syria, in August. During this period people fled for safety, mainly into Iraqi Kurdistan. MSF responded by launching emergency interventions to provide basic medical care and relief for displaced families in several locations.
In June, four mobile clinics started to operate across Dohuk governorate, providing basic medical care and distributing relief items to displaced people. Teams supplied over 1,000 wash kits (soap, shampoo) and undertook water and sanitation activities, including the construction of latrines and showers in Dabin to help maintain a basic standard of hygiene.
In Kirkuk city and the surrounding areas, two teams ran mobile clinics in five locations providing basic healthcare, focusing on chronic diseases, maternal and paediatric care. More than 20,000 blankets and 2,200 wash kits were given to displaced families. Mobile clinics reached displaced people in several locations between Mosul and Erbil from June to August and MSF was the first healthcare provider to arrive and set up a basic health clinic at Bharka camp, where displaced people were gathering. The clinic was handed over to the International Medical Corps several weeks later.
In October, MSF began offering basic healthcare in a clinic in Diyala governorate, focusing on the needs of people displaced by the conflict in the region. Teams conducted more than 4,700 medical consultations. As winter was approaching, they distributed relief items, including blankets, tents and shelter construction kits to more than 400 families living in makeshift camps and informal settlements in northern Diyala.
Between November 2014 and January 2015, MSF assisted displaced people coming from the north of the country and from Najaf, Karbala, Babil, Wassit and Al-Qadisiyyah governorates, by running mobile clinics and health promotion activities, and by providing relief supplies. More than 14,000 kits containing blankets, cooking utensils and hygiene items were distributed, and 1,387 consultations took place.
As fighting intensified in Anbar, Ninewa, Salah ad-Din, Diyala and Kirkuk governorates towards the end of the year, people trying to leave unsafe areas were finding themselves trapped. MSF has repeatedly asserted that protection, access to humanitarian aid and the right to reach safer areas must be guaranteed for all communities.
The consequences of conflict
In June, the day after MSF had completed its basic healthcare clinic in Tikrit, the structure was destroyed by an explosion, and international and Iraqi medical staff were evacuated from the area. The IS group took control of the city and MSF has not been able to return since.
Teams had been working in the general hospital of Hawijah, supporting the emergency services, since 2010. In August, MSF offices in the hospital compound were severely damaged during fighting and this prompted the closure of the project. Also in August, staff had to flee the Sinjar hospital when IS forces seized the town; some staff members later joined the MSF teams in Dohuk and are still working to provide medical services to their communities.
In December, MSF withdrew from Heet hospital after the IS group took the city. Most of the members of the medical team left, and thousands of people from Al-Anbar who had already fled their homes were forced to move on once again.
Assisting Syrian refugees in Iraqi Kurdistan
In addition to the newly displaced Iraqis needing assistance in the region, more than 200,000 Syrian refugees have been living in Iraqi Kurdistan, many in Erbil governorate, and have ongoing healthcare needs. MSF was the main provider of basic healthcare to Syrians in Darashakran and Kawargosk refugee camps, until activities could be handed over to the International Medical Corps in November and December, respectively. MSF had carried out more than 64,000 outpatient consultations. There is still a great need for psychological support among camp residents who have fled violence and are living with fear and uncertainty. MSF has continued to provide a programme of mental health support in these camps and the team carried out more than 1,100 consultations during the year.
MSF remains the main healthcare provider in Domiz camp, Dohuk governorate, home to some 60,000 Syrian refugees. Services include sexual and reproductive healthcare, management of chronic diseases and mental health support. MSF also ensures emergency services and referrals to Dohuk hospital around the clock. In August, MSF opened a maternity unit and had assisted 571 deliveries by the end of the year.
Reconstructive surgery in Jordan
Many victims of war are unable to access reconstructive surgery in Iraq because of the cost and the security situation, and post-operative care such as physiotherapy is lacking. MSF offers wounded Iraqis reconstructive surgery, psychosocial support and physiotherapy through its project in Amman, Jordan. A network of eight medical liaison officers refers patients, and more than 150 Iraqi victims of violence needing these specialist services were referred in 2014.
In February, MSF ended its support of the neonatal unit in Kirkuk general hospital. MSF also completed a programme of training and support in Al-Zahra hospital, Najaf governorate, in October.
No. staff in 2014: 627 | Expenditure: €20.4 million | Year MSF first worked in the country: 2003 | msf.org/iraq