Iraq: “Yesterday, it was calm; we only received 20 war-wounded patients”

On 19 February, MSF opened a field trauma hospital with surgical capacity in a village to the south of Mosul. It has two operating theatres, one intensive care unit, an emergency room, an inpatient ward and other necessary support facilities.

The MSF team at the hospital is composed primarily of Iraqi surgeons, doctors and nurses. They only have the capacity to operate on the most severe life-threatening cases, known as ‘red cases’. Those that can wait are referred to hospitals further afield.

The facility has received more than 915 patients since it opened. Of these, 763 suffered war-related trauma, including 190 ‘red cases’ in need of urgent lifesaving surgery, and 421 ‘yellow’ cases, whose conditions stabilised before they were referred to other hospitals in the region. More than half of the wounded were women (241 patients) and children under the age of 15 (240 patients).

Below are testimonies gathered on 18 March from two MSF surgeons working in the field trauma centre.

After his last shift at MSF’s field trauma hospital a few kilometres south of Mosul, Dr Reginald, a 66-year-old Belgian surgeon, describes his six weeks there as the toughest he has experienced during his long MSF career.

“I’ve been through many other wars: Syria, Liberia, Angola and Cambodia, but I’ve never seen anything like this. In the operating theatre, every case we receive is severe and almost every day we have to deal with mass casualties.

Our patients can be of any age, any gender and suffering from any type of war wound: sniper attack, mortar shelling, airstrike, landmine and other explosions. They are all putting their life at risk to flee a city under siege.

When weather conditions are good, we receive huge influxes of wounded men, women and children. When it’s cloudy or rainy we receive less people. Now, we look at weather forecast to best prepare ourselves and to anticipate mass casualties.

On one sunny afternoon, ambulances started to arrive, one after the other. Usually the stabilisation posts close to the fighting alert us when they are referring stabilised patients to our centre. But that day, due to the chaos, it didn’t happen.

It was really tough. We had to transfer some of them because we didn’t have the space to treat everybody but alongside the Iraqi doctors and nurses we worked around the clock. It was sunny but we never saw the sun as we operated on one person after another until 5am. By then, we had received around 100 patients and we were exhausted. That day confirmed that our surgical unit was a frontline surgical facility and we have since opened a second operating theatre to increase our capacity.

As I finish my six-week assignment, I’m shocked by the number of families dismembered by this war. By the number of mothers and fathers that begged us to save their sons or daughters as they were the only family members left alive. I’m impressed by the strength of the Iraqi people and by the generosity and hard work of our Iraqi colleagues. We could do none of this work without them.”

Testimony from Dr Ahmed*, an Iraqi orthopaedic surgeon who has worked for MSF since 2008 and has been working in MSF’s field trauma hospital a few kilometres South of Mosul since mid-February 2017.

“Yesterday morning, we received a family of four: a mother, a father and their two small boys. They had all been wounded by a mortar grenade. The mother and father arrived dead so we worked around the clock on the two brothers. But the head wound of the smallest boy was so severe that he passed away and we only managed to save the nine year old. I wonder how he managed to survive and how he will survive. From his whole family, he is the only one left.

Then, yesterday afternoon, we received another boy, this time a ten-year-old. He arrived with his left leg almost amputated by a mortar shelling. We went straight into the operating theatre but he had lost a lot of blood on the way to our hospital. For two hours we did orthopaedic surgery, then my colleague did a laparotomy for another hour. But during the night, the boy died.

We try to do everything we can, but sometimes it’s not enough. If I could, I would take a picture for each of the patients I treated to tell their stories and remember them. Here, I operate only on red cases but I would like to do more. I’d also like to follow the yellow cases, the ones we refer to other facilities. I would like to take care of them, to do all I can to help these people who have been through such terrible suffering.”

* Name changed