Iraq: Crisis update Mosul - May 2017
While MSF continues to provide lifesaving emergency and surgical care to men, women and children wounded in the ongoing battle for Mosul, northern Iraq, our teams are now extending their response in order to cover gaps in hospital care, left by the severe destruction of the local health system.
“Most hospitals in Mosul have been damaged or destroyed,” said Marc van der Mullen, MSF Head of Mission. “In West Mosul, medical services are severely disrupted and the ongoing fighting is causing many injuries and deaths. In East Mosul, medical facilities slowly get back on their feet but there are gaps in medical services such as post-operative care, mother and child care, and inpatient care so MSF is working on addressing them.”
MSF is currently working in six medical facilities in and around Mosul, providing lifesaving emergency and surgical care, including mother and child health care as well as providing long term post-operative care to those in need of follow up and rehabilitation following major surgery. The teams are also providing care for children suffering malnutrition, as well as primary healthcare and mental healthcare in the newly established camps for people fleeing Mosul.
Through a strategy of advanced medical posts, which can be quickly opened and moved according to the rapidly changing medical needs, MSF has so far worked to provide life-saving stabilisation and emergency care to people wounded in fighting in west Mosul. During April, MSF has received 175 patients in our two posts in western Mosul, and referred them to other medical facilities with surgical capacity, such as the MSF trauma hospital in Hammam al-Alil, south of Mosul.
MSF is working on broadening its medical services and setting up facilities with surgical capacity, including for emergency maternal care, as well as an inpatient paediatric department. The objective is to fill urgent gaps in medical services to provide for the most vulnerable population groups until health authorities resume services.
Hundreds of thousands of people are still trapped in West Mosul. The patients who make it to our facilities tell us that water and food is running low, that the few supplies available are extremely expensive, and that access to health care is almost impossible.
In East Mosul, MSF is working in a former retirement home transformed into an emergency room, operating theatre, and maternity and inpatient departments. Since the hospital opened at the beginning of March, the team has seen 4,376 patients, over half of whom were emergency cases, and performed 93 caesarean sections.
Also in East Mosul, MSF opened a 15-bed maternity unit on 19 March to provide basic emergency services allowing women to deliver safely. Since opening, the team has safely brought 130 babies into the world.
In a third facility in eastern Mosul hospital, MSF has opened a 24/7 emergency room, that has so far received 336 patients. The team is currently setting up a surgical unit and a 32-bed ward.
South of Mosul
Since its opening, 1,904 patients have been received in MSF’s field trauma hospital in Hammam al-Alil, which was the closest surgical facility to West Mosul for more than a month. Fifty five percent of the patients were women and children, and 82% were war-wounded. To date the MSF team has performed 160 major surgical procedures. MSF has also begun supporting the primary healthcare centre in Hammam al-Alil, carrying out about 500 consultations per day both for the local population as well as for the people displaced from Mosul hosted in a nearby camp.
At the hospital in Qayyarah, MSF treats medical and surgical emergencies. Since January, more than 5,657 patients were admitted to the emergency room. The team in the emergency room sees patients wounded in airstrikes and explosions or by mortar fire. A four bed intensive care unit was recently opened to provide care for burns victims, patients in shock, and other critical cases.
As the Iraqi army advanced into west Mosul, families were able to escape. MSF teams started seeing children with acute malnutrition, as a result of food shortages in besieged West Mosul. To treat malnourished children, mainly babies under six months, MSF has set up a 12-bed intensive therapeutic feeding centre in Qayyarah hospital. In Hammam al-Alil, MSF is running an ambulatory nutrition programme and refers the most severe malnutrition cases to Quayyarah hospital.
With thousands of people severely wounded in the fighting, many are going to face long months of convalescence and rehabilitation. Long-term post-operative care will therefore be one of the main medical needs for the next weeks and months.
“A person’s recovery does not end with their trauma surgery. They often need many months of therapy, both physical and psychological to allow them to rebuild their shattered lives. Our patients will bear the scars of the battle of Mosul for the rest of their lives but our team is helping them to adjust to their new reality, and hopefully return them to their families as healthy as possible,” said Chiara Burzio, MSF’s Medical Coordinator.
In Hamdaniya, southeast of Mosul, MSF is providing long-term post-operative care with rehabilitation and psychosocial support in the hospital, in collaboration with Handicap International. Since 15 March, MSF has admitted 100 patients, about 45% of whom are women and children. This 40-bed facility is the only facility providing such a package of long- term post-operative care in all of Ninewa province.
Camps for displaced people
According to the UN, over 500,000 people have been displaced from Mosul. In 17 sites hosting such displaced people, to the west of Erbil, MSF mobile teams are providing primary health care, treatment for chronic diseases (mainly diabetes and hypertension) as well as psychological and psychiatric care. The mental health programme focuses on severe cases and its activities include psychological and psychiatric consultations, group therapy sessions, psychosocial counselling and therapy for children. Since the beginning of the year, the team has carried out 14,098 medical consultations and 8,238 mental health consultations.