The offensive on the district of Hawijah has forcibly displaced nearly 14,000 people to towns in neighbouring districts of Kirkuk governorate, northern Iraq, where Médecins Sans Frontières (MSF) is witnessing them arriving in urgent need of care.
On arrival at the so-called entry points, 25 kilometres north and 40 kilometres east of Hawijah’s centre, people urgently need shelter, medical care and food. Between the start of the offensive, on 21 September, and 5 October, an estimated 14,000 people arrived at Debis checkpoint, Daquq camps for displaced people, and Maktab Khalid entry point.
MSF teams in the different Kirkuk locations have provided 3,201 medical consultations for people arriving from Hawijah. Among them were six war-wounded, one of whom was eight years old. All the people treated were suffering from blast injuries due to airstrikes and landmines.
“Daquq camp is currently the only camp in Kirkuk governorate receiving people who fled the Hawijah offensive,” said Tatiana Kotova, MSF Kirkuk project coordinator. “It hosts around 11,000 people who have fled Hawijah district since October 2016. The MSF team in the camp has been providing medical care since January 2017 through an outpatient department for general medical consultations. We have also treated people with non-communicable diseases, such as diabetes and high blood pressure, and provided mental healthcare.”
“Fleeing Hawijah was so dangerous that people call it the road of death,” said a 37-year-old man who fled from the south of Hawijah. “We had to pass a narrow road between a mountain and a valley. Many people died on this road. Some of them fell into the valley. It took us between 15 and 16 hours to escape from the besieged town.”
People living in the district have been under siege for almost three years. They have been deprived of basic services such as medical care, as the infrastructure and facilities in the district were not functioning properly and humanitarian aid was not available.
“Due to the siege, MSF teams have not been able to enter the district, but we positioned our activities as close as possible to the frontlines to provide healthcare services to those who need it, including urgent medical for the war-wounded,” said Kotova.
Since the start of the offensive, MSF teams in Qayyarah hospital have received 56 people with war wounds. MSF medical teams in Kirkuk, Tikrit and Qayarrah remain on standby with a triage and stabilisation point ready to deploy if necessary.
“By the time people decide to flee Hawijah, most are already incredibly vulnerable, and then you add to that the physical and mental drain of the journey,” Kotova said. “We receive patients in really critical conditions."
A 40-year-man from the district described the health situation in Hawijah as "terrible".
"We couldn’t find medicine or it was incredibly expensive and we couldn’t afford it," he said. “My mother suffers from high blood pressure, and we couldn’t find her medicine, so we decided to leave.”
MSF humanitarian response to the Hawijah offensive
Through mobile clinics, MSF teams are providing medical and trauma care at Debis screening site and Maktab Khalid entry point to people arriving from Hawijah.
Teams started providing medical assistance at these locations in November 2016, mainly for general medical consultations through the outpatient department and by supporting non-communicable diseases like diabetes, and high blood pressure.
During the months leading up to the offensive, MSF began supporting the emergency rooms in the two main hospitals in Kirkuk with supplies, and training doctors and nurses working with the Iraqi Department of Health to help them manage war wounded trauma cases. In Qayyarah hospital, MSF is providing surgical and emergency medical care to war-wounded arriving from Hawijah. The facility has 62 medical beds, including an intermediate care unit, observational beds and two resuscitation beds. The teams assigned to the Qayyarah hospital are visiting the camps receiving newly displaced people from the Hawijah area, to monitor the nutrition status of the new arrivals and assess the need for a possible intervention.
To the south of Hawijah, MSF launched medical activities through mobile clinics in Salah al-Din Governorate in August 2016. Primary health care services are available in Al Alam camp where 9,000 people displaced from Hawijah and Shirwat are hosted.