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Stabilising emergencies in a pocket of safety

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In Tal Afar district, northwest of Mosul, the lack of functional medical facilities is preventing the population from accessing healthcare. MSF has expanded its activities in the area, opening a maternity clinic in October last year and, recently, a stabilisation unit and children’s ward in the village of Tal Maraq.

MSF started to work in the area in 2015 because many medical structures were completely destroyed and those only partially damaged lacked basic medical material, drugs, and human resources. They were unable to provide healthcare to the population.

“The region here is visibly affected by conflict, says Andrew Cullen, MSF field coordinator.

“Some places seem untouched, while others are completely destroyed. Although there has been no active fighting for more than 18 months, the population has difficulties accessing healthcare.” 

People in the area have to travel over 100 kilometres to the nearest urban areas of Dohuk and Zakho to seek specialised medical care. The long trip is too expensive for most people but impossible for many. As a consequence, medical emergencies can become very critical.

“We started by providing care through mobile clinics,” says Andrew Cullen. “Then we identified the need to assist women in their deliveries. When we had to refer critical cases to other hospitals – for example, for surgeries – we understood what people endured to reach the nearest hospital. The need for stabilisation and emergency care was obvious.”

MSF’s mobile medical teams have been running clinics in three villages in Tal Afar district since January 2015. They provide general healthcare, mental health support, sexual and reproductive healthcare and treatment for chronic diseases.

In October last year, the activities expanded and MSF opened a maternity clinic in Tal Maraq. From the opening of the clinic until February this year, the teams assisted more than 500 deliveries in the Tal Maraq clinic and made a similar number of emergency referrals to Zakho.

In March 2017, MSF opened an inpatient department for paediatric cases (children under 12 years) in the same building, as well as a stabilisation unit for adults with life-threatening conditions.

This is in anticipation of a potential influx of people fleeing from the military campaign in the cities of Mosul and Tal Afar, and to address the current lack of secondary healthcare facilities in the area.

“The original plan was to open only a maternity clinic,” says Ileana Boneschi, sexual and reproductive health manager in Tal Maraq. “But with the stabilisation room and the paediatric inpatient department, this is becoming a real hospital.”

MSF has worked continuously in Iraq since 2006. In order to ensure its independence, MSF does not accept funding from any government, religious committee or international agency for its programmes in Iraq, and relies solely on private donations from the general public around the world to carry out its work. In Iraq, MSF currently employs over 1,600 staff.