This July marked a year since the war in Iraq was declared over. However, the everyday life of the people living here is still far from what you might consider a normal state.
A new country and new challenges
Since mid-July I have been back to work with Médecins Sans Frontières/Doctors Without Borders (MSF), this time in northern Iraq. A new country and new challenges waiting for me as the project's “medical referent”.
Being the medical referent means that my main task here is to guide the medical team and implement the necessary activities as well as constant evaluation and monitoring of the situation.
This means asking some important questions. What do the local people need? What kind of health care is being offered by other organisations (or not)? And once we’ve established what kinds of health services are most needed, what do we need to deliver them - is one doctor enough, do we need an additional psychologist or more medication?
One of the most important questions for MSF is always: are we reaching out to those who need us most? Here in the camp this especially means single women and children who are dependent on external support.
The shadow of war
Al Qayarah is located about 1.5 hours south of Mosul and still hosts about 125,000 people who have been internally displaced – forced to leave their homes and livelihoods to escape the war. The people live in the camps where MSF is working. The war might be over, but this country has not yet found real peace.
Mosul is heavily destroyed. There are still unexploded devices and land mines in the ruins of destroyed houses. These explosives are claiming victims even now.
The need is enormous, the trauma experienced by the people here is hard to imagine
The danger means that not only the reconstruction of Mosul, but also the return of the former inhabitants is greatly being complicated and delayed.
And people are only just starting to rebuild their trust in each other. Many people are simply too traumatised by their war experiences to return yet, having already had to learn to build a new life and process the recent loss of family members and friends.
Patients young and old
MSF has been working in the refugee camps of Qayarah for more than a year. The project I am working in consists primarily of a health centre providing the residents of the camp highly needed access to medical care.
In the project, people of all ages can access both medical and psychological treatment. Since the health care system was well developed before the war, there is also an increased need for treatment options for people living with non-communicable diseases, including, for example, diabetes, cardiovascular disease or asthma.
In addition to that, we are running an outpatient nutrition program for malnourished children. Most of these little patients are still very young – less than six months old – and thus require special attention. This also applies to their mothers, who are often under enormous stress.
A lot of times the mothers of our young malnutrition patients are on their own and have to look after their families without support. This can mean they lack the time and strength to breastfeed their babies.
Body and mind
The last weeks have been busy in other ways too.
At the end of August our emergency room finally opened and guarantees now 24-hour first aid for people living in the camps.
But even more important is the opening of our birth station in early September!
20 babies have already been welcomed into the world in these first five weeks. We have been offering outpatient women’s health care since July, so most of the women come for pre- or postnatal consultations, others for advice on family planning or any health issue that affects women only.
The stories of these women are always impressive, the descriptions of their experiences during the war but also from their everyday life in the camp clearly show what they have been through.
First and foremost, the work is about people who need our support
Our psychological team is another focus of our work and is currently being expanded. The tasks of this team include both individual, family, and group therapy sessions. The need is enormous, the trauma experienced by the people here is hard to imagine.
Again and again we meet patients who have made or thought about suicide attempts – and those we meet are just the tip of the iceberg.
For me, this is already my tenth assignment with MSF. However, this work will never become routine. First and foremost, it is about people who need our support - be it the premature and malnourished twins who are finally, slowly, gaining weight or all those traumatised who are given a listening ear and the time and space to talk.