Covered in dust, four-year-old Ahmed* sits on his father`s lap outside the MSF hospital in west Mosul, Iraq. The boy devours a biscuit that has just been handed to him, covering his face in chocolate. For the moment, Ahmed seems distracted from the horrors he has survived, including the death of his two siblings. The boy's father, Samir, comforts the child`s grandmother who sits beside them, helping her drink water through parched lips. Her face is a visceral portrait of the family`s hardship.
Just a few hours ago, the family escaped through a deadly gauntlet of conflict and violence from the few blocks of Mosul`s Old City which are still under siege. They lived was right on the edge of the battle between Iraqi forces and the Islamic State group (IS), marked by intense bombardment, airstrikes, suicide attacks, improvised landmines and sniper fire. Earlier that day, the house they were in was re-taken by advancing forces. But the relief came too late.
'My granddaughter died of starvation'
“[Three days ago,] my wife was holding our son when a mortar fell,” says Samir. “The wall collapsed in the room next door where my wife and sister were. At first I couldn`t enter the room; there was so much dust I could not breathe. When the dust settled, I went in and began digging through the bricks. I heard my wife screaming and I uncovered them. I picked them up and carried them out. When I removed all the bricks I discovered my son was dead,” he says. “He was one month and five days old.”
As Samir speaks, his grief-stricken mother alternates between mournful exclamations and filling in the background of the story through her tears. “My granddaughter died of starvation and I also had to put my grandson in the grave. Two of them; one starved to death and the other was hit by a mortar. … I buried them in the garden,” she cries. “We have gone three days without water. Even the water we drank was not good, we have diarrhea whenever we drank it,” she says. “During Ramadan we were starving … we were not even allowed to eat scraps from the trash.”
Samir's wife lies on a hospital bed in a neck brace and his sister is across the ward. It is morning and as medical staff prepare for more patients, the sound of explosions can be heard from the front lines. Yesterday was the busiest day since the hospital opened, less than ten days earlier. Ambulance after ambulance, patients arrived. A little boy with burns covering his arms and legs. A woman appearing to be in shock, her face obscured by blood. A little girl in a flower patterned dress, right leg lacerated by shrapnel and left leg blown off at the knee. Wounded patients, mostly women and children, seemingly poured into the hospital, brought in from the front lines.
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Hunger and suffering
The emergency room has turned into a brutal testament to the horrors this battle has inflicted on residents. A little girl told a staff member how she watched her brother die right in front of her. The air is filled with the sound of sobbing, wailing, cries of pain and shock, and guttural exclamations of relief after finally escaping. Family members accompanying the injured wear stories of hardship on their faces: sunken cheeks due to malnourishment, blank stares, weeping eyes and bodies covered in blood and dirt. One woman sobbing in the waiting room pauses only to drink from a juice box before the tears resume. The little boy with deep burns on his limbs still manages to gobble down biscuits, even as his face is contorted in pain when dirty burn wounds are cleaned by hand.
“Hunger and suffering,” an elderly woman says from her emergency room bed, repeating the words over and over. She is 74 years old and has just escaped the battle zone mere hours earlier. “We tried to convince the children to eat tomato paste. We would boil flour in water… the rice we had was so dirty even animals could not eat it,” she says. “Every day we were dying because of the shelling and airstrikes. We don’t know where it was coming from. I lost half of my weight,” she adds. “We were barely having showers … our skin had all kinds of diseases.”
MSF`s facility is one of only two functioning hospitals in this area, and the first priority is life-saving assistance. Medics work urgently to clear beds for new arrivals by referring patients to other hospitals for follow-up treatment as soon as they are stabilized. Despite the influx of war-wounded patients, only a small fraction of the thousands of residents still thought to be trapped in the fighting is making it here. MSF`s greatest fear is that the most urgent cases are dying on the battlefield due to the intensity of the fighting, unable to access life-saving medical assistance.
Happily, for Samir`s family, his wife and sister are among those who made it out on time. They will be referred to another hospital and their journey of healing will continue. But some scars will not disappear. Samir and his wife had three children, and now only one is still alive. With nothing but the clothes on their backs and no money in their pockets, the family steps into the ambulance after their loved ones have been loaded on a stretcher. Shortly after, the vehicle pulls out of the compound. It won`t be long before the ambulance is back again, with another patient fresh from the battleground.
Many others, still trapped in the unfathomable tragedies of the besieged Old City, may never even make it into the ambulance.
*Patients` names have been changed to protect their anonymity.