Trapped in the middle of an ongoing political and complex civil war in Iraq, the battle for Mosul is escalating. People are being forced to flee their homes to live in harsh conditions and no basic medical care. To respond to these widespread medical needs, Doctors Without Borders/ Médecins Sans Frontières (MSF) continues to extend services for the benefit of war-wounded patients and people in need.
While MSF continues to provide lifesaving emergency and surgical care to men, women and children wounded in the ongoing battle for Mosul, 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. MSF is working on addressing them.”
Today, MSF is working in six medical facilities in and around Mosul, providing medical and surgical attention, including mother and child health care as well as long term post-operative care to those in need of follow-up and rehabilitation after a major surgery. The teams are also treating children suffering malnutrition, as well as primary and mental health care in the newly established camps for people fleeing Mosul.
Hundreds of thousands trapped in West Mosul
Through a strategy of Advanced Medical Posts (AMP), which can be quickly opened and moved according to the rapidly changing medical needs, MSF has so far worked to provide life-saving stabilization and emergency care to people wounded in fighting in West Mosul. Over the last month, MSF has received 175 patients in our two AMPs in western Mosul and referred them to other medical facilities with surgical capacity, such as the MSF trauma hospital in Hammam al-Alil, located south of the city.
Today 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 pediatric department. The objective is to fill urgent gaps in medical services to provide for the most vulnerable population 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. They say that the few supplies available are extremely expensive and that access to health care is almost impossible.
Emergency, surgical and maternity care in East Mosul
In East Mosul, MSF is working in a former retirement house transformed in an emergency room, operating theatre, the maternity as well as inpatient departments. Since the hospital opened at the beginning of March, the team has seen more than four thousand patients, over half of whom were emergency cases performing about 93 caesarean sections.
Moreover on March 29, MSF opened a 15-bed maternity to provide basic emergency services allowing women to deliver safely. Since the opening, the team has brought 130 babies safely 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 which will be ready in the next few days.
Treating patients wounded by airstrikes and mortar fire
Since its opening, almost two thousand 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. Close to 55 per cent of the patients were women and children, and 82 per cent 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, slightly about six thousand patients were admitted to the emergency room. The team in there 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 program and refers 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 NGO Handicap International. Since March 15, MSF has admitted hundred patients, about 45 per cent 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.
MSF mobile teams provides assistance in 17 camps
According to the United Nations, 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 program 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 MSF team has carried out more than 14 thousand medical consultations and more than eight thousand mental health consultations.