14 Jun 2016

MSF - Iraq Battles Shouldn’t Overshadow Grave Humanitarian Needs

As Iraqi security forces battle to retake Fallujah, in the western province of Anbar, from the Islamic State (IS) group, humanitarian needs in this newest hotspot and elsewhere in the country are ever increasing. More and more, the ongoing large-scale military campaigns as well as political factors are overshadowing the pressing humanitarian needs of millions in Iraq.   

In Fallujah, 50,000 people remain trapped in the city and are reportedly suffering from serious shortages of food, water and medical supplies. Some of them leave all their belongings behind and undertake hazardous journeys under snipers fire or make use of rudimentary means to help them get across the Euphrates River to flee the violence. The perilous journeys can last for days in order to avoid active battle grounds around the outskirts of the city. Reports of people being shot dead while attempting to reach safer realms are frequent. Those who make it often end up in crammed camps for internally displaced populations (IDPs) and makeshift tents.  

Those scenes have sadly become absolute normalcy in Iraq in the past two years and the consequences on the population are heartrending. In addition to decades of successive conflicts, internal political instability and the severe economic crisis that have eroded Iraq’s fragile infrastructure and crumbling services, the humanitarian crisis in the country is further magnified by the war in neighbouring Syria.  
Médecins Sans Frontières (MSF) is working across Iraq in 11 governorates providing basic healthcare,   mental health support and emergency preparedness to the most vulnerable populations in areas where security is volatile close to the frontlines.  

Back in June 2014, IS overran Iraq’s second largest city Mosul and Tikrit, abruptly forcing more than 1,000,000 Iraqis to flee their homes. Exactly two years later, more than 3,200,000 Iraqis remain internally displaced causing an increased strain on already destitute host communities.  Overall, 8,000,000 people in Iraq are in dire need of humanitarian assistance. The alarming numbers are expected to steadily increase with no end in sight to the armed conflict in Iraq.  

Military campaigns are under way, relentlessly, in several parts of the country causing massive destruction.  Access to services has become a real challenge for entire communities, host and displaced populations alike.  The scars of the conflict are evidently and progressively affecting the whole Iraqi society.  The human suffering is tremendous.

Deplorably, the humanitarian crisis in Iraq is highly neglected while political goals prevail and military operations continue in full force. The humanitarian assistance delivered so far is largely insufficient if compared to the magnitude of the needs present on the ground.  In several parts of the country basic infrastructure and medical facilities have been badly damaged by the war, potable water is barely available and sanitation conditions are extremely poor.  This continuously exposes to high risks of epidemics, such as cholera which already broke out once in November 2015 due to poor hygiene conditions and inadequate sewage and water system.  
However the unbalance between what is financially invested to sustain the military operations and what is allocated to fund the required humanitarian assistance is staggering. Efforts seem to be solely focused on the battles and the need to crush IS.  This fails to take into account the requirement of ensuring that the Iraqi populations are adequately assisted, their sufferings alleviated and, consequently and ultimately, the society unified. An increasingly fragmented Iraq is therefore in the making.

The response to the humanitarian emergency in Iraq should be prioritised.  People in need do not necessarily have unhindered access to services. Thousands of displaced families are scattered all over the country, very close to frontlines, in isolated informal settlements and obliged to pass through checkpoints or tight security screenings to be able to reach much needed aid.  This represents a significant deterrent for access to care: pregnant women do not feel comfortable to go to a primary health care centre for their antenatal care visit or to a hospital to deliver; patients with a chronic condition would rather not go to take their monthly medicines.  
Urgent humanitarian assistance firmly requires to be provided proportionally to the scope of the military operations. It is becoming unstainable for humanitarian actors to cover ever-growing needs generated by the ongoing military campaigns. Present resources and means simply cannot suffice. While nowadays  humanitarian efforts are orientated  towards covering  the most acute needs of the families displaced from Fallujah, it is imperative to make sure that basic assistance continue to be sufficiently provided to other millions of people in need, equally vulnerable, in other parts of the country.

*Fabio Forgione is Médecins Sans Frontières/Doctors Without Borders (MSF) Iraq head of Mission

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