“I still remember the exact moment I understood what it means to be neutral and impartial,” says Abdulrahman Dhannoon Khaleel, MSF Project Coordinator Support in West Mosul, Iraq. “This was 2017; I had only been with MSF for a short time then. We were working in a makeshift hospital in the Nablus neighbourhood, in West Mosul, close to the front line. And injured people were arriving at our hospital every hour.” 

Between the fronts

Between 2016 and 2017, the Iraqi Security Forces, supported by a US-led international coalition, launched a military offensive to retake Mosul from the Islamic State group, who had been occupying the city for three and a half years.  

“The situation was chaotic,” Dhannoon recalls. “One day, we received a wounded child in the MSF makeshift hospital. The six-year-old was being interrogated on the suspicion that his father was a member of the Islamic State group. We put ourselves in front of the boy and protected him. The only thing that mattered to us was that he needed medical help.”

“In the end, it turned out that he and his parents were civilians,” continues Dhannoon. “They tried to flee the city but did not manage to escape the fighting. They were swept away by the battle and got stuck in the old city - a maze of small streets and historic houses, until the neighbourhood was liberated. In the chaos, the young boy was separated from his parents.”

Now, more than four years later, the devastating effects of the war are not only still visible, but also still strongly felt in Ninewa governorate, northwest Iraq, and in its main city, Mosul. Many people are still displaced; people’s psychological trauma remains largely untreated, and many of the damaged health facilities are not yet fully functional again. 

Hope for the future

“I was here when the Islamic State group took the city in 2014 up until the end of the war. It is impossible to explain what that was like,” Dhannoon remembers. “There are simply no words for it... It was like being tortured from the inside. There was no future... nothing.”
 
“The things we have experienced put a heavy burden on us. Nobody talks about that though,” says Dhannoon. “Yes, the war is over, yes, the city is safer, but you can still see a lot of anger and pain in people’s eyes wherever you go.” 

“People here want to look forward,” Dhannoon continues. “Many would say that they are happy, but in reality, we have seen a lot of misery, really a lot of misery.” 

Just like its people, Mosul is fighting to get back on its feet. The traces of the war still shape the cityscape, but reconstruction efforts are progressing. 

MSF teams are trying to heal both the physical and psychological scars of the war by providing access to much needed healthcare for the heavily affected people of Mosul. We run a hospital offering free neonatal, maternity, and paediatric services in the Nablus neighbourhood, on the west bank of the Tigris River. 

Further east, in Al-Nahrawan, one of the poorest neighbourhoods of Mosul, another similar project is run by our teams. At both locations, an average of up to 1,000 children are born and cared for each month. In eastern Mosul, MSF also offers reconstructive surgery and comprehensive post-operative care at the Al-Wahda Hospital. There, our teams provide much-needed care for people injured by accidental or violent trauma. 

From January to October 2021, we provided 1,029 surgical interventions, 4,494 and 1,351 inpatient and outpatient consultations respectively. Psychological support and health counselling services are also available at all three locations.

A recovering health system

“People tend to think that when a battle is over, things naturally go back to normal,” explains Esther van der Woerdt, Head of Mission for MSF in Iraq. “But the truth is that recovery takes years – not to say decades.” 

“Many of the basic infrastructure were destroyed or damaged during the battles and many of them still need to be rebuilt or rehabilitated,” says van der Woerdt. “Public healthcare structures in Mosul are struggling to cover the needs, and some people still cannot afford healthcare, either because they have lost everything in the conflict and/or are hardly making ends meet after they lost their livelihood. In that sense, the free healthcare services that we offer are quite essential for the people.”

Besides providing healthcare services, we are also helping the city’s health system to get back on its feet and are providing the required support to ensure it can cope with new emergencies. In 2019, MSF rebuilt a hospital dedicated to the treatment of infectious diseases in the east of Mosul, to improve access to health services for the local community. 

And between March and December 2020, we supported Mosul’s health system in dealing with the COVID-19 pandemic, by temporarily transforming our 62-bed post-operative care centre (known today as Al-Wahda Orthopaedic Hospital), in the east of the city, into a COVID-19 isolation and treatment centre for suspected and confirmed COVID-19 cases.

From the time MSF transformed the hospital into a COVID-19 facility until returning to our regular activities, our teams cared for 975 COVID-19 patients. To further extend the support to the COVID-19 response in the Ninewa governorate, MSF also ran a 16-bed intensive care unit between November 2020 and April 2021 to offer advanced care for severely and critically ill COVID-19 patients, where 14 patients were cared for.

“Our activities in the city are evolving with the context,” says van der Woerdt. “And we’re trying to adapt to the best of our ability to people’s medical needs, guided solely by our medical ethics and neutral and impartial principles.”