As protests continue to rock the southern Iraq city of Nasiriyah, the capital of Dhi Qaar province, Médecins Sans Frontières (MSF) continues to extend a hand to local hospitals. MSF is helping these facilities scale up their preparedness for mass casualty incidents, whether due to recent violence accompanying the protests or any other event leading to an influx of wounded.

On 1 October 2019, large-scale protests erupted in the Iraqi capital Baghdad. These were soon echoed in other cities in the country’s south. In Nasiriyah, intermittent spells of violence included the use of live ammunition and deployment of tear gas canisters, and left scores of people dead, wounded or permanently maimed.

MSF providing training to local staff

Since December 2019, MSF has been supporting the emergency department of Al-Hussein hospital. Our teams are working with experienced local staff on boosting preparedness for mass casualty incidents and helping them deal with a sudden influx of patients more efficiently.

Additional training on trauma care has also been provided to further strengthen the skills of doctors and nurses at the emergency department, focusing on critical injuries. While adaptations were made to work spaces to accommodate more patients, medical equipment was also donated to the facility.

Furthermore, in collaboration with the department of health, volunteers providing first aid and paramedics in the city were trained by MSF to improve their capacities of dealing with wounded people. First aid kits were also donated to the volunteer medics.

Further west, in the southern province of Najaf, where millions of Muslims from Iraq and beyond converge at Islamic shrines for the two observances of Ashura and Arbaeen annually – which sometimes results in stampedes – MSF has also provided support to local health facilities.

Training to better cope with mass influxes of wounded

There too, demonstrations have been taking place for the past few months. MSF has been providing mass casualty incident plan (MCIP) trainings to local staff at Al-Hakim General hospital, Al-Sadr Teaching hospital and Al-Furat Central hospital, helping in better dealing with an abrupt increased flow of patients.

“Regardless of the ongoing demonstrations in the province, Najaf often witnesses mass-casualty incidents,” says Dr Mohammed Ali, an MSF doctor. “A mass casualty incident plan is a multidisciplinary process that involves medical and non-medical areas in and out of health facilities to coordinate together amidst instability.”

Dr Ali, who oversaw the training, further explains that “the focus is on preventing conveying the chaos from the incident scene into the emergency room at the hospital, and on enabling facilities to provide healthcare to emergency patients without any hindrance.”

MSF responding and supporting hospitals during the protests

These hospitals in Nasiriyah and Najaf are two of many in the country that have been swamped with abundant numbers of wounded people in the past months but the capital Baghdad, where the first spark of the protests was ignited, has taken the brunt of the violence.

“From the first day of the protests, MSF kept a close eye on the situation in Baghdad and reached out to local health facilities to identify their needs,” explains Shaukat Muttaqi, MSF’s Head of Mission in Iraq. “We supported some with donations of emergency medical supplies.”

In the closest hospital to Al-Tahrir square, at the heart of protests in Baghdad, a makeshift emergency service unit was set up in collaboration with local staff to assess the severity of wounds, and either treat or refer patients to other hospitals in the city.

Meanwhile, the capacity of the Baghdad Medical Rehabilitation Centre (BMRC) was increased from 20 to 30 beds to receive more patients referred to the facility after undergoing surgeries in other hospitals in the city. There, patients benefit from early physiotherapy, post-operative care and mental health support to ease and treat the psychological burden of the injuries.