Like every morning, Dr Ramah Essa arrives at the MSF clinic in the Al-Abbasi subdistrict in Kirkuk governorate, northern Iraq, to follow up on patients with chronic diseases. It’s around 8:00 am, and several patients are already waiting for him to arrive. He starts his day with an older woman who suffers from diabetes and hypertension. She regularly comes for routine check-ups.
In this MSF facility, Dr Ramah and his colleague Dr Saif receive patients seeking medical attention for Non-Communicable Diseases (NCDs) like diabetes, hypertension, asthma, epilepsy, and psychiatric disorders. Such conditions require long-term or lifelong medical treatment and close follow-up to avoid developing complications that may lead to critical situations.
“We have between 3,000 to 3,500 patients on treatment who visit us regularly in Al-Abbasi clinic”, Dr Ramah says. “Together with Dr Saif, we see around 50-60 patients on average every day."
Since 2016, MSF has been providing free access to healthcare services to those who fled Hawija during the control of the Islamic State group and the ensuing battles to retake the area, the returnees, and those who did not leave. Our teams first ran mobile clinics at the reception sites for people fleeing Hawija. Then we worked at the displacement camps, where those who fled were settling. But since 2020, these camps have been closed following a decision by the federal government, forcing families to return to their areas of origin and sometimes leading them to face secondary displacement to other regions.
Many healthcare facilities were either partially or entirely destroyed during the battles to retake Hawija from the control of the IS group, leaving the returning population with reduced access to much-needed healthcare services. As the needs of the people and the existing gaps in healthcare provision grew, MSF shifted the activities to focus on NCDs, mental healthcare, and sexual and reproductive healthcare.
Before the battles, the healthcare system had already suffered from shortages in supplies and healthcare workers in this region. But now, with several damaged facilities still not restored or non-functional, along with the additional pressure placed on the system to cater to the healthcare needs of the returnees, meeting the tremendous needs in the area is impossible. People often must travel long distances to attend a medical consultation. Because the facilities close to them are out of service, face shortages, or because they never existed at all.