After years of conflict and instability, accessing healthcare is a daily challenge for Iraqis. Seven Aussie women describe their experiences working for Médecins Sans Frontières (MSF) to provide lifesaving and life-changing treatment in Iraq.
Claire Manera, from Perth, WA, is Head of Mission, overseeing a project which encompasses mental health programs alongside basic healthcare, treatment for chronic diseases, nutrition programs, obstetric care, surgery and rehabilitation.
In Iraq, MSF is helping people put their lives back together after years of conflict and devastation. Post-traumatic stress disorder is common for those who witnessed unimaginable events that affected their loved ones. Clinical depression is also experienced by many, especially those who lost their husbands, wives, parents, children, homes and livelihoods, and ultimately, their hope for the future. MSF is providing large-scale mental health programs, including psychiatric treatment and psychosocial counselling through teams of dedicated international and national staff. The changes this support brings to the population are hugely evident, especially in children. This also brings huge relief to the parents; you can see the weight lifted off their shoulders once their children start responding to treatment.
Jennifer Duncombe, from Lake Macquarie, NSW, is the Project Coordinator (PC) in Erbil. Her job involves anything from determining the project’s activities, ensuring safety of the team, facilitating training, and networking to ensure the team’s activities are known and accepted in the community.
There is no typical day for a PC in MSF, especially in a dynamic, often-volatile context like Iraq! Our project has evolved considerably since it started in 2013, following a large influx of refugees from Syria. Our mobile clinic teams went wherever the need was – providing care from the back of a bus, on a chicken farm and in a mosque. Now, as well as treating chronic diseases, we provide high-quality mental healthcare to displaced people coming from places like Mosul and Kirkuk.
I think that too often, mental health gets left behind because we are so consumed by the immediate, gory, in-your-face needs of conflict. Lifesaving care is, of course, imperative. But, sometimes I wonder, what is the point of resuscitating people or reattaching their tendons if we can’t then help them face the consequent, inevitable, inescapable mental trauma of war?
Emma Parker is from Canberra, ACT, and is the Medical Team Leader in the camps for internally displaced people between Mosul and Erbil.
We are concentrating on providing treatment for non-communicable diseases such as diabetes, hypertension (high blood pressure) and heart disease, which are some of the highest causes of morbidity and mortality for people in Iraq. Since Mosul was retaken from the Islamic State group, more than two thirds of the displaced people living in camps have returned to Mosul or surrounding areas. However, we have seen some families return to the camps. They tell us there is nothing left for them in Mosul: houses have been destroyed, there are limited services including water, electricity and healthcare, no employment opportunities and in some areas, security is still a concern. The population we are treating still remains at around 30,000 people.
Many of our patients have experienced horrific things but the hospitality of the Iraqi people stands out: they are always so inviting, wanting to talk to us about our countries and how they feel about both the past and the future of Iraq.
Geri Dyer, from Cairns, QLD, is a psychiatrist treating people in the Erbil project, for conditions including post-traumatic stress disorder, anxiety and depression.
The impact of trauma has resulted in significant mental health problems for internally displaced people in Iraq. Many have witnessed the death of at least one family member or are left with uncertainty about their fate. Some have been tortured. Some already had chronic mental health issues and have been unable to access treatment. The difficult living conditions in camps and poverty also exacerbate the symptoms and can lead to suicidal ideation or suicide attempts. There is ongoing stigma around mental health issues, but the reputation of MSF in providing effective, quality care is growing. Many people are resigned to ongoing conflict in the region, so giving people skills or treatment in an effort to ease their suffering can be extremely rewarding.
Kiera Sargeant is an Australian nurse living in Auckland, NZ, and is the Project Medical Referent in central Iraq.
We provide reproductive health care, treatment of non-communicable diseases and mental health services to returnees within the Diyala governorate. We are fighting the stigma around mental health, using community mental health workers and health promoters to encourage people to talk to counsellors. The women talk about their lives, their troubles, their losses. Many fled their houses, leaving everything behind and losing loved ones. Many thought it would just be for a short period of time, and now when they want to return to their homes, they cannot. The houses have been destroyed, they are too old or don’t have any money to rebuild. Even though it often feels like we are surrounded by sadness, it amazes me how resilient the children are, playing together, combing a doll’s hair or playing soccer. These small things make the tough days easier.
Grace Yoo is from Sydney, NSW and worked as the Pharmacy Coordinator for MSF’s north Iraq project.
My role involved maintaining the supply of medicines and medical equipment, clinical support in regards to medicines and protocols and training the country pharmacist. Our main challenge was getting medical supplies over the border, and gaining access to the multiple locations where we stored our medical supplies. We also grappled with shortage of supplies. In a conflict context like Iraq, it is harder to guarantee the quality of medicines and the needs can change quite drastically.
The most rewarding aspect of this assignment was having the opportunity to work with an amazing group of people. Everyone was dedicated and motivated, especially the local staff. They were so welcoming, always positive and really believed in MSF. It was a humbling experience.
Sacha Myers, from Ballarat, VIC, is the Field Communications Manager in Iraq. She travels to projects around the country, interviewing patients and staff, and hosting journalists.
My job is to tell people’s stories. Every time I sit down with a patient to hear their story, I feel so privileged to do my job. It’s very humbling to hear intimate and often heart-wrenching details about their lives.
My girlfriends in Australia are in all the midst of having kids. When they share stories about the challenges they faced in childbirth, my mind always jumps to the question: would they have survived if they were in Iraq? Although Iraq had a decent healthcare system, years of conflict have destroyed medical services in many locations. It’s particularly hard for women returning to post-conflict areas to access maternal care.