The bare necessities: How the ICRC is making a difference in Iraq

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Juan-Pedro Schaerer, the ICRC's head of delegation for Iraq, talks about the growing need for essential services in the country. He explains the challenges that the ICRC faces, especially the difficulty of reaching those most in need, and how the organization has been providing uninterrupted emergency assistance by constantly adapting its way of working to the changing security constraints.

What challenges are the people of Iraq facing today and how would you describe the humanitarian situation?

The situation in Iraq started changing in 1980 with the Iran-Iraq war. The process continued during and after the 1991 war and of course the 2003 invasion brought about more sudden and drastic change. The big shift was that Iraq became a more dangerous place for the average person. Bloodshed in Iraq takes many forms: kidnapping, robbery, death threats, sectarian attacks, armed clashes and bombings. Violence has been a factor of Iraqi life for almost 30 years, but its nature and intensity have varied.

Security has improved in certain areas, mainly in the big cities. Iraqis are learning where to go and where not to go. Indeed, this is becoming an essential survival instinct. In some areas you can now stay out until relatively late at night. In others, you have to be more careful.

The only constant in the equation is the growing need for essential services. Security is one thing, but in order to survive - or even to want to survive - people need food, water, health care and shelter. Whether an individual can obtain these essentials depends on whether they are available and whether he or she can afford them. It is not easy to find a job, especially one that pays enough to cover food, electricity, water, health, schools and transport. The minimum wage is USD 70 a month, whereas minimum household expenses are around USD 200 to USD 250 a month (to be checked with IQS). Women are the sole breadwinners in many households, because the men of the family are missing, dead or detained.

Water is one of the main problems. Iraq is hot most of the year and Iraqis consume large quantities of ice. But the chronic lack of electricity affects water pumps and filtering stations, so people have to buy ice made with untreated water. This leads to disease, such as the recent cholera outbreak.

Decent health care is expensive. Treatment for chronic diseases is beyond the means of many Iraqis, as is advanced surgery. Some can afford to go abroad for treatment, but most cannot. The cost of treatment is not the only problem; health services are more readily available in the larger cities, but in rural areas people have to travel.

What are the main obstacles the ICRC faces in Iraq and how does it cope with them?

In any conflict zone, you need two things in order to conduct humanitarian operations: direct contact with people, so you can understand their needs, and a minimum level of security, so you can act on those needs. Not that we can only work where there is peace. The ICRC was 'born on the battlefield' and operates in hot spots all over the world. Taking risks to help people is part of our job. At one stage, however, things got so dangerous for humanitarian workers in Iraq that our work was severely curtailed.

The ICRC started working in Iraq in 1980 and has never left since then, despite the consecutive wars. We did have to scale back our activities, in particular following attacks on our personnel, and most of all after the bomb attack on our Baghdad office on 27 October 2003. However, we decided to stay in Iraq, knowing that people were counting on us. And we still managed to help. It was a drop in the ocean, but that drop quenched the thirst of thousands of people. It was worth it.

Today, security is less bad than it was in 2003. We can reach those in need more readily. But despite the improvements, the security situation in Iraq still imposes too many limitations on the ICRC's work.

Those limitations are a problem, because the needs are growing and we should be doing more to meet them. To work properly, we have to assess the needs before we act and evaluate the impact of our actions afterwards. In some areas we can do this, but in others we cannot. There are needs throughout Iraq, but some areas are simply too dangerous for us to operate in.

The only way that the ICRC can reach the people who need its help is to maintain contact with all those involved in the conflict. The complexity of the conflict and the number of groups involved make it very difficult to maintain these contacts. On the one hand we have to talk to everyone, but on the other hand it is essential that all parties respect our neutrality and our independence.

What are the ICRC's priorities for 2009?

The needs today are great, and humanitarian action can only cover a percentage of the most urgent.

The ICRC will concentrate on the most pressing of those needs that we can meet under our mandate, in the fields of water, food, health, livelihoods, detention and missing persons.