What happens when 5500 displaced persons seek refuge in a village of 1500 inhabitants? It happened in Seje, a village in northern Kurdistan. As there are no healthcare facilities for the thousands of Yazidis who fled Islamic State, nor for the local residents, Cordaid is about to open a primary health center to meet the most dire needs.
Circumventing Mosul we travel to the north of Kurdistan, to the village of Seje, not far from the Turkish border. It is located in the governorate of Duhok. On the way, we stop at the only emergency hospital in the city of Duhok, a city of 350,000 inhabitants. We’re at 30 kilometres from the front line of the military operations against ISIL. Chief physician and deputy director of the hospital is Dr Ihsan Abdullah. He divides his time between running the hospital and operating injured civilians and soldiers – Kurdish, Iraqi and yes, also ISIL soldiers.
“Shot wounds, torn off limbs… we see it all here”
“We do not have enough human and financial resources to treat the many injured soldiers and civilians,” he explains. “Shot wounds, shrapnel wounds, suicide attacks, torn off legs and arms… we see it all here. On top of that, Duhok city is full of displaced families. Many of them are Yezidis who fled from Sinjar. They too come to our hospital.”
Before 2014 – the year in which ISIL took nearby Mosul – doctors operated some 15 patients a day in the relatively small hospital. “That number has more than doubled,” says Abdullah.
Imploded economy affects hospitals
But the pressure is not just in the numbers of patients. “The war has devastated the economy. We are facing a financial crisis. We can hardly pay our staff. And there is a shortage of everything, from needles and sutures to important medical equipment.”
But the biggest problem is the lack of essential drugs. “This is literally costing lives”, Dr Abdullah explains. “Of the 20 kinds of antibiotics we only have 2.”
There is extra pressure on Duhok emergency hospital as other hospitals nearer to Mosul refer patients to Dr. Abdullah. “Because of the siege of Mosul, they are even more burdened than we are. And they haven’t got the intensive care units we have. So the agreement is that they refer cases to us.”
Crossing the Tigris
In one of the treatment rooms of Dr. Abdullah’s hospital, we talk to Berivan, an 18-year-old Yezidi girl. She has an acute renal inflammation. In short sentences, she tells us her story, her mother standing beside her. “I come from Sinjar. In 2014, when ISIL came, we had to run. By foot we went to the river Tigris and crossed it.”
For three years now she has been living with her family in an IDP camp in Duhok. “We do not know anything from home. We do not know if our house still exists”, she continues. When she is asked what life is like in the camp, she just says “okay”. She doesn’t want to talk. She wants to get rid of the pain. That’s why she went to the hospital. Like Berivan, many Kurds suffer kidney problems due to the bad quality of the drinking water in the country.
Seje, a village that became a town
To the east of Duhok lies Seje, a small and originally Christian village. The streets are quiet on the Tuesday afternoon that we enter. Most men are either at work or in search of work. Most women and children stay inside.
Seje looks like any other Kurdish village. But it isn’t. After ISIL took Sinjar in 2014, fleeing Yezidi’s found their way to Seje. The village is now bursting at the seams. On top of that the only health center it had – also serving the surrounding villages – closed its doors a short while ago. The local government does not have the means to reopen it.
Yazidis, the most persecuted minority
In August 2014 tens of thousands of Yazidi people – a minority that is particularly hated and persecuted by ISIL – took to the mountains to escape death. This was after ISIL had taken Sinjar, their main city, and slaughtered 2000 of its citizens.
For months, fleeing Yazidis were stuck on Mount Sinjar. Those who could eventually moved on to safer places, especially in Duhok governorate. And thus it happened that 5500 Yezidis found refuge in the village of Seje. They moved in with relatives or friends of relatives, in rented houses, in camps, in containers, in tents.
“My dream is to go home again”
Qovan, a boy of 16, is one of them. He is shooting birds with an airgun, when we meet. Qovan has lived in Seje for more than two years now. “Two days before ISIL came, we fled our village. Fortunately, Kurdish Peshmerga soldiers warned us just in time and told us we had to run.”
Qovan no longer goes to school. “I would like to, but there is no school here in Seje. Hopefully, next year, I will be able to commute to Duhok and go to school there.” He laughs when we ask what life is like in Seje. “I do not know what to think about it. We live in a house without furniture. My dream is to go home. One day.”
Stuck on Mount Sinjar
Omar is in his twenties. He is a Yazidi from Sinjar. He studies psychology in Duhok. When Lavigne Putrus, Cordaid’s health expert in Kurdistan and a medical doctor, asks him some questions, he takes time to answer them. “When we were surrounded by ISIL, we fled to the mountain near Sinjar. We sat there for 6 months. We were stuck. We lived on the food that was dropped from aircrafts”, he explains.
Sinjar has been recaptured on ISIL. But according to Omar the city is largely in ruins. Five months ago he left Sinjar. In order to continue his university studies, Omar left the place. Eventually he found a home in Seje, where a Christian family offered him and five other Yazidi refugees free shelter. His new faculty at Duhok is not too far away.
Health center for 7000 people closed its doors
A month ago, Seje’s primary healthcare center closed its doors. The medical organization that ran the center decided to leave. And the local government does not have the means to take over. It’s a disaster for the overpopulated village. Omar puts it like this: “When you’re ill you easily pay 20,000 Iraqi dinar for a taxi to take you to the nearest hospital in Duhok. And then you haven’t even paid for the drugs that are prescribed by the doctor. Most displaced people cannot afford that. So they simply skip going to a doctor. And their poor health further deteriorates.”
Cordaid jumps in
To provide access to basic healthcare – both to Yazidi IDPs and to Seje residents – Cordaid jumped in to fill in the health gap. Lavigne Putrus: “Our support will allow two doctors, two nurses, one pharmacist, one vaccine expert and two nutritionists to work here. We will make sure drugs are available and people can come for consultations and basic treatments. Children will be vaccinated to prevent the outbreak of diseases like measles. And we will offer special medical nutrition services. This is badly needed, given the fact that we have already detected over a hundred cases of undernourishment among children.”
Seje’s primary health care center will not be able to treat emergency cases. “But we will refer them to hospitals in the area, such as the emergency hospital in Duhok”, explains Putrus.
Less pressure on health systems
These referrals are of great importance. But at least as important is the filtering effect of a well-functioning clinic in a village like Seje. If people have access to medical assistance outside of the bigger cities, they are less likely to end up in one of the bigger hospitals like the one we visited in Duhok. And thus the pressure on healthcare facilities caused by the war becomes somewhat less intolerable.