Iraq's growing health crisisстатья из журнала
Аннотация: Thousands of Iraqis have fled their homes following attacks by Sunni rebels who have taken over areas of the north and west of the country. Paul C Webster reports. Officials with UN agencies in Iraq and the International Federation of Red Cross and Red Crescent Societies (IFRC) warn that supplies of medicine, food, and fuel have been severely disrupted in and around Mosul, a northern Iraqi city with a population of 1·5 million that has been occupied by anti-government forces since early June. Citing reports from displaced people who recently fled Mosul, Saleh Dabbekeh, spokesman for the IFRC, says hospitals in the city remain open, but are working with skeleton staffs. “Many people working in the hospitals live outside the city and cannot travel to work. Additionally, some physicians are leaving.” On June 21, WHO reported that two of the 14 hospitals in Mosul and its environs have been damaged by heavy shelling. Médecins Sans Frontières also reported that its clinic in Tikrit, a city halfway between Mosul and Baghdad, was severely damaged as a result of a shelling. The fighting has extended beyond Mosul to other cities including Samara, Baquba, and Ramadi, says Dabbekeh. “Accurate figures of casualties are unavailable, but reports claim the figures stand in the hundreds”, the IFRC says. A physician from Fallujah, a mid-sized city near Baghdad wracked by fighting between government and opposition forces in recent months, told The Lancet on condition of anonymity that both the city's hospitals have been damaged in the fighting, that many physicians and health workers have fled, that supplies of food, fuel, electricity, and medicine are jeopardised, and that the government has stopped paying salaries in many conflict areas. The physician said that conditions in Fallujah are extremely dangerous and that the insecurity is now reaching many areas where evacuees from the city earlier fled. In Mosul, primary health-care centres are functioning, although at most only half of staff are working, WHO says. Basic health services, including maternal and child services and chronic disease treatments have been disrupted in some areas and public health conditions in Mosul and the surrounding region are increasingly dire, according to Marzio Babille, UNICEF representative in Iraq. “According to a UNICEF team that recently visited Sinjar and Tel Keif, only a few kilometres away from the front-lines in Mosul, the supply routes from Baghdad have been cut and new supply routes from Kurdistan have not yet been established”, Babille says. “UNICEF and the WHO are now considering airlifts of vaccines and medicine from Kurdistan.” The disruption of fuel supplies will begin effecting the availability of water in Mosul within 45 days, Babille predicts. “This could become a huge issue”, he warns while noting that water chlorination supplies are also in jeopardy. Electricity from the main grid has been cut off in Mosul since June 16, with health facilities intermittently operating generators. The fuel and electricity shortages threaten to disrupt refrigeration of crucial medicines including cold-chain polio vaccines, Babille warns. A recent rash of new polio cases in Iraq—the first in 14 years—has propelled a series of crash vaccination drives since April. “We need to immunise extensively and intensively in secure areas and among internally displaced persons”, Babille said after explaining that due to the recent fighting in Mosul and surrounding Nineveh and Anbar provinces, public health surveillance has been severely curtailed. “We have very little certainty about polio and measles prevalence in the areas affected by the fighting, and among displaced people.” WHO says a recent sub-national immunisation day could only take place in less than 30% of areas of Mosul, and no independent monitoring was possible due to security concerns. At least 500 000 people in Mosul have been displaced, according to the International Organization for Migration (IOM). 100 000 of these people are being hosted in Kurdistan, the IOM says, while 200 000 people who were not able to pass through border checkpoints remain located in disputed areas adjacent to the Kurdish border. A further 200 000 people have been displaced from the west to the east side of Mosul. An additional 470 000 people were displaced earlier by fighting between the Iraqi army and armed opposition groups who have controlled the cities of Ramadi and Fallujah since January. The new flood of displaced people from Mosul almost doubled Iraq's internally displaced persons caseload in less than 1 week and “created an alarming environment in Iraq”, the IOM warned in a June 13 report. An estimated 225 000 more displaced people have fled to Kurdistan to escape fighting in Syria. The influx of Syrian refugees resulted in the resurgence of polio and other infectious diseases including leishmaniasis, WHO reports. “While the Kurdistan health system and health indicators are better than the rest of Iraq”, WHO says, catering for an additional 550 000 people is “beyond its capacity”. UNICEF estimates that half of Iraq's internally displaced people are children. UN officials in Baghdad began warning in April that funding from the Government of Iraq and foreign donors for programmes to help people displaced by the violence was inadequate.
Год издания: 2014
Авторы: Paul Webster
Источник: The Lancet
Ключевые слова: Health and Conflict Studies
Другие ссылки: The Lancet (PDF)
The Lancet (HTML)
PubMed (HTML)
The Lancet (HTML)
PubMed (HTML)
Открытый доступ: bronze
Том: 384
Выпуск: 9938
Страницы: 119–120