WHO responding to health crises caused by large-scale population displacements in Iraq

September 2014

Intensified conflict has sparked a massive displacement of people across Iraq, posing a wide range of health threats. WHO and partners are responding to this crisis by controlling disease outbreaks, supplying medicines and strengthening hospitals, clinics and the health workforce.

A child is administered the OPV during the polio measeles NID campaign in Iraq 14-18 Sept 2014.
WHO/Dr. Nima Sa'eed

Armed conflict has triggered massive population displacements in Iraq. The United Nations estimates that 1.8 million people have been displaced since early August; 850 000 of these in the north of the country. Large groups of people have been forced to move as many as 3 times – all leading to major health risks that the government and international agencies, led by WHO, are striving to meet.

“Political, security, and humanitarian challenges are driving the health challenges across the country, where national health systems are under great stress, with many hospitals and clinics damaged, and healthcare workers often caught up by the insecurity,” says Dr Syed Jaffar Hussain, WHO’s representative to Iraq. “A key thing we have done is to convince the Government to strengthen the health infrastructure to respond to the increasing workload.”

Iraq’s humanitarian health crisis was declared a “Grade 3” emergency – WHO’s highest degree of severity - on 12 June, 2014. This means that WHO has been mobilizing all three levels of the Organization – headquarters, regional, and country offices, to respond. At the same time, the Inter-Agency Standing Committee, the international humanitarian community’s lead guidance-setting agency, termed the overall emergency in Iraq a “Level 3” crisis.

Insecurity and massive population displacement expose people, especially the most vulnerable, to a wide range of health concerns. Health-care workers and health facilities are also impacted by the violence. Maintaining appropriate levels of care to deliver essential health services is a major challenge.

Communicable diseases pose major threat

One of WHO’s main concerns in these situations is to prevent and control the spread of communicable diseases such as diarrhoea, respiratory infections and other diseases related to overcrowding. Immunization is a key priority. Earlier this year, 2 polio cases were confirmed: Iraq had been polio-free for 14 years. There is also a high risk that measles could spread. The disease is endemic in Mosul, which has seen half a million people displaced since June 2014.

“The deteriorating health situation and rising temperatures increase the risk of epidemics,” says Dr Hussain. “All the risk factors that enhance the transmission of communicable diseases in emergencies are present in the current crisis in Iraq. Cholera is endemic in the northern part of Iraq and has the potential to cause large-scale illness and death.”

Obtaining sufficient funds to respond to the health crisis is a major concern. WHO estimates that approximately US$150 million is required to respond to the health needs of more than 5 million beneficiaries (1.8 million displaced people and 3.5 million living in host communities). Considerable support has been provided by numerous donors, including Italy, the Kingdom of Saudi Arabia, Kuwait, the Republic of Korea, and the United Kingdom. But more is needed.

WHO responding on many fronts

WHO and its health partners have been undertaking numerous actions, including:

  • vaccinating, with emphasis on polio and measles. Some 18.5 million children under the age of 5 were vaccinated against polio between March and June 2014, and another 3.75 million in August. The campaign included children living in displaced persons camps and host communities, as well as Syrian children living in refugee camps in Iraq, including within three regions affected by the ongoing conflict;
  • making health-care accessible to all displaced people through mobile and fixed health facilities;
  • delivering around 600 tons of necessary medical supplies since June 2014 to health-care providers in areas affected by displacement;
  • strengthening the health workforce by recruiting doctors, nurses, and other professionals, including over 300 staff who themselves were displaced by the insecurity and have been deployed throughout northern Iraq; and
  • deploying partners from the Global Outbreak and Response Network (GOARN) – a team of experts drawn from participating health institutions – to assess the increasing public health risks and to recommend actions to mitigate those risks.

In addition to its massive population of displaced people, Iraq is hosting 250 000 Syrian refugees in the country’s north who require humanitarian assistance and whose health needs place additional strains on Iraq’s fragile health system, as well as a number of Palestinian families who have been subjected to secondary displacement from Mosul.