Shortage of staff and lack of medical equipment have forced smaller hospitals to send patients to medical facilities in Erbil. Photograph: (Getty)
Four years of fighting and destruction have left hospitals scant, and Iraqis impassive to war
After kilometres of a perfectly built road crossing along an empty and harsh desert Iraqi environment, a small checkpoint appears.
“Documents! Where are you going?,” an official says.
“Mahkmour.” The small town is roughly a hundred kilometres south of Mosul. Its hospital, which receives several injured by firearms on a daily basis, will be one of the many structures close to the southern frontline of the Mosul offensive.
“No, you can’t go to Mahkmour. Speak with the commander,” says roughly, a soldier pointing towards an old house on the top of a hill.
The post seems to represent the current Iraqi situation, a place where war has become constant. Military life has become so routine and normal that soldiers care little to exhibit an image of order and discipline. Their rooms are not as the ones we usually imagine: tidy, clean, modular. Probably they were, but after spending years in the same checkpoint in the middle of Iraq, aesthetic becomes less important day by day. Beds are slightly sloppy, evidence of one of the many early and hasty wakening. Shoes are everywhere and weapons - mainly AK-47 - lie on the beds and under the pillows. Walls are not well painted and the floors not too clean. It resembles a long-term jail but without the family pictures, drawings, books or posters, nothing which helps to understand the identity of the people living there. Everything looks impersonal, only imperfections personalise the place: an open packet of cigarettes on the bed, a sun cream tube on a pillow, a movie ticket on the floor, an ashtray full of cigarettes’ butt on the end of a rifle.
The whole atmosphere is the one of a place where nobody wants to be, but it is forced to.
The commander sits in the operational room, his fatigue is open and worn in a casual way, it is slightly bigger than his size. He does not speak a single word of English, only German which he learned when training in Koln. A young Peshmerga soldier approaches the window, he speaks French and is willing to help. “I studied French at the university of Mosul before Daesh came,” he says. The university has now been shut down, he decided to voluntarily join the Peshmerga army after he was forced to flee Mosul with his family.
“Why are you going there?”, asks the commander swatting a fly in a swift motion.
“We want to visit the hospital close to the frontline and understand how things are going there.”
The atmosphere is calm, almost dozy due to the noon heat. The commander looks at us with the expression of a man who found on his way an annoying event which he would have preferably avoided, but now is forced to manage. Several phone calls later the hospital manager agreed to pick us up and take us to Doctor Saman, who prefers not to disclose his surname.
“Fighting is going on in many areas between Mahkmour and Mosul and everyday we have to heal firearms injuries and send the patients to the bigger hospital in Erbil”. The hospital is clean, but small, too small for the number of injured who could arrive once the official operations to liberate Mosul starts.
“I think the doctors are not enough for this situation of war. I think the equipment here is not enough. I think that even the medication we have in order to stabilise a patient, especially in case of emergency, from the frontline is not enough. I am asking the Kurdistan Regional Government to provide us with further medication, further staff,” says doctor Saman.
“How many doctors you have here?”
“We do not have resident doctors. We have rotating doctors coming for a six-day-a-month shift from the capital city (Erbil) and two medical assistants.”
The situation in Mahkmour’s medical facility does not differ from the several others in the area. These structures were mostly built for small towns, and meant to be primary media points with the function of stabilising a patient and send him or her to larger, better-equipped hospitals.
The city lies close to what will most likely be the battle of Mosul’s southern frontline. It won’t be easy to manage the impact of the major ground operation in Iraq, that has been constantly battered since the last four years.
Every time a patient with bullet injuries arrives, doctors have to inform the national security agency, the Asayish which comes in to assess if the patient is a possible Islamic State terrorist.
“As a doctor there is not even a need to ask this question. My job is to save everyone so even if I have to heal a Daesh terrorist I do it, then the security will do the rest.”
A car with three members of the Asayish reaches us in the hospital parking and does not abandon us from that moment onwards, primarily to control our movements. This is something else which happens in war torn areas: limitations.
There are places where you can’t go, things you can’t do, words you can’t say, streets you can’t walk. This is what war does beside claiming lives: it is pervasive, it pauses normality. Whatever the topic, war and its consequences will sooner or later appear. Speaking with a barber while shaving you discover he fled Mosul, the fruit seller at the corner lost his brother in Sinjial against Daesh one year ago, the neighbour’s son left his studies to join the army and fight. Casual interlocutors over a tea or a cigarette have always a war story to tell.
It invades minds and movements and becomes a constant, unwanted guest in the majority of conversations and considerations.