Progress Report Iraq and Syria - March 2018

Next CADUS mission in Syria and rebuilding in Iraq – Things are moving on!

We made an request to WHO (World Health Organisation) and are waiting for a reply. If it gets approved and we receive the funds, CADUS can send medics and technicians to Syria in order to provide first aid with our mobile hospital for the next six months. Other requests and plans include: an emergency room, an emergency operating theatre, intensive care (after operations), X-ray capabilities and the ability to give blood tranfusions. X-ray apparatuses in particular are almost nowhere to be found in Northern Syria anymore. If WHO should decline our request (for lack of funds), we would transfer the mobile hospital to a Kurdish  partner organisation – Kurdish Red Crescent (KRC), also known as Heyva Sor a Kurd. This way, we can at least support an organisation who is already working in the area in providing a minimum of medical care for patients. In Iraq, CADUS is going to focus on rebuilding ruined hospitals and installing reanimation rooms. The mobile hospital ist still located in Erbil (Northern Iraq). It was supposed to be transferred to Syria in January. But without visa, no entry.

The biggest obstacle – getting visa for Iraq

We had to wait three month for our technician's visum. Now, it looks like we can finally get started this week! Why are things going so slow? There's always a blocker somewhere. Bureaucracy is arbitrarily putting barriers in our way. Corruption is a major problem. Before he was allowed to leave Baghdad, CADUS technician Martin Lautwein had to pay 400 Dollars after his latest mission. Demanding fees from departing aid workers – that's actually illegal.

CADUS is in it for the long run

CADUS is planning a long-term operation in Syria. This is only possible with financial support from WHO or other major donors. There are still a few financial obstacles. CADUS crew members (medics and technicians) have to be able to take leave from their regular jobs for a month at least. Arrival and departure will take some time and of course you want to get some work done rather than having to leave after just a week. The organisational effort (travel, finding your place in the team, getting to know the procedures and the locality) would be disproportionate to the aid provided. For this reason, we decided to pay a small salary to every crew member, as we know very well that most employes can't just work unpaid for one or two months. CADUS needs visa and permissions for the crew to cross the border to Syria. But also supply of medicine and other material such as bandages has to be ensured in the long term. This point is causing problems for all the other NGOs as well, as it requires more permits, which are hard to get. Crossing the border means stress and lots of bureaucracy. There isn't just one office responsible for checkpoints. You have to go to three, four or five agencies to get your papers. When you cross the border, you will be examined many times at military checkpoints. All this with an international crew, relief supplies, trucks. It's definitely quite different from travelling within the Schengen Area.

Fighting is over in some places – but cities are littered with booby traps

Medical supply gaps are still worst in ar-Raqqa and the surrounding area. Besides a few TSPs (Trauma Stabilization Points), PHCs (Primary Healthcare Points) and one mobile hospital, there is still no adequate supply of emergency care as well as general medical care. In Raqqa, fighting has stopped but the town is littered with booby traps – the legacy of the so-called „Islamic State“. People are still falling victim to these booby traps daily, often with deadly outcome. Not all victims are killed instantly, but very often there is no hospital with an operating room nearby. When patients reach an hospital, it is often too late and they have already bled to death. In this situation, an X-ray apparatus enhances the  diagnostic and therapeutic capabilities of local medics immensely, and considerably improves patient survivability.

No other NGO, no working hospital: That's where we want to go!

The situation is even worse in Deir ez-Zor (in the outh-East of Raqqa) and the surrounding area. There are still fights going on between IS and coalition forces, and there are still IS cells. We also know that this whole area is mined as well. It will probably take years until de-mining can begin. Only some streets are being „cleared“ – those that are used by the military. At the moment, there is no NGO operating in the area and there are no hospitals that are still working, simply because of security reasons.

CADUS is focusing on Raqqa and Deir ez-Zor

Probably we wil go to Raqqa first and – as soon as the security situation gets a bit better – also to Deir ez-Zor. All national and international health partners (such as Kurdish Red Crescent and Doctors Without Borders) as well as WHO are involved in the decision where we will work in the end and when we will move there. This way we make sure that we are closing gaps where they actually exist, but the final decision is ours of course.

WHO support or not – private donations are still essential

A WHO mission and the financial coming with it is not the solution to all problems. Funding by WHO is project-specific. 50 Euro that are approved for syringes have to be spent on syringes – even if we need money more urgently for seals and visa at the moment. For this reason, we still need private donations urgently, as we can command them on our own discretion.

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Author: translated by Konstantin Delles

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