Five days in Iraqi Kurdistan By Louise Hart Tuesday: We’re on our way to Kurdistan for a four-day visit. On the plane to Erbil, we have the chance to observe our fellow travellers at close quarters. Most are white Westerners, and virtually all are men, but there is some variance. One unsmiling burly man wearing sunglasses surely works in security? Another – a friendly, slightly anxious young American – tells us he is here to work for an NGO, supporting orphans. We circle Erbil, waiting for clearance to land, and see patches of white across the horizon: refugee camps. In the distance glints the Great Zab river, and further on is Mosul, from where many camp occupants have fled. Over brown dusty grasslands, our plane comes down and lands next to a cluster of Apache helicopters. Other battle-ready aircraft line up beside the runway. Passing through immigration, Alex is gently quizzed on whether he is in the military. They hardly give me a glance and don’t ask the same questions – leaving me mildly disappointed. Exiting the airport, we undergo additional security checks that keep Kurdistan safe, even from the rest of the country: our luggage is scanned a second time. Dusk falls as we drive through Erbil: fragments of the city light up unpredictably around us, and the muezzin’s call to evening prayer rings out. Hotel security is strict too. A wall-mounted photograph of Kurdistan’s president passing through a body scanner makes clear no one is exempt. Wednesday: Our first full day in Kurdistan is sunny. We soon discover Erbil is a spacious, airy city, with nice cars using well-maintained roads to weave through a bustle of enterprises. The heart of Erbil lies in the citadel, a mere 6,000 years old. Today is a day to meet potential new partners. One meeting is at the UN compound, where we’re held at the inner security gate for 35 minutes as guards try to find the people we are here to see. Eventually, we are waved inward to see someone who makes it clear we aren’t his top priority today and hustled onward 15 minutes later. We’re in! Later we meet the representative of an aid agency whose strict security policy has kept him living and working for two months in a hotel he’s only rarely allowed to leave. Suffering cabin fever, he’s delighted to have company and looks enviously at our planned schedule of visits. He’s heavily involved in policy-making around the camps for internally displaced people (IDP) but explains wistfully that he’s never actually seen one. As we meet with peer NGO agencies, this helps fill gaps in our understanding. In this region, events and context shift rapidly. We’re at the slightly awkward stage of anticipating the move from emergency response to recovery phase – it’s imminent but not yet upon us. The question of what to do with Kurdistan’s two million refugees and IDPs is one that no one can yet answer. Meeting humanitarian needs while managing security concerns about the potential for IS to infiltrate constitutes a tricky balance. The result is a containment policy that keeps affected individuals in camps with no clear long-term plan. Thursday: Today it’s cold and wet. We collect paperwork from a local partner’s office, then swing by a warehouse to load boxes of medicines from a chilly, air-conditioned environment into the back of our vehicle. On the road to Mosul, we pass cars heading the other way, some being stopped at checkpoints. They’re crammed full of people and possessions. We also pass refugee camps with distinctive white tents arranged in neat lines that stretch far into the distance. Crossing a river, we come into territory formerly held by IS. Buildings are riddled with bullet holes, streets are strewn with rubbish, and entire towns and villages are deserted, half destroyed by blasts. On the doorstep of one of these abandoned towns, we arrive at our first IDP camp. Poignantly, it houses some of the town’s inhabitants, who can see their former homes as soon as they open their tent doors. Destroyed infrastructure and the risk of unexploded bombs prevent them from going home – and now, with border shifts and reclamation of land, it’s even less likely to happen. Originally Iraq, then occupied IS territory, this is now part of Kurdistan. As battle concludes, families who used to live here will be caught in the middle, the future uncertain. The camp entrance is covered with NGO signs offering solidarity and services. People carry blankets that have been handed out recently, very welcome possessions on a morning like this. As we drive into a controlled area of the camp, joining a throng of standard-issue NGO land cruisers, we watch the people disappear into the rows of UNHCR branded tents. This camp was built to house IDPs who fled when joint forces began to drive IS from eastern Mosul. Security concerns about infiltration have led to a containment policy, restricting movement into Kurdistan. People here can return to Mosul if they want to, but Mosul offers little safety and few services. So, for now, they wait and watch. As we park, people stand around the gate, looking in – waiting for nothing in particular. That’s what strikes me most about this place. Everyone is in limbo. This is not a life anyone wants. The individuals we see have fled terrible, frightening situations. Yes, they’ve reached a place of comparative safety, but now they’re in a holding pattern, waiting for another phase of life to begin. And until it does, they can do nothing. They’re unable to go home, unable to go anywhere else, unable to work, and unable to plan any sort of future for themselves or their families – even to change what happens tomorrow. We’re glad to visit the camp clinic and speak to doctors working there. We also talk to camp residents, and one family of ten invites us into their home: a medium-sized tent. It has a few non-food items distributed to all new arrivals: a jerry can for water, a cooking pan and some pillows. Other than these, there’s not much inside the tent, but the family is incredibly welcoming. Before we can say no, they brew us a cup of tea. The smallest child is seven months old, rosy-cheeked and wonderfully photogenic. Knowing this, his proud mother rearranges him for better angles as we take photos. Later, we meet a senior figure from the regional health administration. He talks of how economic crisis has paralysed Kurdistan but says this does not undermine commitment to meet the humanitarian needs of those fleeing conflict, despite challenges and financial burdens. To me, this is typical of the generous hospitality we’ve encountered from everyone we’ve met today. Friday: Alex and I are feeling much more at home. It’s sunny again today and having been here a little while, I’m feeling less worried about security concerns. We visit two clinics that receive medical support through our local NGO partner. Friday is the beginning of the weekend here, and it’s soon clear that the medics who work at the clinics have volunteered to come in to talk to us on their day off. The significance of this gesture emerges as they tell us they’re only being paid a fraction of their salaries, and then only sporadically (because of the economic crisis). Supplies of medicines are running low, and they are frustrated they can’t treat patients that come to them for help. They’re willing to try to make a difference by coming in their spare time, reaching out to us and asking for needed medicines. We visit our partner’s two warehouses. In the medicines warehouse, we carry out a Good Distribution Practice (GDP) audit to check our supplies are stored and distributed suitably. In a much larger warehouse, the partner is storing a mountain of other donated goods for wider needs: blankets, clothes, football boots, toys and equipment piled high. Here and there are inappropriate or damaged items that represent the worst kind of donation dumping. But, overwhelmingly, what’s here will do a lot of good. In the afternoon we visit a second IDP camp, established earlier and much closer to Erbil. Four hundred families living here fled when IS first invaded Mosul. They were spared living under IS occupation and the worst of the fighting, but they’ve now been in this camp for nearly three years. For the small children playing in the road, this is normal life. There’s more of a sense of permanence. The camp has formal streets, proper drainage, and signs demarcating different areas. Families are housed in ‘caravans’: prefabricated small cabins donated by the Taiwanese government. These aren’t always bigger or warmer than tents, but doors can be locked, providing a sense of privacy and security. The camp has electricity, and we spot upgraded roofs, individual water tanks and even satellite dishes. As people here left before IS took hold, they are allowed to leave and travel around more freely. There are signs of enterprise such as a small shop, a bakery, and even a hairdresser. In some ways it’s good to see signs of normality; on the other, it’s sad this should become normal at all. We’re about to leave when a car pulls up, beeping its horn loudly. It’s a familiar signal: we realise this as children appear from all directions clutching empty saucepans and congregate in a jostling mob behind the car, ready for food to be handed out. Normal? Hardly. Saturday: We visit the hospital, where security is tight because it’s treating the victims of an IS chemical attack. It’s tricky to gain entry, and when we do manage it, we pass several people from the media and camera operators waiting for access. The pharmacist tells us how desperate things have become since the economic crisis. He shows us how stock is significantly depleted. Many shelves are empty. Then he takes us through the hospital to meet patients. We’re hoping to meet people who’ve received the medicines IHP can provide; but instead, he introduces us to victims of the chemical attack. One woman tells a shocking story and I feel bad we are causing her to relive that trauma. Instinctively, I touch her on the arm to say thanks, but as we go out, our host quietly reminds me that physical contact with someone exposed to a chemical weapon is a bad idea. He makes me sanitise my hands. In the intensive care unit (ICU), we find none of the protective disposables you’d expect. They’ve run out, the nurse tells us. Two patients are men, and a third is a five-year-old boy who has fallen from a height. His body is tiny and frail, dwarfed by the adult bed, and his head is wrapped heavily in bandages. The parents, on each side, are murmuring to him and kissing his hands. The boy opens one eye, but it is not clear if he can see or comprehend them. A week ago, he fell from a roof he was playing on. The hospital is doing everything it can, but it has run out of several of the medicines it needs to treat him. Worse, doctors do not have the equipment to gauge the pressure on his brain. Without this capacity, they cannot tell how bad his condition has become, or determine the correct dosage of medicines. It’s all guesswork. Silently, the boy’s mother begins to cry. I’ve seen many emotive things, but it’s this one that causes me to tear up. Afterwards, we head to the burns unit. From outside, we can hear cries of pain from people suffering inside. Suddenly we’re given disposable protective gear, though I notice that no one else going into the ward is wearing any. The first two people we meet have attempted suicide. One is a 15-year-old boy, his torso covered with bandages. He tried to kill himself by setting himself alight and exudes weary misery. We mutter our apologies and move on. The second case is similar; this time a sorrowful-looking young woman with bandaged hands and feet. The doctor gives a fleeting explanation about a family dispute over an arranged marriage. A third patient is severely burned, her body barely visible under a swathe of bandages. Her sister-in-law is with her and explains she had an accident with a kerosene heater. The hospital has run out of certain medications, so this family must buy their own help. One bottle of medication, needed twice a day, costs $70-80. Few people in Kurdistan can afford to do this for long, if at all. As we leave the room, we find out it’s likely this was another attempted suicide. It’s hard to be positive, but our partner host arranges a final lunch for us before meeting his next set of newly arrived guests (who are here to support other camp initiatives: football and sewing projects). Our four-day visit has opened our eyes and given us valuable insights into the health work happening in Kurdistan. Thinking of those I’ve met, I feel the weight of responsibility to ensure that we can put to good use the time and effort people have spent in telling us their stories and showing us their situations. As an organisation, we want to use what we learn to raise awareness of the needs in Kurdistan and increase donations of medicines and medical supplies that are desperately needed.