Iraq: A beacon of hope in Mosul for patients in need of post-operative care

19 Jul 21

Years after the battle against the Islamic State group ended in Mosul, Iraq, the health system in the city has not yet recovered. Patients with violent or accidental trauma injuries still find difficulty accessing adequate secondary healthcare services.

Providing comprehensive post-operative care 

Since 2018, Médecins Sans Frontières/Doctors Without Borders (MSF) has been running services at Al-Wahda hospital providing comprehensive post-operative care to patients from the city and surrounding areas.

“In Ninawa governorate, there is a shortage of skilled surgery staff and post-surgical care,” said Dr. Yuely Capileno, MSF Medical Team Leader, “MSF is trying to fill this void in Mosul and offer these patients a chance to recover.”

MSF’s al-Wahda post-operative hospital in East Mosul.

Many people in Mosul still bear scars as a result of the conflict.

For many, these are debilitating injuries which have dramatically affected their lives.

Most patients who were wounded during the conflict and treated at the frontlines did not receive adequate follow-up needed for their injury to properly heal.

For some, this results in future complications such as wound infection, limited mobility and in severe cases, amputation.

Finding adequate treatment 

But conflict and violence are not the only reason why people need MSF’s services in Mosul. Injuries like traffic accidents or falls, for instance, can cause physical trauma.

The lack of sufficient orthopaedic services in Mosul’s public hospitals and the difficult economic climate in the country has made it challenging for people affected by these accidents to access the care and necessary follow-up needed.

A patient being prepared for operation at MSF's Al-Wahda hospital in East Mosul.

In many cases, even when they have the financial means, patients struggle to find adequate treatment in private hospitals.

“I was treated by the medical posts in the frontlines and was sent to a hospital to be stabilised,” said Saqr Badr, whose leg injury was a result of a targeted sniper as he tried to flee Mosul in 2017.

“After that, I was discharged, but still had a big wound in my leg that would regularly get infected. I stayed in my bed for a long time not able to move my leg.”

Saqr Badr standing in the outpatient department in al-Wahda hospital in East Mosul after visiting for follow up after being discharged from the facility.

In 2018, Badr spent two months at the MSF Al-Wahda hospital in Mosul, before being referred to MSF’s hospital in Amman, Jordan, to complete treatment.

“I came back to Iraq and was finally able to walk. But four months ago, I had an accident at work and broke my leg again in the same place. I ended up coming back to MSF’s hospital in Mosul. That’s the only place where I could be treated,” said Badr.

Responding to COVID-19

In 2020, when the COVID-19 pandemic reached Iraq, the hospital was temporarily transformed into a COVID-19 treatment facility for suspected and confirmed cases.

“We wanted to continue to support the healthcare system and at the time, it felt logical to temporarily switch the services in our facility,” said Capileno.

The inpatient ward in Al-Wahda hospital in Mosul when it was a COVID-19 treatment and isolation center.

Between March and December 2020, almost 1,000 COVID-19 suspected, and confirmed patients were cared for at the hospital.

When the hospital returned to its regular activities in early 2021, it had undergone major upgrades.

"Patients with multidrug-resistant infections are given single rooms, rather than staying in open-plan wards, to avoid the spread of infection to other patients and medical staff"

DR. YUELY CAPILENO, MSF MEDICAL TEAM LEADER

The 33-bed inpatient ward had been replaced with 40 individual isolation rooms.

“The isolation rooms made sense when we were treating COVID-19 patients, but these are also very useful for our regular activities. Many patients admitted to the post-operative care hospital arrive with multidrug-resistant infections, and antibiotic resistance is a problem throughout the country so ‘contact precautions’ are fundamental. Patients with multidrug-resistant infections are given single rooms, rather than staying in open-plan wards, to avoid the spread of infection to other patients and medical staff,” said Capileno.

Expanding the admission criteria

Two additional operating theatres have also been built to make room for advanced surgery.

Dressing change for one of the patients in the inpatient department at Al-Wahda hospital in East Mosul.

“At the beginning of 2021 we expanded the admission criteria. Now we treat a variety of cases ranging from fractures requiring fixation, complex fractures, corrective surgery, all types of chronic osteomyelitis, and medical complications associated with amputation.”

"Patients staying at our facility often tell us that they don’t know what they would have done if we weren’t here"

Dr. Yuely Capileno, MSF Medical Team Leader

Since the beginning of the year, MSF teams have conducted more than 400 surgical interventions and provided more than 2,600 consultations to patients in the outpatient department.

MSF also provides mental health services, health promotion, and physiotherapy for patients coming to the hospital.

Eleven years old Mustafa laying in MSF’s Al-Wahda Comprehensive post-operative hospital in Mosul.

“Patients staying at our facility often tell us that they don’t know what they would have done if we weren’t here. By adapting and expanding our activities, we hope to serve even more people in Mosul and to continue offering relevant medical services for the people who need it,” said Capileno.

MSF in Mosul

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To support the recovery of the health system in Mosul, MSF also provides comprehensive and basic maternity services in the city.

In June 2017, MSF opened Nablus hospital in west Mosul to provide safe, high quality and free maternal and neonatal care to women and their babies in an area of the city where the community and the health system continue to struggle.

In July 2019, MSF opened a smaller facility at Al Rafadain Primary Health Care Centre, also in west Mosul, providing routine obstetric and newborn care and offering local women another safe place to deliver.

Combined, these two facilities welcomed more than 11,500 babies in 2020.

The teams also offer high quality care to sick and premature newborns, family planning services and gynecological consultations.

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