WHO’s response to trauma cases saves hundreds of lives in Iraq

WHO has supported the Government of Iraq and the Kurdish Regional Government with emergency lifesaving health services, including emergency medicines and other medical supplies like trauma and surgery kits. These supplies are meant to support the increasing number of trauma cases received at trauma stabilization points and en route to the final points of performing surgery. 

Four-year-old Farouk*, his father and 3 other members of his family were at a water distribution point near their home in Mosul when they were injured. Soon after the incident, a military ambulance team transported them to a hospital in Erbil, making multiple stops at trauma stabilization points to monitor their condition and provide care. 

It took them 4 hours to travel from their village to Erbil because health facilities in the newly liberated areas of Mosul are non-functional. At Hamdaniya, they were transferred to a civilian ambulance for transportation to an emergency hospital in Erbil. Dr Gona Jaafar, a WHO consultant who is training doctors in Erbil on war surgery, was in the emergency room when Farouk and his father were brought in. 

According to Dr Jaafar, during her routine visit to the hospital on 26 December 2016, she saw 3 injured children and one adult lying on the beds in the emergency section, while another adult with an injury on his neck moved from bed to bed checking on the injured. She learnt that this family of 5 had been injured. The 2 children were Farouk’s brother and cousin, one injured on the upper right chest and another injured in both legs.

Both were in a stable condition while the adult patient was Farouk’s father, also in a stable condition. Farouk's condition, however, was more critical. He had sustained serious injuries to his left chest and lower abdomen. “As I checked his pulse, I saw that he was seriously hurt, but he was not crying and frequently tried to close his eyes,” said Dr Jaafar. “And then I noticed something else; in his right hand were 2 keys and one coin that he held tightly. He said to me, "They are mine". 

After his surgery, Farouk was moved to the intensive care unit, and continued to hold on to his keys and coin. Dr Jaafar believes that Farouk could have drawn his strengthen from these objects. Eight days after arriving at the hospital in Erbil, Farouk has since recovered and is out of danger. He remains quiet in his recovery bed, occasionally glancing at medical teams that come to attend to him. 

He and his father will soon be discharged and will head back to Mosul from where the family will continue dressing Farouk’s wounds. Farouk and his father will face additional challenges on their journey back home, as many areas around his area remain inaccessible and insecure. In spite of these uncertainties, he is happy to join his family back home. 

Farouk and his father are just 2 out of a total of 2666 casualties arriving at hospitals in Erbil from Mosul since 17 October. To make sure that they survive the long journey without additional risk, WHO is currently working with the Directorates of Health of Ninewa and Erbil together with health partners to strengthen trauma stabilization points close to the front lines in Mosul, with the goal of ensuring that critically injured patients are referred to hospital as quickly as possible. 

WHO continues to support referrals through 10 ambulances donated to Directorate of Health of Ninawa and 27 ambulance teams belonging to Directorate of Health of Erbil. In addition, WHO is supporting Emergency Hospitals and West Emergency Hospitals in Erbil by building staff capacity and providing medicines and supplies for patients requiring surgical care. On average, the hospitals each receive 20 to 30 injured patients a day. 

The majority suffer from shell injuries and gunshot wounds. Lying next to Farouk was a 14-year-old boy, Mohamed, whose leg was amputated due to injuries he sustained from shelling in another area inside of Mosul. As the conflict continues, WHO estimates that a total of 40 000 people will require urgent hospitalization for injuries. WHO is working with national health authorities and partners to establish field hospitals as well as restore main hospitals closer to the front lines. 

In addition WHO has subcontracted an NGO partner, Emergency, to provide comprehensive care and increase bed capacity for all trauma cases in the emergency hospital. WHO’s activities for the Mosul response are possible with continued support from the European Union (ECHO), the Office of U.S. Foreign Disaster Assistance (OFDA) and the government of Kuwait. 

* Both names used here are not real ones, they have been changed for security reasons.

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