The extremist group known as the Islamic State has been in control of the northern Iraqi city of Mosul for over a year now and health care there has become more and more problematic, a report from the provincial council-in-exile said several months ago.
Doctors, nurses and patients inside Mosul this week confirmed the report’s findings, saying that while some of things mentioned in the report have changed, others have stayed the same. “In Mosul, hospitals have not closed – but they have certainly reduced their services,” says Khalid al-Musali*, a doctor working in Mosul.
“There are no vaccines for children and many essential medicines are no longer available. There is also a shortfall in basic services. For example, there’s no electricity in hospital corridors for 20 hours a day and patient’s rooms are lit by battery. Only the corridors in the emergency department and the intensive care unit are lit continuously.”
Anyone needing an operation usually has to wait between two and three months now. And many types of medication are no longer available in the city, says one Mosul pharmacist who wanted to be known only as Mohammed. Inventories have been used up and at the start of 2015, Baghdad stopped sending medicines and other health supplies to Mosul, knowing that the Islamic State, or IS, group were sending a lot of the supplies onto the other major city they control, Raqqa in Syria.
Now medicines come to Mosul in trucks from Syria and usually these drugs are manufactured in China, India, Turkey or Syria and are of dubious quality. “A lot of medicines are simply no longer available. I myself went to about 20 different pharmacies to try and get medicine my mother usually takes,” the pharmacist added. “The situation now is even worse than it used to be during [the time when Iraq was under international sanctions].”
The number of patients coming for medical care has fallen steeply, reports another employee, mainly because of the costs. “Staying in hospital for just one night costs IQD5,000 (around US$4). In a specialist wing that goes up to IQD30,000 (around US$26). A medical examination costs anywhere between IQD20,000 (around US$20) and IQD250,000 (around US$217) and operations can go up to IQD1 million (around US$870). For example, a Caesarean costs half a million dinars.”
In fact these prices are about the same everywhere in Iraq. But they are extremely burdensome to the locals of Mosul, most of whom don’t have jobs anymore and have not been paid for months. It is also well known that the IS group takes the hospital’s funding for themselves, paying out only around a third of the hospital’s income, workers say.
The medical workers in Mosul have not received any money from the government for months and must make do with what the IS group sees fit to give them. Since the group first took control of Mosul, the extremists have imposed tough conditions on medical staffers – they are not allowed to leave the city under any circumstances and those who don’t show up to work are subject to severe penalties.
Medical staff must also work under strict rules – for example, female doctors are no longer allowed to treat male patients and staff cannot work together with the opposite sex. Official Iraqi Health Department figures suggest that these rules must affect around 2,000 doctors and around 15,000 nurses and other medical staff working in 12 public hospitals in Mosul, as well as in dozens of clinics and doctor’s surgeries around the city.
Those individuals who fled the city early on had all of their property confiscated by the IS group. As a nurse, Ahmad al-Jibouri used to earn around a million dinars every month, thanks to the Iraqi government. Now he gets just IQD75,000 (around US$65) from his new employers, he notes. “And those earning the most, like doctors and nurses, don’t get more than IQD100,000 either,” he adds. “Real income only comes from working at private clinics.”
While the hospitals may have become prisons for the medical staff, they’ve also turned into five star hotels for the IS fighters and their families. “Priority is always given to fighters wounded in battle,” the doctor, al-Musali, reports.
“And there are special pharmacies that provide them with all kinds of medications, all free of charge. Doctors are forced to treat these people no matter where they are, whether in hospital or at a clinic, and nobody can refuse to do so.” The families of members of the extremist group also get preferential treatment, often free of charge. “They get free doctor’s services while others, who are much poorer, have to pay,” he adds.
Nearly all of the doctors and nurses that NIQASH spoke with confirmed the fact that they were under increasing pressure from the IS group. However, as many locals are aware, not all of the doctors in Mosul have fared so badly.
Famous local doctor and senior member of the local medical school, Fares Ali Bilal, is well known for having pledged allegiance to the IS group early on. “In fact he treated [IS group leader] Abu Bakr al-Baghdadi when he was injured in coalition bombings in May 2015,” Hisham al-Hashimi, a researcher into armed groups in Iraq, told NIQASH.
*Names of individuals still in Mosul, or with families still in Mosul, have been changed for security reasons.