“I was thrown to the ground and almost passed out,” he says. “I received first aid by an army unit and then brought here.” The treatment centre, a small tent by the side of the main access road out of Mosul, is one of the first places where causalities are treated as they are taken out of the combat zone.
Some 20 minutes away, in the biggest ground offensive in Iraq since the US-led invasion of 2003, Iraqi army units are embroiled in a fierce battle to retake Iraq’s second largest city from Islamic State militants. Seven weeks after the start of the Mosul offensive, hundreds of civilians have been critically injured or killed and tens of thousands of people have been forced to flee from their homes.
Run by International Medical Corps (IMC) – one of many aid groups supported by EU Humanitarian Aid in Iraq – the makeshift stabilisation unit treats dozens of patients every day, some with life-threatening injuries. “Once the patients are clinically stable, they are put in waiting ambulances and rushed to the nearest hospital an hour’s drive from here,” says Luigi Pandolfi, a technical expert with EU Humanitarian Aid in Iraq.
Javier Rio-Navarro, who heads EU Humanitarian Aid’s operations in Iraq, is alarmed by the deteriorating humanitarian situation as the fighting has now moved into Mosul’s densely populated areas. “The threat to civilians has exponentially increased,” he says. “We are also concerned about the limited humanitarian access for the few of EU Humanitarian Aid’s partner organisations that are able to operate in the active conflict zone.”
Rio-Navarro said that EU Humanitarian Aid’s main priority at the moment is to ensure medical evacuations of civilian casualties, to provide effective protection and to enable life-saving services to reach civilians. In order to ensure the delivery of emergency healthcare and life-saving surgical care along the main displacement routes out of Mosul, EU Humanitarian Aid has provided over €15 million to partners such as the World Health Organization, International Medical Corps, Première Urgence, the United Nations Populations Fund and La Chaîne de l'Espoir.
Meanwhile, in the camps hosting families displaced by the conflict, EU partners are delivering healthcare, food, shelter, water and other critical assistance. In 2016, €134 million in humanitarian funding for Iraq was mobilised by EU Humanitarian Aid. Over €50 million of this has already been allocated to the emergency response in and around Mosul, as well as to assist people fleeing Hawija, a city south of Mosul and the last major Islamic State stronghold in the oil-rich Kirkuk province.
On the outskirts of the city of Qayyarah, some of those fleeing the escalating fighting are crowded together in the Jeddah camp – one of the many areas in which EU Humanitarian Aid is focusing its ongoing emergency support. Smoke from burning oil wells, set alight by retreating Islamic State militants, casts a black cloud over the entire area.
“We walked for days to get here,” said Muhammed*, who managed to escape Mosul with his wife and four children. “Life is hard in the camp, but at least we are safe. We are worried about the many people who are still trapped inside Mosul.” For those who have been traumatised by the conflict, EU Humanitarian Aid is also supporting programs that provide mental and psychosocial care.
“People have seen some horrible things,” said Michelle Engels, who oversees psychosocial programs at Action Contre La Faim, an EU partner organisation. “Many walked for hours, saw dead bodies along the way; they heard gunfire, saw explosions.We are giving people a space where we can provide educational sessions on stress management in a crisis. We also have psychologists who can provide more intensive psychological support. It’s all about helping people to cope with the conflict.”
Over 80 000 people have been displaced since the military offensive started on 17 October. The UN estimates that as many as an additional 1.5 million people are likely to require humanitarian support by the end of 2016. Of them, up to 700 000 people could be in the need of shelter. As people flee the combat zone, they are being targeted by Islamic State militants, facing cross-fire, improvised explosive devices, snipers and artillery barrage.
Thousands are at risk of being forcibly expelled or trapped between fighting lines, while tens of thousands may be held as human shields or face sectarian reprisal attacks. There is also the risk of public facilities and homes being purposely targeted, booby-trapped or contaminated by unexploded ordnance.
On a recent visit to the Jeddah camp, Jean-Louis De Brouwer, the EU Humanitarian Aid director for Europe, Eastern Neighbourhood and the Middle East, reiterated the need for fighters on all sides to abide by the principles of international humanitarian law. “Money and financial support is one thing, but we also have to make sure that civilians are protected,” De Brouwer said.
“We have made it clear that there are certain lines that absolutely must not be crossed and that there must be a clear distinction made between civilians and combatants.”
Some names and identifying details have been changed to protect the privacy of individual.