Potential impact of conflict on health in Iraq

Briefing note: March 2003

Preparing for the health effects of renewed conflict: the work of the international community

The absolute need is for concerted action by all members of the international community to help safeguard the health of people who might be affected by the conflict, and to provide relief to those who face particular dangers.

The goal is a coordinated, flexible, rapid and effective response reflecting best health care practice, in line with the policies and strategies of the national government, and based on the most up-to-date information on population needs.

Guiding principles and goals

The health of all civilians needs central emphasis in the international humanitarian response to any crisis.

The ultimate goal is to reduce illness and death in both the acute phase of the emergency and in the longer term.

This calls for:

• rapid assessment and monitoring of the health situation in different locations;
• the most reliable information on the health situation and needs of different population groups, obtained on a regular basis through surveillance and then made available to those planning and implementing the humanitarian response;
• coordinated responses to people’s health needs during the emergency phase in ways that bring together all national and international partners, thereby maximizing the benefit obtained from available technical resources;
• prompt, authoritative technical expertise and guidance for public health action, including the investigation of suspected disease outbreaks, whatever the cause;
• the training of health workers to respond to specific problems, as needed; and
• advocacy for maintaining people's access to health care, and respect for the neutrality of health professionals and essential health services.

Once the acute phase of the crisis has ended, all those concerned with people’s health must work with national authorities to move rapidly into a planned and effective restoration of the health system infrastructure, functions and services.

The health sector’s coordinated response

Health Coordination Group
The World Health Organization (WHO) has been given the role of leading the Health Coordination Group, a planning and implementing umbrella under which UN agencies, governments, international organizations and nongovernmental organizations (NGOs) have teamed up to provide a coordinated response to health risks in Iraq and surrounding countries during and after armed conflict in the region. The Health Coordination Group aims to be as inclusive as possible and as such welcomes the participation of all organizations which have experience of providing health services and health care support in emergency situations and their aftermath.

The Health Coordination Group is working to:

• achieve the highest possible level of preparedness at national, sub-national, community and family level to limit the health consequences of armed conflict;
• ensure appropriate ordering, procurement, placement and distribution of drugs, medical supplies and equipment;
• mitigate the effects of the conflict on the health of the general population, Internally Displaced Persons (IDPs), Internally Stranded Persons (ISPs), refugees and other vulnerable groups;
• move as rapidly as possible, post-conflict, to restore services and support recovery and rehabilitation of the health sector.

Priority population groups

Planning of response efforts to the health crisis has taken into consideration that different groups of people would have different health needs:

• Resident population: The main activity in the last months has been to strengthen the capacity of the Iraqi health care system by positioning medical supplies and drugs inside the country in order to help Iraqi health workers to manage a potential health crisis.
• Internally Displaced Persons (IDPs): Health kits already stored in the region would be brought into the areas where displaced people concentrate, as soon as security clearance is given.
• Refugees and asylum seekers: All health partners would be working closely with UNHCR to address the health needs of people arriving in camps in neighbouring countries.

Phases

The coordinated response would be staged in phases according to the security situation prevalent in the country:

• First Phase: No access. The health response would be in the hands of Iraqi nationals from the Ministry of Health, UN agencies and NGOs. In the months prior to the conflict, UN agencies and partners trained local staff in preparedness and response in emergency situations. Also, medical supplies and emergency kits already pre-positioned inside the country would be used. Health services would be provided to refugees in camps located in the neighbouring countries, specially in Iran and Turkey, where the biggest influxes are expected.
• Second Phase: Partial access. UN agencies, ICRC and several Health NGOs would carry out cross-border operations to bring in drugs and medical supplies that have already been pre-positioned in neighbouring countries.
• Third Phase: Full access. International and national health workers would work together to re-start the Iraqi health care delivery system and to resume the drug supply system, as quickly as possible.

Supplies and health staff are already in place Kits containing supplies for basic health care are already in place in Iraq to cover around half a million people for three months. In addition, supplies stored in Government warehouses are estimated to be the equivalent of three months normal consumption. In surrounding countries, kits to cover around 150 000 refugees for three months are in place. Supplies for another 750 000 are reported to be in the pipeline or available to be called on within a few days for use in Iraq and the region. Several fully staffed field hospitals and at least 6 self-contained and staffed clinics are on standby.

Almost 250 international staff are in place or can be rapidly deployed to work on health projects and an approximately equal number are on standby to provide back-up, including some specialist care, as needed. The number of national staff that are currently or tentatively planned to be employed by international agencies/organizations is considerably higher. These would complement the staff of the health systems of Iraq and neighbouring countries and volunteers of the national Red Crescent Societies.