Iraq's Transition from State of Crisis to Development Response - Doctors of the World

Iraq’s Transition from State of Crisis to Development Response


Iraq was plunged into turmoil in 2003 when the USA and its allies launched an invasion to overthrow the Iraqi government of Saddam Hussein. Though the war ended over a decade ago, in 2011, the consequences have been long-lasting and completely devastating to the country. It is estimated that half a million Iraqis lost their lives, causing at least 9.2 million to be displaced, and resulting in more than 4.7 million to experience moderate or severe food insecurity. 

The war seriously destabilized the region and left it vulnerable to exploitation. In 2014, the Islamic State of Iraq and the Levant (ISIL) was established. ISIL was a transnational militant Islamist terrorist group, which spread further violence and displacement among the Iraqi civilian population until 2017, when the Iraqi government defeated them in Mosul. 


Post Conflict Iraq


At the height of the conflict with the Islamic State, Iraq had nearly 6 million displaced civilians. Now nearly 5 years later after ISIL, significant improvements have been made to the humanitarian situation in Iraq, with the notable decline in the number of people requiring humanitarian assistance from a high of 11 million people in 2017 to 2.5 million in 2022.

Nonetheless, Iraq remains fragile and millions still require assistance. Today, 1.3 million people still live outside their region of origin, 70% of them for more than 5 years. While 4.7 million people have returned to their areas of origin, the humanitarian needs of these populations, particularly those displaced and returned from camps, have increased significantly over the past year. Some 2.5 million people are still in an emergency today, compared to 1.8 million in 2020.

The reasons for this great vulnerability are multifold: trauma linked to the exactions of the Islamic State, community tensions, concerns about the remnants of war, as well as damaged or destroyed housing. The lack of available services, particularly in terms of healthcare and education, as well as the lack of means of subsistence are also reasons for non-return. \

Furthermore, in October 2020 the Iraqi government accelerated the process of closing IDP camps. As of January 2021, it is estimated that more than 45,000 people have had to leave 14 camps in federal Iraq, adding to the one million displaced people living outside the camp. Without a durable rehousing solution, most have found emergency solutions and 30% of them are now in secondary displacement.

Despite its numerous advancements, the state of Iraq remains vulnerable and requires international support to help rebuild itself. But since Iraq is no longer in a state of crisis and as other humanitarian emergencies develop abroad, the funding to support Iraqi development has dwindled significantly. 


A Lack of Health Infrastructure and Medical Staff


Despite the Iraqi government’s defeat of ISIL in 2017, there still remains some operations from ISIS across the country, leading to conflict and armed violence in parts of the country. Health infrastructure and personnel are lacking in the areas most affected by the conflict (mainly the provinces of Nineveh, Anbar, Salah Al Din and Kirkuk) and the damage caused by the violence constitutes a major barrier to access to care for the more vulnerable including internally displaced persons, populations in host regions and refugees from Syria. Large-scale medical aid in Iraq must be deployed in order to lend a helping hand to medical personnel.

Multiple Health Emergencies Unfolding 


The healthcare infrastructure in Iraq has been seriously damaged over the years due to conflict, and has been further dealt with multiple shocks over the last few years. COVID-19 in particular seriously compromised the healthcare system that already was struggling due to a shortage of staff and medicine. In 2019, there were around 8.4 physicians and 19.4 nurses per 10,000 population. Iraq was unable to cope with the additional stress the pandemic added to its healthcare system.

Major health needs include communicable disease prevention, sexual and reproductive health care, care for older people with chronic conditions, mental health needs,  gender-based violence prevention and response. Overall, 76% of total deaths are due to noncommunicable diseases while 10% due to communicable diseases, maternal, perinatal and nutritional conditions and 14% are a result of injuries.

Furthermore, climate change is a growing threat in Iraq. Iraq is reportedly the fifth most vulnerable country to global warming and climate change. The impacts of rising temperatures, worsening droughts, and increasing number of sandstorms are exacerbated by political conditions. Poor governance, including water mismanagement, has contributed to the effects of the drought. It is expected that the water shortage implied by the onset of a major drought could have a negative impact on agricultural production,  and therefore on people’s livelihoods and food security, and increase the risk of the spread of diseases like cholera. Climate-induced migration has already been observed in the most affected part of the country in 2021.

Our Sustainable Support for Local Health Actors


In response to the humanitarian emergency in Iraq and the multiple dangers suffered by the local populations, Doctors of the World has put in place an action plan in several areas.



Meeting the Needs of Refugees


In Iraq, Doctors of the World works in close collaboration to support the Directorates of Health (DoH) in the governorates of Dohuk, Kirkuk and Ninewa, by providing quality health services within 14 primary health care centers.

In the Dohuk region, in Iraqi Kurdistan, Doctors of the World is present in the Chamesku health center, the largest camp for displaced people in the region, providing a sustainable humanitarian response to the health needs of nearly 27,000 inhabitants.

In the governorates of Nineveh and Kirkuk, our organization supports local health actors and centers by providing free essential drugs and medical equipment, logistical support and infrastructure renovation, as well as capacity building for local staff.

We also provide mental health and psychosocial support services (individual sessions and group activities), and refer serious cases to specialized services. In 2021, Doctors of the World began to implement direct services to combat gender-based violence (GBV), exacerbated by the pandemic and the restrictions imposed.


Restoration of Public Health Infrastructure 


Since 1990, our humanitarian actions in Iraq have aimed to improve access to quality health services for all people affected by the conflict, for the displaced as well as for the host communities. However, as conflict continues to decline, our efforts shifted in 2018 to focus on more sustainable support for local health actors by restoring healthcare infrastructure so that they are equipped to face any future health emergencies.

A transition increased by the COVID-19 crisis which encouraged us to provide more support to existing health structures. As part of this development, our organization also supports the integration of mental health and psychosocial support services, as well as services related to gender-based violence. To ensure the sustainability of our actions, our humanitarian mission in Iraq is carried out in consultation with the local populations.

The humanitarian aid deployed by Doctors of the World in 2022 to Iraq made it possible to achieve:

  • 165,246 primary health consultations in health centers,
  • 4,408 individual consultations and group sessions in mental health and psychosocial support,
  • 8,693 sexual and reproductive health consultations
  • awareness sessions on prevention of the COVID-19 pandemic for 54,049 people
  • training of 245 medical staff
  • support for 7 primary care centers
  • 191,275 beneficiaries reached



Iraq Crisis Response Plan 2022-2023

World Report 2023: Iraq | Human Rights Watch

Iraq 20 Years After the Invasion: Humanitarian, Displacement, and Climate Change Challenges.

WHO EMRO | Health system strengthening | Priority areas | Iraq site


© Olivier Papegnies