Abstract
Background
The Battle for Mosul began in October 2016 as the world's single largest military operation since the 2003 invasion of Iraq. In anticipation of massive displacement of Iraqi refugees, the Al-Hol camp was erected at the Iraqi-Syrian border meant to respond to the immediate needs of about 100,000 people. The Kurdish Red Crescent (KRC) in partnership with Un Ponte Per (UPP) operated two clinics in the camp, receiving over 200 patients daily.
This study aims to describe health services utilisation, complaints, diagnoses and treatment of Iraqi war refugees in the camp and make recommendations to improve humanitarian response for these vulnerable populations.
Methods
By means of a cross-sectional analysis of all patient data collected in two primary healthcare clinics and an emergency room in the camp between March 2017 and March 2018 are reviewed and analysed, regarding demographics, complaints at presentation, diagnoses and treatment.
Results
Of all 148,743 patient contacts, 93,341 were individual consultations with health services provision to registered Iraqi refugees in both clinics, and 55,402 were Emergency Room encounters.
Most frequent specific complaints (over 20%) were of respiratory origin (including infections and asthma), watery diarrhoea (8%) and urinary tract infections (7.6%). Urinary tract infections, anaemia and vaginal discharge were common among the female population. Non-communicable diseases like diabetes and arterial hypertension were frequent and consistent complaints throughout the year equally in male and female adults. Skin diseases included over 700 cases of leishmaniosis, mainly in the older population and in the first months. Mental health disorders remained under detected and 44% of diagnoses were categorised as unknown or “other”. There were 302 live births, and the highest Crude Mortality Rate (0.21) was in week 33.
Emergency treatment included nebulisations, dressings, injections, suturing, splinting, and stabilization prior to referral to more advanced care outside the camp.
Conclusions
Many Iraqi refugees in Al-Hol sought treatment for illnesses associated with prolonged poor living conditions, combined with seasonal variations in hostile desert climate: respiratory tract infections mainly seen in children, gastrointestinal diseases, urinary tract infections, and gender specific complaints of vaginal discharge and anaemia.