NEXT STOP: IRAQ

January 16th, 2017 Posted by Iraq, Volunteering, W.H.O. No Comment yet

NEW YORK —NYC Medics will be deploying emergency medical teams to Iraq this month to help save civilian lives in the ongoing battle by coalition forces to retake the embattled city of Mosul from ISIS.

Executive Director Kathy Bequary says teams will begin to deploy in February, in two-week rotations, for the next 3- to 6 months and will be operating under the guidance of the World Health Organization. NYC Medics will be setting up a Trauma Stabilization Point (TSP)—a field clinic behind the front lines of the military offensive led by U.S. forces. TSPs are the first point of medical contact with people gravely injured in the conflict and will help to provide those injured with vital emergency and stabilization care. Bequary says it will NYC Medics’ first time volunteering in a political conflict zone since its founding mission to Pakistan 12 years ago following the Kashmir earthquake.

“Latest statistics indicate that 10 percent of the trauma casualties being reported in Mosul are children under the age of 15,” says Bequary. “Operating this TSP will have a life-saving impact on thousands of people caught in the fighting. We can’t stand by while people die because the appropriate medical care is not available.”

Dispatches sat down with Bequary in mid-January, just prior to deployment, to talk about this new mission, which comes in response to an urgent W.H.O. request for humanitarian assistance. What follows is an edited transcript of that conversation.

Q: What is top of mind for you as you prepare to depart for Iraq?

BEQUARY:  This will be the first time that NYC Medics has worked in a conflict zone. We’ve worked in Pakistan and have been in places in Pakistan where foreigners had not been in 50 years, and where they probably wouldn’t go now. So it’s not something that’s unusual for us. But a known and active military conflict is very different and it has a very different criteria and set of standards.  I was just in Iraq, doing an assessment for us to size up the risk and the landscape, and we’ll be inside a secure zone in Erbil, about an hour outside Mosul, where the military offensive is with the coalition forces. It’s where the support is most needed now. There are so many civilians still trapped in Mosul. They have their electricity cut off, no clean water, no access to food. On top of all of this, they’re caught in the conflict between ISIS and U.S.-led coalition forces trying to take back the town from ISIS. It’s very sad.

Q: There are still civilians living and working in Mosul.

BEQUARY: People living there are in grave danger. They’re trapped. People, civilians, are being used—women and children and the elderly—as human shields by ISIS so that ISIS can move through the town during the fighting. ISIS is planting IEDs and using mortar attacks all over the place. These civilians are being injured by that. They’re being targeted when they try to flee, and they are being killed indiscriminately. ISIS is trying to rule by fear. And those people hurt don’t currently have access to the appropriate care necessary to keep them alive in the field and during transport to the hospital where they can receive higher level surgical trauma care. As a global mobile medical nonprofit, we cannot stand by while this happens.

Q: When you stepped up to respond to the WHO’s request for emergency medical teams in Iraq, what were the trend lines in terms of numbers of casualties?

BEQUARY: Growing fast. As of November 17th, there were 455 casualties reported, 17 percent of which were children, and these are grave injuries—gunshot wounds, IEDs, injuries from bombs and mortar attacks. Two weeks later, during the first couple of days of December, that number skyrocketed to over 950 casualties, which prompted the urgent call for humanitarian assistance from the World Health Organization, and it is why NYC Medics is responding. The numbers are growing, still. There is a security zone and inside that bubble is where the coalition forces are working, and we’ll be working at the very front edges of that bubble as the coalition advances further into Mosul. Coalition forces have been advancing quickly and now they are in the city, and there are civilians in there, and (troops) have to go building-to-building and don’t know who or what is in there.

We will be inside that security zone, anywhere from 10 to 15 kilometers behind coalition forces, and we will be the first point of medical intervention for people injured with grave injuries. It’s not going to be a child with diarrhea from dirty water. It’s not going to be kids with fevers. As a Trauma Stabilization Point, we will be the first point of medical contact. Patients will come to us and it will be all about stabilizing the patient and getting them stable enough to be able to go from the front lines to a receiving hospital for more definitive surgical care. Right now, these people are coming in and dying before they can get to the hospital, an hour away. It’s because they’re bleeding out or because their injuries are so great. We’re going to stop that. We are going to stop that from happening. We’re going to intervene by stabilizing these people so they can make the trip to get hospital care. We’ll be saving thousands of lives that are now without access to this kind of intervention.

Q: NYC Medics leaders and volunteers are all highly trained in emergency medicine but what goes through your mind now in terms of ensuring you have all the skills you need in the field for a mission like this?

BEQUARY: This is true-on trauma care. An emergency room here in New York may see a gunshot wound in once every week or two, but in Iraq, it’s going to be happening all the time. Every single patient will be at that trauma care level. Trauma care is emergency medicine, emergency medicine doctors and emergency medicine physician assistants and nurses and especially paramedics, who are very used to working in that very crazy, chaotic environment. They will all play a very significant role and will be assembled into very tight mobile medical care teams, working together.

Q: What about the emotional toll of this type of deployment on volunteers?

BEQUARY: Again, our people and our volunteers have seen trauma care in the field and in emergency rooms. We’re highly trained medics, and as always, we focus on vetting our volunteers very closely, and getting to know who they are individually, and what kind of experiences they’ve had in the past. Are they capable of working in a remote area? A lot shines through when you’re looking at someone’s personality and how they interact with others, and we’ve been very fortunate to have people we already know and we have a team ready to go. We’ve been talking individually to our close-knit volunteers. We’re not putting word out yet more generally until we have a first set of teams ready to go.

Q: So how big of a team do you need to fulfill this obligation?

BEQUARY: First, we’ll be a team of eight, and be there for two weeks. We will do two-week rotations and we’re looking at 3-6 months. There are a lot of people that we’ll be moving. We have to be really smart about how we vet our volunteers and select who we put in the field. And we also have to be very transparent and very clear about how we manage them. You’re going to get pulled from the team if we see you having trouble, and it may just be that you need a day in a hotel to sleep or decompress or it may be that you’re done and you’re being sent home. Safety is first. It’s not only the safety of the individual volunteer, but the safety of the patient and every single team member around them – and the safety of the coalition forces who will be supporting us and be moving around us. It’s everything. Mental health is a huge priority and something we are always focusing on and being very diligent about.

I’ll be the team leader in the beginning and I will need to make sure my teams are strong and capable and ready and well-prepared. We have a duty not only to our patients and the people we are going to help, but also to our volunteers—to make sure they are appropriately trained to work in conflict.

There will be a mandatory training they will have to undergo here in the States and then, when they arrive in-country, we will be working with Peshmerga forces (link here: https://en.wikipedia.org/wiki/Peshmerga) and then the coalition forces and ideally, we’ll also be working alongside the W.H.O.  Every volunteer, upon arrival, will be briefed and updated on all of the security stuff going on and any new policies, practices, and procedures that have to be implemented. They’ll get that as first-hand knowledge before they go out.

And then the other thing we have to really think about is PTSD, for volunteers returning, because you can only see so many blown-up body parts and wounded children without it truly affecting you and staying with you. We’re setting up a service for our people to be able to access post-mission, for them and their families, and to provide support to families while volunteers are in the field and then support them and individually when they return.

Q: When do you leave?

BEQUARY: Our motto is farther, faster – and so I want our teams to start getting there as quickly as possible so we can start helping as soon as possible. These are deaths that, with us there, can be prevented.

Interested in volunteering? Check out volunteer positions available and minimum qualifications for deployment here.

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