The arrival of the COVID-19 pandemic in Iraq coincided with the country’s emerging from a war with ISIS militants and civil unrest that displaced millions of people and destabilized the economy of the country. For decades, the health and welfare sectors in Iraq were neglected for decades due to wars, civil unrest, and sanctions. The weak health infrastructure, shortage of funds and resources, as well as the political and economic uncertainty in Iraq, are identified as some of the biggest challenges in curbing the spread of COVID-19 within the country and providing humanitarian assistance to those who are affected.

Even after three years since the official end of the war against ISIS, the humanitarian situation in Iraq remains fragile. The people of Iraq face protracted displacement, food and water safety concerns, unemployment, and resource scarcities, lack a proper welfare system, and continue to live in uncertainty due to socio-political instability and economic crises. The Covid-19 pandemic has exacerbated the situation in Iraq by slowing development, raising poverty rates, and increasing food insecurity. The poverty rate in Iraq reached 31.7 percent in 2020, and the country was ranked 123rd out of 189 countries in the 2020 Human Development Index (WFP; 2022).

As a result of civil wars and unrest, there are 1.2 million Internally Displaced Persons (IDPs) in Iraq as of January 2021 (Warda and Shihab; 2021). These IDPs live in congested camps, where they are unable to self-isolate and lack access to proper healthcare facilities, clean drinking water, and proper sanitation facilities. Several individuals and families have reported secondary displacements, as they are forced to return to IDP camps because of security concerns, lack of employment opportunities, and resources in their areas of residence. An increase in poverty, a deadly pandemic, a lack of resources needed for upward mobility, and the absence of a proper policy framework to address these critical issues present a very high risk and precarious environment for IDPs in Iraq. The containment measures and travel restrictions imposed to curb the pandemic caused delays in providing humanitarian aid and assistance and exacerbated existing vulnerabilities for IDPs in Iraq. 

Humanitarian Organizations to the Rescue: Strengthening the Health Sector 

The response of the Iraqi government to this crisis was met with severe criticism, highlighting the negligence in implementing proper legal and welfare frameworks to provide assistance to IDPs and safeguard their basic human needs (Warda and Shihab; 2021). The increasing number of cases overwhelmed the health sector of the country, and the IDPs were the most vulnerable due to their precarious living conditions. However, even amidst these challenges, various humanitarian organizations, subsidiary organizations of the UN (United Nations), and many NGOs (Non-governmental Organizations) worked extensively along with the health workers of Iraq to provide emergency medical care and assistance to those in need. 

Médecins Sans Frontières (MSF) deployed emergency medical teams to IDP camps in Iraq to provide medical assistance and mental health support to patients and their families, put up makeshift hospitals and increase bed capacity as well as testing facilities. Furthermore, the MSF provided free and high-quality primary and secondary healthcare services to pregnant and lactating mothers and special treatments to those with chronic illnesses residing in IDP camps across Iraq. 

To combat a deadly pandemic, the health system should be equipped with well-trained health care professionals as well as with critical infrastructure that is needed to function during emergency situations. The entire health system as well as all other sectors of a country should be well organized and prepared to face emergency situations and identify and quickly respond to the dynamics of such situations. As in the case of Iraq, IDP camps also consist of a large number of people with chronic diseases such as lung infections, tuberculosis, diabetes, hypertension, and kidney diseases which are of high risk for severe Covid-19 complications. All these factors highlighted the importance of a well-equipped healthcare system and the preparedness of the health workers in responding effectively to provide good quality treatment for patients and prevent any complexities from threatening the lives of patients as well as the health sector of the country. A team of doctors and experts from MSF responded quickly by collaborating with the management of several hospitals in the country to train their medical and non-medical staff to face emergency situations and took measures to increase the number of treatment facilities, improve logistics and technical support within these hospitals to treat patients who require emergency treatment and special care. 

As an organization which has long term experience in responding to public health emergencies, Oxfam International played a commendable role in developing the health infrastructure in Iraq to support those living in high-risk environments such as IDPs. The weak health infrastructure in Iraq limited access to proper treatment and contributed to poor quality of healthcare outcomes particularly among vulnerable groups such as IDPs. Through their response plan, Oxfam supported hospitals and treatment centers with the renovation of sanitation infrastructure and isolation rooms, provided protective equipment for health workers and worked together with the local community to raise awareness and conduct training programs for health workers. These activities helped to stabilize and improve the health infrastructure of Iraq and provide efficient, safe, and effective healthcare for patients, especially vulnerable groups such as IDPs during the pandemic. 

Precarious Economic Situations and Basic Needs

The inability to find access to basic needs such as proper nutrition, educational materials, good quality sanitation facilities, hygiene items, and a proper income exacerbated the socio-economic fragility of the IDPs. The social and welfare disparities caused by the pandemic, transformed into a fully-fledged economic crisis. The plummeting economic activity because of the pandemic has highlighted the income insecurity of vulnerable populations, exposing them to falling incomes and loss of livelihoods. In this context, various humanitarian organizations in Iraq implemented response plans to address these grievances and help IDPs survive during these challenging times. 

In the city of Erbil many displaced youth have chosen to move to the cities to find part time employment opportunities in small businesses, restaurants, cafes, supermarkets, and construction sites to support their families living in camps or temporary shelters. The lockdowns imposed to curb the pandemic severely affected these youth who depend on informal or day labor as their primary source of income. These individuals and their dependents had to seek assistance from the state or humanitarian organizations. In this light, Oxfam International implemented a strong response plan and came forward to assist IDPs in Iraq by working closely with local authorities and communities. During the lockdowns, the distribution of food and financial assistance to IDPs and low-income families was severely disrupted. However, with the intervention of Oxfam, the distribution process of cash and essential food and medicine for IDPs and other vulnerable families in Salahaddin and Mosul was expedited.  These activities helped vulnerable groups carry out their day-to-day activities and fulfill their basic needs even with the support of limited resources during these challenging times. 

Strengthening the Immunization Process 

The COVID-19 pandemic and associated preventive measures led to the disruption of routine immunization activities of Iraq, resulting in an increased number of children being vulnerable to vaccine preventable diseases such as polio, measles, and rubella. The Ministry of Health of Iraq and UNICEF launched a campaign to support the speedy delivery of COVID-19 vaccines and conduct routine immunization services in all districts and governorates of Iraq by paying special attention to the vaccination of vulnerable populations such as IDPs and refugees who live in congested informal settings and are at high risk of being exposed to the deadly virus. UNICEF also extended their support to the Ministry of Health, Iraq to join the COVAX facility to secure Covid-19 vaccines for approximately a quarter of the population of Iraq. UNICEF also launched a campaign with more than 1,300 mobile outreach teams across Iraq to operate primary healthcare centers throughout the country, train staff to conduct awareness raising programs, and carryout Covid-19 vaccination and routine immunization programs targeting millions of children and those most vulnerable to Covid-19, including IDPs and refugees (UNICEF; 2022). 

Violence and Abuse amidst a Pandemic 

The pandemic disproportionately affected women and minorities living in IDP camps as they are exposed to mental trauma caused by gender-based violence and racism. Due to the weakness and instability of social safety nets, the socio-economic impact of the Covid-19 pandemic on these groups is more catastrophic. These types of marginalized groups are often underrepresented in leadership and decision-making positions and their voices and basic needs are not often taken into consideration. 

The media played a pivotal role in exposing the plight of these highly vulnerable groups residing in IDP camps. After a wide media coverage on the above matter, Ministry for Migration and Displacement in Iraq, several NGOs along with the UNHCR (United Nations High Commission for Refugees) came forward and provided food, sanitizers, cleaning agents and personal protection equipment as well as cash to purchase essential items to IDP camps in Kurdistan region of Iraq where many displaced members of the Armenian minority group are living in temporary shelters (Institute of Development Studies; 2020). 

The role of media institutions in conveying grievances and needs of vulnerable groups to relevant authorities more broadly is a crucial factor. The cordial relationship between the media and humanitarian organizations in Iraq contributed greatly to the wellbeing of female IDPs during the pandemic. Oxfam International responded quickly to media reports on Gender Based Violence (GBV) in IDP camps by distributing food baskets which included flyers on GBV with an emergency helpline for victims. 

Since the outbreak of the pandemic, CARE International in Iraq has been continuing with their water, sanitation and hygiene, healthcare, and gender programs to support the most vulnerable and marginalized groups. CARE and other partner organizations played a crucial role in IDP camps across Northern Iraq by providing business opportunities, career guidance advice and psychosocial support, in particular to women and children. To mitigate gender-based violence and child abuse, CARE has also been carrying out awareness campaigns for IDPs and providing them with information on referral pathways and support services available in different regions of the country. Furthermore, CARE also took measures to improve the condition of health facilities in areas with a high concentration of IDPs, refugees and other marginalized groups by providing good quality laboratory supplies, personal protection equipment, disinfectants as well as high-quality maternity and neonatal care (CARE International; 2020). 

Driving Food Insecurity 

The pandemic disrupted production and supply chains and heightened food insecurity in Iraq. The financial challenges also made it harder for IDPs in Iraq to purchase food and essential items. In response to this, the World Food Program (WFP) has come forward to support 225,000 IDPs with monthly food assistance, mainly in the form of cash transfers. During the pandemic, WFP added 39,000 vulnerable IDPs and refugees in Iraq to its monthly assistance program, supporting them throughout the crisis (WFP; 2022). In addition to cash transfers, the WFP engages in many awareness raising programs for IDPs and other vulnerable groups on good hygiene practices and trains volunteers on taking preventive measures, sanitizing items frequently used for food distribution, and expediting food supply chains.

The WFP has also taken steps to promote new cashless payments for IDPs so that they can purchase food and essential items “contactless” by using their mobile phones, which is both convenient and hygienic. By implementing these programs, the WFP expects to create positive changes in the lives of vulnerable groups in Iraq during emergency situations and support the government of Iraq towards achieving the goal of zero-hunger by strengthening social protection, economic and social empowerment of vulnerable populations and by building community resilience 

Persistent Vulnerabilities among IDPs in Iraq Continue 

Therefore, it is evident that humanitarian organizations such as CARE, MSF, Oxfam, UN Subsidiaries, and many other NGOs played a commendable role in urging the government and policymakers of Iraq to take steps to find durable, long-term solutions to the humanitarian crisis caused by decades of conflict and a deadly pandemic. The continuous efforts made by these organizations pushed political leaders, religious scholars, and community organizations to come forward to strengthen social protection for vulnerable groups through community resilience, youth and women’s empowerment, and increased funding and budgetary allocations to support them and help them survive during crises. However, even after these strenuous efforts, the IDPs of Iraq continue to face many socio-economic hardships and health related challenges that are pushing them towards a very unstable and precarious situation. 

The scarcity of water caused by the drought condition which affected Iraq in 2021, the reduction of humanitarian assistance and the incomplete rehabilitation of public infrastructure play a pivotal role in this regard (MCNA IX Brief ;2022).

 The financial insecurity and social risks caused by the conflict and Covid-19 pandemic, protracted displacement and slow rehabilitation process continue to exacerbate the vulnerabilities of IDPs in Iraq. Their access to basic needs such as health facilities, education, social welfare, and insurance schemes tends to be further limited due to the lack of necessary documentation. In addition to this, the high costs of services are also posing a barrier to the rehabilitation and resettlement processes of IDPs in Iraq. The fragmented access to basic services has increased the vulnerability of IDPs to protection risks and slowed down the process of IDPs returning to their place of origin. Limited prospects to establish a safe and dignified lifestyle and deteriorating economic and social conditions in their areas of return also jeopardizes the resettlement and recovery processes for the IDPs in Iraq. If the acute needs of IDPs are not fulfilled properly through immediate aid and humanitarian assistance, they will face life-threatening consequences which are likely to transform into a massive humanitarian catastrophe. 

Furthermore, all the governing institutions of Iraq, whether federal, regional, or local, do not maintain a sufficient level of preparedness to address emergency situations (Warda and Shihab; 2021). The guidance on safety and humanitarian responses varied between federal, regional, and local governments. These practices were hampered due to neglect and corruption. Therefore, the resettlement process of IDPs were disrupted and they were forced to live in congested camps amidst the rapid spread of Covid-19. 

Recommendations and Way Forward

The COVID-19 pandemic presents four crises in Iraq: health, economic, security, and socio-political. In order to respond to these four crises, it is necessary to ensure economic stability and strengthen livelihood opportunities for those who are most vulnerable to COVID-19, such as IDPs and refugees. The humanitarian organizations and communities that are working to support IDPs have shown us that they are able to adapt to challenging situations and new norms that emerge from these situations. Their strenuous efforts have shown us that they are capable of creating positive changes in the lives of vulnerable groups and guiding them to adapt to new norms and challenges emerging from crisis situations as well as making use of the opportunities emerging from these situations for their betterment. 

However, Iraq is a country which is highly exposed to shocks related to climate change, conflicts, political and economic instability. As a result of these shocks, the resilience of the people and stability of institutions have been repeatedly worn out over the decades. Therefore, it is necessary to implement proper frameworks and policies to rebuild these institutions and allocate more resources for them to build community resilience to ensure social protection for vulnerable groups. 

Therefore, to address these challenging situations properly in future, I make the following recommendations. These recommendations can be used to uplift the living conditions of IDPs during crises in Iraq as well as other parts of the world. Humanitarian organizations should come forward to constantly train and educate community leaders, volunteers, professionals, academics as well as vulnerable groups such as IDPs and refugees to understand the different dynamics of these shocks and challenges imposed by these shocks and prevent inequalities from deepening further through sudden shocks such as Covid-19 pandemic and health emergencies. This can be done by organizing workshops and seminars for both IDPs and policy makers with the support of media institutions. Proper mechanisms should be formulated to strengthen public infrastructure that can face emergency situations without any disruptions and support all sectors to function without any hindrance during emergency situations. 

Humanitarian organizations should also work closely with government ministries and national Covid-19 task forces to jointly develop mechanisms to identify the critical needs of vulnerable populations, encourage donors and foreign governments to facilitate and allocate funds for the wellbeing of the vulnerable groups. These organizations should provide technical assistance and expertise to the government of Iraq to develop the legal framework of the country to address the grievances of IDPs, refugees and urge federal, local, and regional governments to implement a strong coordination mechanism to provide better education, food, shelter, and healthcare to IDPs and rebuild infrastructure that would help to receive and protect IDPs. The federal government should also establish a well-equipped emergency authority to issue early warnings and prepare in advance to face emergency situations, with a special focus on providing aid to vulnerable groups. 

Furthermore, humanitarian organizations should take measures to urge governments and policy makers to implement inclusive and participatory decision-making processes on Covid-19 response and long-term policies and programs to strengthen the recovery and rehabilitation processes of IDPs in Iraq and help them to integrate into society without any fear about their safety and social security. These organizations should also coordinate with government institutions and community leaders to strengthen official data systems to be inclusive of all the relevant information and prepared for crises including advancing civil registration systems, developing national guidelines and quality standards for supporting vulnerable communities and deploying emergency relief systems without any disruptions for them during crises. 

In order to achieve these targets, the active participation of all relevant stakeholders, such as state and community leaders, policy makers, professionals, academics, media institutions, humanitarian organizations, and IDPs themselves, are crucial factors. The positive changes that are required for recovery and rehabilitation can be achieved only through the collaborative efforts of all responsible parties. 


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