How has the humanitarian situation evolved since the start of the offensive?
The number of displaced people has increased considerably over the last two months. At the start of the offensive, the Iraqi and Kurdish armed forces retook villages around Mosul before arriving at the edge of the city. Over time, there has been a major increase in the number of casualties. Many civilians have been victims of gunshot wounds or stepped on mines while fleeing. Sometimes, people are also simply caught up in the fighting. And the numbers keep on rising: this week, there were 30% more casualties than last week.
This increase in casualty numbers can also be attributed to the number of people who have been returning to their homes over the last few weeks. Indeed, some of the IDPs are beginning to return home, once the violence ended in their region of origin. They often do so risking their lives: these areas are highly contaminated and particularly hazardous for residents, due to the intensity of the fighting that took place there and the large number of improvised explosive devices left behind by the Islamic State group in the field. Apart from these risks, returnees face another problem: there are few services accessible in areas where fighting recently ended, to which humanitarian actors do not necessarily have access yet.
Lastly, the onset of winter marks a tipping point in the humanitarian situation. It’s getting colder and colder in Iraq, so displaced people are faced with numerous problems in their everyday lives. It might be a problem heating their tents, dressing or simply accessing basic things like water. Although the humanitarian effort is better coordinated than it was two months ago, the weather makes the lives of displaced Iraqis much more complicated.
Where are the displaced people living now? What are their living conditions like?
Since the start of the offensive, displaced people have primarily fled to the east and south of the city of Mosul. Some 80% of them now live in camps and the rest live in the surrounding districts, generally with relatives who have already settled there.
The conditions in the camps are very basic: the displaced people need to adapt to life in a tent, to sharing toilets, and so on. But they do have access to basic services and can eat every day. Some of them have not been able to eat properly over the last two years, and they can now eat several meals a day, for example. The children can also go to school, which, for the vast majority of them, they haven’t been able to do for two years.
Various humanitarian organisations are also supplying aid in host communities, where the remaining 20% of the displaced population now live. They do not necessarily have access to basic services and it is therefore vital that humanitarian actors are able to provide them with assistance. Handicap International is part of the network of actors working in both camps and communities. Over the last few weeks, we have set up physiotherapy and psychosocial support activities, and also provided IDPs with risk education activities on mines and explosive remnants of war.
Why is physiotherapy, psychosocial support and risk education on mines and other explosive weapons, essential at this stage in the crisis?
We are dealing with people who have lived some terrifying experiences over a period of two or more years. They are generally in a state of serious psychological distress and some are extremely traumatised. It is vital to assist them as early as possible so that their condition does not get worse. That’s why we offer psychological first aid (PFA) to all of the displaced people we meet. Those who need longer-term assistance can then benefit from psychosocial support or get help from one of our psychologists.
Regarding physiotherapy, the casualties often arrive in large numbers, in the safe areas. Rehabilitation is essential to avoid any type of complications (permanent disabilities and amputations) following an injury or surgical operation. What makes our physiotherapy services all the more important is the fact that displaced people have generally been forced to leave everything behind them, including their mobility aids, if they are already disabled. Apart from people injured in the conflict, the situation of vulnerable displaced people who already have a disability can worsen if we do not intervene urgently.
Lastly, our risk education sessions on mines and explosive remnants of war are just as necessary. Every day since the start of the offensive, men, women, but especially children are injured by explosive weapons. It is vital that they are able to recognise the dangers and know how to protect themselves. What has made these prevention activities all the more urgent is the fact that population movements have picked up speed since part of the population began returning to their region of origin, where there is no fighting anymore.
How do you think the situation is going to evolve over the coming weeks?
The number of displaced people is likely to increase considerably over the coming weeks and months. We also expect an increase in the number of casualties, because fighting in Mosul is getting fiercer by the day. And the winter is going to be very harsh for all displaced people. As for the rest, we can only guess what the situation is going to be like.
However, there are two major possibilities, when you look at what is happening in Mosul at the moment. It is possible that armed forces will employ a “scorched earth” policy over the coming weeks, so that the fighting comes to an end rapidly, but that will probably mean that a lot of people are going to die or be injured. The humanitarian evacuation of these residents is therefore a pre-condition.
The other possibility, and the most probable, is that this offensive will drag on. The number of victims would be lower but life would be much more complicated for the city’s one million inhabitants. Food would begin to run short and we would certainly be faced with cases of malnutrition, for example. That’s without taking into account the fact that basic health care would be almost non-existent for the population there. In either case, the situation is critical and the emergency is going to get worse with each passing day.