Life and lives in Qayyara

The Qayyara hospital has that chemical-like smell that seems to infuse hospitals the world over, a combination of disinfectant, rubber gloves, despair and hope.

The town of Qayyara, 80 kilometers south of Mosul, was retaken in autumn 2016 and heavily damaged in the fighting.

Qayyara Hospital was badly damaged by conflict, limiting the functionality of the hospital. ©UNICEF 2017/Jennifer Sparks

“Only the ground floor emergency rooms are operational. The rest of the hospital is too damaged to have patients there. It was hit by bombs,” says one of the hospital workers as he shows us rooms full of debris and shattered windows.

While we are speaking, one of the ubiquitous white Toyota trucks seen across Iraq pulls up to the front door of the hospital, and a young man is rushed inside by the men who had brought him.

Many parts of the building are too fragile to enter, but a lack of alternative locations means the emergency room is crowded with people from the surrounding area, as well as from Mosul.

UNICEF’s Health and Nutrition team is visiting a growth monitoring training being held at the hospital for health practitioners working inside camps for displaced families.

UNICEF is concerned by an increased rate of malnourishment of children coming out of Mosul. ©UNICEF 2017/Jennifer Sparks

Department of Health officials and UNICEF supported teams are seeing an increase in the rates of child malnutrition here. Iraq has historically had very low rates of malnutrition; a middle income country, most people are able to feed themselves and their families.

However, limited food supplies in west Mosul combined with families’ dwindling cash supplies has meant that meeting the nutritional needs of their children became increasingly difficult for those caught in the violence.

“The cases of malnourished infants under six months are the ones that stick with me the most,” Maha, one of the trainees, tells UNICEF. “There has definitely been an increase in the number of children who need supplements.”

Despite the damage in Qayyara, the town is quickly coming back to life. Next to heaps of rubble are piles of fresh concrete blocks; new homes are being built next to the ruins of others. Cars twisted by explosions adorn the top of market stalls while newer models of imported cars are stuck in traffic jams. The main road is lined with mechanics’ garages, food stalls and clothing shops.

In the nearby camps, tens of thousands of people from Mosul, Kirkuk, Hawija, Salah al-Din and surrounding villages are still in residence, as yet unable to return home. Medical teams are working hard to make sure that vulnerable young lives are being protected.

Special portable coolers for vaccines are used by mobile health teams in the camps as they go tent to tent delivering immunizations. ©UNICEF 2017/Jennifer Sparks

In the Jeddah 2 camp for internally displaced people, parents visit the “baby huts”, or UNICEF supported centres where children’s growth and nutrition is assessed and vaccines administered.

Disgruntled babies cry and squirm when getting shots or unpleasant tasting polio vaccinations. Some of the older children put on a brave face that often does not survive the jab. Cheeks are lightly pinched so a Vitamin A pill can be administered with the measles vaccine.

Khalid isn’t impressed by getting his Vitamin A supplement to go along with his measles vaccine. ©UNICEF 2017/Jennifer Sparks

In another hut, growth assessments are underway. Those children who are old enough to stand have their height measured against the wall. The littlest ones are laid down on the measuring board — often protesting loudly as the health workers hold their feet still.

Next, a tape measure is laid lengthwise down the upper arm, the mid point marked. The tape measure then wraps around the arm at the marked spot to check circumference.

Babies’ growth is monitored when they arrive at the camp. This child is showing signs of malnourishment, indicated by the measurement reading in the red area. ©UNICEF 2017/Jennifer Sparks

If it reads green and the weight and age statistics correlate, the child is fine. If the tape measure reads yellow or red, or the weight, age, and height measures do not correlate, the child will receive nutritional supplements.

Those found with moderate acute malnutrition (MAM), the child will receive Plumpy Sub — a supplemental food taken every two days.

For cases of severe acute malnutrition (SAM), the child will receive Plumpy Nuts — a high energy, high calorie supplement.

One SAM case being treated in Qayyara Airstrip Emergency Site is 7 month old Aisha. When she and her family arrived in the camp 10 days ago, she was a very ill baby.

Aisha gives her dad a big smile. Mohammed is holding the nutritional supplement that has helped Aisha recover. ©UNICEF 2017/Jennifer Sparks

“We came from Mosul 10 days ago. There was nothing, absolutely nothing. There was no food for adults or for children. My wife wasn’t getting enough to eat, so she couldn’t produce milk for Aisha. That’s why she’s malnourished.”

10 days of Plumpy Nuts and Aisha’s looking alert, reaching for the food packets and giving her dad a big smile. Medical teams will continue to monitor her growth, and treatment will continue until her measurements are up to standard.

Asked them how they celebrated Ramadan. Mohammed says, “We didn’t fast. We’ve gone so long without food that right now we’re trying to get healthy.”

Growth monitoring and nutritional supplements are generously funded by the Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO). More information about ECHO can be found here: http://ec.europa.eu/echo/.


Jennifer Sparks is a communications consultant with UNICEF Iraq.