Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-18T10:49:13.931Z Has data issue: false hasContentIssue false
  • English
  • Français

Health and Health Seeking in Mosul During ISIS Control and Liberation: Results From a 40-Cluster Household Survey

Published online by Cambridge University Press:  28 March 2019

Riyadh Lafta ,
Valeria Cetorelli  and
Gilbert Burnham Open the ORCID record for Gilbert Burnham [Opens in a new window]
Riyadh Lafta
Affiliation:
Department of Community Medicine, Al Mustansiriya University, Baghdad, Iraq
Valeria Cetorelli
Affiliation:
United Nations Relief and Works Agency for Palestinian Refugees, Amman, Jordan
Gilbert Burnham*
Affiliation:
Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
*
Correspondence and reprint requests to Dr Gilbert Burnham, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., E8132, Baltimore, MD 21205 (e-mail: gburnha1@jhu.edu).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

ISIS seized Mosul in June 2014. This survey was conducted to assess health status, health needs, and health-seeking behavior during ISIS control and the subsequent Iraqi military campaign.

Methods

Forty clusters were chosen: 25 from east Mosul and 15 from west Mosul. In each, 30 households were interviewed, representing 7559 persons. The start house for each cluster was selected using satellite maps. The survey in east Mosul was conducted from March 13–31, 2017, and in west Mosul from July 18–31, 2017.

Results

In the preceding 2 weeks, 265 (5.4%) adults reported being ill. Some 67 (25.3%) complaints were for emotional or behavioral issues, and 59 (22.3%) for noncommunicable diseases. There were 349 (13.2%) children under age 15 reportedly ill during this time. Diarrhea, respiratory complaints, and emotional and behavioral problems were most common. Care seeking among both children and adults was low, especially in west Mosul. During ISIS occupation, 640 (39.0%) women of childbearing age reported deliveries. Of these, 431 (67.3%) had received some antenatal care, and 582 (90.9%) delivered in a hospital. Complications were reported by 417 (65.2%).

Conclusions

Communicable and noncommunicable diseases were reported for both children and adults, with a high prevalence of emotional and behavioral problems, particularly in west Mosul. Care-seeking was low, treatment compliance for noncommunicable diseases was poor, and treatment options for patients were limited. (Disaster Med Public Health Preparedness. 2019;13:758–766)

Keywords

health-seeking behaviorIraqISISMosul
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 4 , August 2019 , pp. 758 - 766
Copyright
Copyright © 2019 Society for Disaster Medicine and Public Health, Inc. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Doocy, S, Lyles, E, Akhu-Zaheya, L, et al. Health service access and utilization among Syrian refugees in Jordan. Int J Equity Health. 2016;15:108. doi:10.1186/s12939-016-0399-4 CrossRefGoogle ScholarPubMed
Rassekh, BM, Shu, W, Santosham, M, et al. An evaluation of public, private, and mobile health clinic usage for children under age 5 in Aceh after the tsunami: implications for future disasters. Health Psychol Behav Med. 2014;2:359–378. Epub March 27, 2014.CrossRefGoogle ScholarPubMed
Doocy, S, Sirois, A, Tileva, M, et al. Chronic disease and disability among Iraqi populations displaced in Jordan and Syria. Int J Health Plann Manage. 2013;28:e1–e12. doi:10.1002/hpm.2119. Epub 2012 Jun 8.CrossRefGoogle ScholarPubMed
Cetorelli, V, Burnham, G, Shabila, N. Health needs and care seeking behaviours of Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq. PLoS One. 2017;12(8):e0181028.CrossRefGoogle ScholarPubMed
MSF. Health survey in Kutupalong and Balukhali refugee settlements, Cox’s Bazar, Bangladesh. December 2017. https://www.msf.org/sites/msf.org/files/coxsbazar_healthsurveyreport_dec2017_final1.pdf. Accessed August 28, 2018.Google Scholar
Lafta, R, Aflouk, NA, Dhiaa, S, et al. Needs of internally displaced women and children in Baghdad, Karbala, and Kirkuk, Iraq. PLoS Curr. 2016;8:pii: ecurrents.dis.fefc1fc62c02ecaedec2c25910442828.Google Scholar
Lett, RR, Kobusingye, OC, Ekwaru, P. Burden of injury during the complex political emergency in northern Uganda. Can J Surg. 2006;49(1):51–57.Google ScholarPubMed
Al-Salh, S, Arango, T. Sunni militants drive Iraqi Army out of Mosul. NY Times, June 10, 2014.Google Scholar
IOM. IOM tracks Iraqi displacement as 500,000 flee fighting in Mosul. June 11, 2014. https://www.iom.int/news/iom-tracks-iraqi-displacement-500000-flee-fighting-mosul.Accessed August 30, 2018.Google Scholar
White, R. The secret eye inside Mosul. New Yorker, October 27, 2016.Google Scholar
Gradham, D. Islamic State creates jihadi health service. BMJ. 2015;350:h3487.CrossRefGoogle Scholar
Cunningham, E. Islamic State imposes a reign of fear in Iraqi hospitals. Washington Post, November 25, 2014.Google Scholar
Rudaw, Iraq. ISIS executes more doctors in Mosul. Published December 28, 2014. http://www.rudaw.net/english/middleeast/iraq/28122014. Accessed August 28, 2018.Google Scholar
Baskaran, A. The Islamic State (Daesh) healthcare paradox: a caliphate in crisis. Global Public Health. Published November 1, 2015. http://www.ghjournal.org/the-islamic-state-daesh-healthcare-paradox-a-caliphate-in-crisis/. Accessed August 18, 2017.Google Scholar
Lafta, R, Al-Nuaimi, MA, Burnham, G. Injury and death during the ISIS occupation of Mosul and its liberation: results from a 40-cluster household survey. PLoS Med. 2018; 15(5):e1002567. https://doi.org/10.1371/journal.pmed.1002567 CrossRefGoogle Scholar
Siriwardhana, C, Adikari, A, Pannala, G, et al. Prolonged internal displacement and common mental disorders in Sri Lanka: the COMRAID study. PLoS One. 2013;8:e64742. doi:10.1371/journal.pone.0064742.CrossRefGoogle ScholarPubMed
Tawfeeq, M, Abdelaziz, S. ISIS uses water as weapon in Mosul fight. 2016. http://www.cnn.com/2016/11/30/middleeast/mosul-water-isis/index.html. Accessed August 30, 2017.Google Scholar
BBC. Mosul diaries: poisoned by water. Published December 19, 2014. http://www.bbc.com/news/world-middle-east-29600573. Accessed August 30, 2017.Google Scholar
Aboulenein, A. Iraqis dig their own wells in battle-scarred Mosul. Reuters. Published May 11, 2017. http://www.reuters.com/article/us-mideast-crisis-iraq-mosul-water/iraqis-dig-their-own-wells-in-battle-scarred-mosul-idUSKBN1872P0. Accessed August 30, 2018.Google Scholar
Roome, E, Raven, J, Martineau, T. Human resource management in post-conflict health systems: review of research and knowledge gaps. Confl Health. 2014;8:18. http://www.conflictandhealth.com/content/8/1/18.CrossRefGoogle ScholarPubMed
Cetorelli, V, Burnham, G, Shabila, N. Prevalence of non-communicable diseases and access to health care and medications among Yazidis and other minority groups displaced by ISIS into the Kurdistan Region of Iraq. Confl Health. 2017;11:4. doi:10.1186/s13031-017-0106-0.CrossRefGoogle ScholarPubMed
Mateen, FJ, Carone, M, Al-Saedy, H, et al. Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System. Bull World Health Organ. 2012;90(6):444–451.10.2471/BLT.11.097048CrossRefGoogle ScholarPubMed
Doocy, S, Lyles, E, Roberton, T, et al. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan. BMC Public Health. 2015;15:1097. doi:10.1186/s12889-015-2429-3.CrossRefGoogle ScholarPubMed
Al-lela, OQ, Bahari, MB, Salih, MR, et al. Factors underlying inadequate parents’ awareness regarding pediatrics immunization: findings of cross-sectional study in Mosul-Iraq. BMC Pediatr. 2014;14:29.CrossRefGoogle Scholar
Lokuge, K, Shah, T, Pintaldi, G, et al. Mental health services for children exposed to armed conflict: Médecins Sans Frontières’ experience in the Democratic Republic of Congo, Iraq and the occupied Palestinian territory. Paediatr Int Child Health. 2013;33(4):259–272.CrossRefGoogle ScholarPubMed
Bolton, P. Mental health in Iraq: issues and challenges. Lancet. 2013;381(9870):879–881.CrossRefGoogle ScholarPubMed
Al-Nuaimi, MA, Hamad, RA, Lafta, RK. Effects of witnessing or exposure to community violence on mental health of Iraqi men. Qatar Med J. 2015 Jul 9;2015(1):10. doi: 10.5339/qmj.2015.10. eCollection 2015.CrossRefGoogle ScholarPubMed
Gopalan, SS, Das, A, Howard, N. Maternal and neonatal service usage and determinants in fragile and conflict-affected situations: a systematic review of Asia and the Middle-East. BMC Womens Health. 2017;17(1):20. doi:10.1186/s12905-017-0379-x.CrossRefGoogle Scholar
Van der Zee, R. The doctor who ran a secret clinic under ISIS: “I try to put hope in their hearts.” The Guardian. Published March 31, 2017. https://www.theguardian.com/global-development-professionals-network/2017/mar/31/i-try-to-put-hope-in-their-hearts-running-a-secret-clinic-under-islamic-state. Accessed August 30, 2018.Google Scholar
Supplementary material: PDF

Lafta et al. supplementary material

Lafta et al. supplementary material 1

Download Lafta et al. supplementary material(PDF)
PDF 71.6 KB
Supplementary material: File

Lafta et al. supplementary material

Lafta et al. supplementary material 2

Download Lafta et al. supplementary material(File)
File 18.4 KB
Supplementary material: Image

Lafta et al. supplementary material

Lafta et al. supplementary material 3

Download Lafta et al. supplementary material(Image)
Image 91.8 KB