Mobile medical teams help IDPs in north

Rather than going to the doctor, the inhabitants of the tent village opposite Kirkuk's football stadium wait for the doctor to come to them. This is the fourth time in three months that Dr Ghada Hamid Toma has paid them a visit, and she and they now have the system down to a tee. As they line up patiently, she and her assistants pull three chairs and a blue plastic table out of the back of the Land-Rover and set them up in the dust. Within two minutes, everything is ready for the first patient. Alfa Sadiq complains of recurrent attacks of nausea and temporary blindness. "It always happens at night, when there's not a taxi within a mile of here," she told IRIN. "Even if there was, I wouldn't be able to afford the 1,000 dinar ($0.60) fare to take me into town." Dr Toma has examined her before and knows she has high blood pressure. She checks again, scribbles out a prescription, and sends her over to her medical assistant, Oraha Jokhana, waiting in the Land-Rover. "One of these after every meal," he explained, handing over a thick packet of pills. "Dissolve them in a glass of water." The 300 families encamped here are among an estimated 50,000 returnees to Kirkuk who largely depend for their medical care on mobile teams coordinated by the city's Department of Health. Dr Toma's team is funded by Qandil, a Swedish NGO based in Arbil. The other two are run by Peace Winds Japan and the International Rescue Committee. "Thanks to them we've raised immunisation levels among returning internally displaced people (IDPs) from 25% to 70 per cent," Dr Burhan Omer Rashid, humanitarian coordinator for Kirkuk governorate, told IRIN. But with many more returnees expected in the next few months, he believes he will need two more teams, one for each of Kirkuk's five directorates. The conditions opposite the stadium are rudimentary, and Dr Toma will only be able to spend around three hours here before moving on to the next one of the 170 IDP settlements known to have sprung up around Kirkuk since last spring. Yet in some ways the tent dwellers here receive better attention than they would in one of the city's overstretched health centres. First, there is the issue of cost: patients here pay a nominal fee of 500 dinars ($0.30) for the medicine they receive. More importantly, explains Oraha Jokhana, Qandil's team is not bound by the highly inefficient "top down" drug distribution system that ensures that most heath centre pharmacies are empty by 10 o'clock. He points to the neatly arranged boxes in the back of the Land-Rover - tablets, creams, syrups and pills for chronic conditions. "All this is procured by Qandil," he said. "We keep very close tabs on what we use and what we are asked for. That way, if there's a shortage of something, it can quickly be righted." "We're fortunate in having accurate statistics of the number of people we're dealing with," Dr Toma added. But she insists one of her most important jobs is to educate her patients. "A lot of Iraqis have come to see doctors as purveyors of pills," she said. "If necessary, I give medicine, but as often as not I find myself giving patients very simple advice - wash your hands before eating, cut your nails, and only drink boiled water." "The local authorities pay no attention to us at all," said Lemia Abdullah, whose nine-year old daughter is still suffering from a stomach infection she picked up from bad water before moving back to Kirkuk. "But we're all immensely satisfied with the medical team."