War, violence, and political upheaval in Iraq have displaced numerous individuals and families, leaving these vulnerable individuals in need of clean water, shelter and food, and access to health care. In southern Iraq, economic collapse, political uncertainty and conflict between militias have contributed to the gradual decay of the primary health care system, and the inability of some rural families to freely travel to central locations to access health care, while continued insecurity has resulted in an exodus of health care professionals.  Women and children often have reduced access to health care, particularly in some rural areas in southern Iraq where social constraints on women's movement combined with severe poverty constrain access to health services available in large population areas. In northern Iraq, Arab internally displaced persons (IDPs) face linguistic barriers which prevent them from seeking medical care until their health conditions become critical and often untreatable. Thus many Arab IDPs encounter discrimination or outright hostility in the existing health sector in Erbil, Sulaimaniya or Duhok, particularly as a growing influx of IDPs is placing pressure on already overburdened and under-resourced health centers and hospitals. While most IDPs live within one hour of a hospital or clinic, structural problems within the Ministry of Health effectively block healthcare delivery, including low staff salaries, short clinic hours, and overburdened physicians who routinely see 150 to 200 patients per day without triage or screening. As a result, diagnosis, examination, patient follow-up and referral are all highly compromised.

Summary

In cooperation with the Ministry of Health (MoH) and in partnership with various Iraqi NGOs, Heartland Alliance provides primary health care services to vulnerable IDPs, returnees, refugees and host communities in northern and southern Iraq.  Through health care centers and mobile medical clinics, Heartland Alliance's medical staff provides basic primary health care, including vaccinations for women and children, prenatal health care services, chronic disease management, as well as preventive education and services to address infectious disease and other major causes of morbidity and mortality. Through these services, this project provides basic health care for up to 10,000 internally displaced Iraqis per month, and is conducted in coordination with the UN Office for Humanitarian Assistance and WHO. 

Activities

To provide primary health care services to IDPs and refugees in Iraq, Heartland Alliance is:

• Providing mobile clinics that offer primary health care for IDPs and host communities, which consist of one to two physicians, one medical assistant, one laboratory assistant, and one social worker, at least one of whom will be female;
• Targeting chronic disease and working with existing MoH facilities to institute basic record-keeping and monitoring of elderly IDPs with chronic diseases;
• Assuring that women have access to prenatal care;
• Improving record keeping and epidemiological surveillance of infectious disease in MoH clinics serving IDPs.