Dr. Rivah and her colleagues at Al-Quds Primary Health Care Center (PHCC) in West Mosul, Iraq have their hands full trying to keep two-year-old Mohammed still long enough to administer a polio vaccine.
Eventually, they calm him enough to give him two vaccines in a row. By the time Mohammed realizes what has happened and the tears start flowing, Dr. Rivah is already updating his immunization card, and her colleagues are preparing a new round of immunizations for the next young patient.
Months after military operations to retake Mosul, PHCCs like Al-Quds are still filling a critical gap. They are clinics – not fully resourced like hospitals — operating far beyond their usual capacity. “This PHCC helps the neighborhood. People don’t just come from nearby, they often come from very, very far away to get help. But we’re not a hospital — people don’t stay overnight here,” says Dr. Rivah.
The dim hallways of the two-story PHCC are crowded with people. Surrounding buildings have been damaged – West Mosul was hard hit during military operations to retake the area last year.
Some people have come for routine services; others for emergencies. Women come for obstetric care, including giving birth. This gives staff an opportunity to spread the message about vaccinations. “For mothers who are giving birth here, we tell them about the immunization program, so they know exactly where to come and when,” Dr. Rivah says as she shows the schedule pre-printed on the immunization card which makes it clear which vaccines should be administered at what age.
Medical infrastructure was severely damaged during military operations to retake Mosul in 2017. In addition to regular, prolonged power cuts, there was also a severe shortage of medicine. Hospitals were regularly targeted, and many doctors and nurses were among the 800,000 people who fled the city. Dr. Rivah was among those who stayed. She explains, “I’ve been working here for 4 years. I didn’t leave, but I did have to stop work for a while.”
For many residents, coming to the PHCC is still difficult. One of the most effective ways to ensure children are getting their vaccinations is for medical providers to go to them. “We also have immunizers who walk through the neighborhoods and tell parents about getting their kids vaccinated,” says Dr. Rivah.
Vaccination initiatives are showing positive returns. Iraq remained polio-free in 2017, with two rounds of national polio immunization days undertaken by the Ministry of Health, World Health Organization, and UNICEF, reaching over 5.6 million children under five. UNICEF supported mass vaccination campaigns and nutrition screening for children leaving conflict-affected areas. More than 306,000 children under 15 were vaccinated against polio in Mosul, and nearly 300,000 were reached with measles/rubella vaccination.
Iraq remained polio-free in 2017, with two rounds of national polio immunization days reaching over 5.6 million children under five
Immunization is just one health-related activity UNICEF supports in Mosul, by providing cold-chain supplies and training to government staff who carry out door-to-door vaccinations.UNICEF will soon work with the Department of Health to help rehabilitate water services for hospitals across the city in partnership with the Qatari Red Cross.
For Dr. Rivah, immunization is one of the easiest ways for parents to keep from having to bring their children back to the hospital with a preventable disease. “I’m happy we can help people in the PHCC. People here have suffered a lot. We have all the vaccines available here to help keep children healthy.”
Jennifer Sparks is a communications consultant with UNICEF Iraq and has previously covered humanitarian operations across the Middle East and North Africa.