“My name is Nashwan and I was born in 1976. I have three children and I have been married for 15 years. I have a diploma in information technology but after graduation I couldn’t get work in the public sector so I worked as a freelancer. Then I drove a taxi. We had a comfortable life.
We still live in Mosul in the same house and the same area. Even during the darkest times of the conflict, we didn't flee.
On 11 March 2017, our neighbourhood was retaken [from the Islamic State group]. Two days later, we went out to buy food and we were happy. But the fighting was continuing in the neighbourhoods around ours. There was a tall building nearby and there was a sniper on top. He started hunting us down. My neighbour was shot in the head and killed. My brother was shot in the leg. The sniper shot me in the back and in the leg.
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Nashwan, 42, is one of the many war-wounded patients still trying to recover a year after the conflict in Mosul officially ended, May 2018. © MSF/Sacha Myers
People in the neighbourhood helped us and they took us to the Iraqi forces. The soldiers checked our documents and then took us to the hospital in Hamman al-Alil (30km south of Mosul). There, doctors checked me and then sent me to Qayyarah. In the Qayyarah hospital, they removed the bullet from my back. But they didn't have the capacity to treat my leg. So, they sent me to Erbil.
In Erbil, they put the external fixations on my leg and said that I would be fine and would just need time. After five days, I went back to the east side of Mosul. I live in the west side of Mosul but all the roads were still closed or destroyed [because of the ongoing conflict], so my family put me on a cart and pushed me home. I waited in my house for several months for the bombs to stop.
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Nashwan, 42, is prepared for surgery at the MSF post-operative care facility in east Mosul, May 2018. © MSF/Sacha Myers
During these seven months at home, the pain started to grow in my leg and hip, and eventually it became unbearable. So in October 2017, I went to the general hospital in west Mosul. They did x-rays and tests and they said I needed a huge operation. But they didn't have the capacity to do the operation.
Afterwards, I went to a private doctor. He said it was a massive operation and it would cost 2 million IQD ($USD 1,664). My economic situation was bad at the time and we had small children. My neighbours came together and raised the money for my operation. I did it in a private hospital. They inserted an internal fixation.
After the operation I went home for six months. I still had pain and it was increasing. Eventually it was so unbearable that I couldn't stand it anymore. But I didn't have any money. The wound started opening and fluids started coming out of it. So I went to the general hospital.
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Nashwan, 42, is prepared for surgery at the MSF post-operative care facility in east Mosul, May 2018. © MSF/Sacha Myers
The general hospital referred me to the MSF post-operative care facility and I arrived on 11 April 2018. I was one of the first patients. Since I came here I have had three surgeries. First, they opened the wound and cleaned it. They were concerned about all the fluid coming out, so they did some tests. They took a sample from the wound and they prescribed a certain type of drug for me to take.
Life has been really hard. My injury has had a negative impact on my life - my family, the way I interact with my kids. I can’t play with them. I can't work and we haven’t had an income. I've been really depressed and I cannot talk to people. Even to go to the bathroom, I need someone with me. And I need the crutches to go everywhere. It's been really hard for me. But thankfully the hardest part has passed now that I am here.”
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MSF has opened a new comprehensive post-operative care facility in East Mosul to provide services for people injured by violent or accidental trauma, March 2018. © MSF/Sacha Myers
It’s been one year since the conflict in Mosul officially ended. But the battle to rebuild the city and people’s lives is far from over. Large swathes of Mosul, particularly in the west, remain decimated. Mines and booby traps still ensnare homes and health facilities.
Some people with no other option have returned to Mosul and live in their damaged homes, often without water and electricity. Poor hygiene conditions are increasing the risk of disease, and trauma injuries are a regular occurrence as people try to rebuild their houses in dangerous conditions.
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Mosul’s old town experienced intense shelling, aerial bombing and attacks with improvised explosive devices during the conflict to retake the city from the Islamic State group, April 2018. © Sacha Myers/MSF
Access to healthcare is a daily struggle with nine out of the 13 hospitals damaged in the conflict. The reconstruction of health facilities has been extremely slow and there are still only five beds per 10,000 people, well below the international minimum standards for health service delivery.
As a result, many war-wounded patients in Mosul have endured months of agony waiting for follow-up care. They often received hasty surgery on or behind the frontlines to save their lives, and now they need additional surgery, pain management and physiotherapy to regain use of damaged limbs and muscles and to prevent losing more or all of their movement. Many people are also in need of urgent mental healthcare as they relive the violent trauma of the past and try to cope with the loss of loved ones.
In 2017, MSF worked in and around Mosul to provide lifesaving services for people caught in the violence. We ran several trauma stabilisation posts in East and West Mosul, and managed four hospitals offering a range of services including emergency and intensive care, surgery and maternal healthcare. MSF currently runs a maternity hospital in west Mosul and a surgery and post-operative care facility for war-wounded patients in east Mosul.
