Field hospital near Mosul treats military, civilian casualties alike

NINEVEH PLAINS, Iraq - It was set up to lessen the burden of hospitals in the Kurdistan Region of Iraq that are overwhelmed by the many casualties from the war against the Islamic group ISIS in Iraq’s second city Mosul. This field hospital is based in a recently-liberated territory just outside the city.

For the military, it is a Casualties Collection Point (CCP), where Iraqi and Kurdish soldiers injured in battle are treated and stabilized, before moving to other hospitals or back to the battlefield.

But since half of all casualties in Mosul are civilians – over 1,600 since October - the hospital is treating them too, and this has grave consequences for the security procedures.

Set up and run by the Christian American aid organization Samaritan’s Purse, the makeshift hospital is surrounded by tall concrete T-walls, and entering is only possible through secured gates.

The press is told not to mention the location of the hospital while taking pictures are prohibited.

“ISIL is a brutal group,” says hospital director Edwin Caros, 77, using one of the acronyms for the radicals. “We understand well what they can do against those who treat people they perceive as being infidel. And that an attack would be used as propaganda. We try to keep our people safe as the enemy would be thrilled to harm us.”

Caros himself is a semi-retired Emergency Room physician, and ‘his people’ are international doctors and nurses who come in and stay for limited periods, and local staff for security, translating and nursing.

As the crackle of a walkie-talkie announces the arrival of wounded civilians at the gate, the staff quickly finish their lunch outside in the warm winter sun. The arrival announces the end of the morning quiet; most patients are brought in in the afternoon after the first lull in the fighting.

Inside the T-walls white, air-conditioned tents offer two operation rooms, a well-stocked pharmacy and blood bank and three patients sections, one for women and children, one for military and a third one for other men between 15 and 50 years of age.

Caros refers to the latter group as “enemy combatants”, even though it is unclear who is connected to ISIS and who is not.

“We serve everybody who comes,” states Caros, adding that men of a fighting age present a “huge security issue. Even women and children are not considered to be completely safe,” as ISIS also uses them for suicide attacks.

For fear of that, all injured who enter the outside gate, are fully undressed before considered safe enough to enter the reception area of the hospital, where they will be labeled according to condition: black (dead on arrival), red (life threatening injuries), yellow (badly injured), green (can walk).

The undressing is in violation of the conservative culture in Iraq, Caros agrees. “We see the very modest women trying to cover up the whole time. Luckily we have some wonderful Iraqi ladies who can put them at ease.”

They need to, as no family is allowed inside, with the only exception made for a parent to accompany a wounded child. All others must wait in a special place outside, where an Iraqi staff member will keep them updated about their beloved ones.

The international staff of the hospital is Christian, and claims to be ‘called’ to do this work, Caros explains. “We are here to do God’s work and we hope it shows. I hope my treatment and interaction reflects my faith.”

Doctors will ask the patients to allow them to pray for them, he says, and nobody refuses. “We see the surprise on their faces about the loving and dignified treatment, and their thankfulness.”

As all patients are treated equal, he realizes that he must have prayed for enemy combatants too. “Well, that is OK, as they have been misled by ISIL.”

Today, the nursing section is quiet; of the 40 beds, only in the women department a couple have been taken. Most patients stay for 48 to 72 hours, to be transferred to hospitals in Erbil or, depending on their wounds, back to Mosul.

In the first two weeks after the opening, just after the New Year, doctors treated some 150 patients, with injuries caused by snipers, ISIS car bombs and air raids by the coalition forces.

Previously, all the wounded had to be taken to Erbil, a drive that could take two hours because of check points and traffic, and many would die.

“Only less than ten percent we have not been able to save,” says Caros. “We save lives because we are only ten minutes from the battlefield.”

Inside the city, no hospitals are functioning anymore, and apart from a trauma-stabilization post the UN health organization WHO set up, there is no care.

Yet with the battle moving soon to the right bank, and the river Tigris in between, it is unclear how the field hospital can continue its important work then.