News & views | 1 April 2020 | by Saba Azeem0
Iraq, Human Security Survey and the coronavirus pandemic
While the current incidence of the global pandemic is more focused on China and Europe, the full effects of the COVID-19 on poorer countries, especially in conflict and post-conflict countries, is expected to be far worse than what is being seen in Europe, with numerous second and third order effects which are yet to fully emerge. Like the rest of PAX, the PoC team’s projects are also on hold, and our partners have had to adapt their programming in Iraq to respond to more pressing needs in the country.
By Haydar Khattar and Saba Azeem
COVID-19 in the context of Iraq
From the first official case which was identified by the Ministry of Health in the Southern governorate of Najaf on 24 February, until 31 March 2020, a total of 630 officially reported cases have been reported, along with 46 deaths. However, critics fear that these official figures are not trustworthy, and that the incidence of the virus is much greater. Most of this is attributable to the lack of testing available, and many people not going to health facilities out of fear of being quarantined. The country and the public infrastructure in turn is already over-stretched with years of conflict; The World Health Organisation (WHO) estimates that there are only 14 hospital beds in Iraq for every 10,000 people. Many in Iraq have been bracing themselves for a rise in cases in the weeks ahead, but the country’s hospitals are ill-prepared to deal with large numbers. They have been ravaged by decades of conflict and have received little investment in recent years, leaving them woefully bereft of medicine and equipment.
Critics say that the spread of the COVID-19 was not taken seriously by the Federal government initially as despite announcing closing of borders with Iran towards the end of February, many were still crossing over. Diplomats, however, had been excepted and some have been trying to bend the rules to bring in their families. Additionally, Iraqi airways was also still operating daily flights from Iran when most other airlines had cancelled them. However, many of those trying to cross over were Iraqis: an estimated 500,000 live in Iran, and tens of thousands have returned since the virus broke out. They are university students, business people, construction workers and professors, and many have lived in Iran for years.
After the first case was detected in the country, it was governors of northern and western governorates who started to apply tighter security measures; the governors of Ninewa and Salahaddin issued a ban on visitors entering from Central and Southern governorates into their own. The governors also ordered security actors to apprehend civilians who were violating curfews. Similarly, many entities, including some hotel in Iraq, were applying their own internal guidelines towards the end of February and beginning of March. For instance, hotels in Sulaymaniyah were not letting in guests who had travelled from Iran. Despite claims of road closure in Kirkuk when the first cases surfaced, the roads were still open, as PAX staffers travelled by road from Sulaymaniyah to Erbil. The London Eye hotel in Kalar was also converted into a quarantine zone as it was rumoured that many infected PMF soldiers had entered from Iran. Even as late as 23rd March, 4 Iranian citizens were reported as having visiting Najaf despite curfews being imposed.
The situation, however, is different in Baghdad and the Southern governorates. Despite a lockdown imposed, authorities are struggling to fully enforce it. Religious authorities are making claims that the virus is not real, or that people can be cured by doing visitation of Imams. At the moment mass gatherings are taking place to commemorate Imam Khadhim. People joining these gatherings are ignoring any health care advice on the spread of COVID-19. Given the sheer number of pilgrims, the authorities are also confounded on how to effectively stop the masses from walking on foot towards the shrine; health officials are also unofficially anticipating an exponential spike in new cases as a result.
The Kurdistan Regional Government (KRG) extended the suspension of working hours in the region to 16 April; initially imposed on 14 March, and was set to expire on 1 April. Kirkuk’s crisis cell, the governor of Ninewa and the Ministry of Health crisis cell in Federal Iraq have all also extended curfews and movement restrictions until 11 April for the time-being. The Iraqi Aviation Authority has similarly also extended the ban on commercial flights carrying passengers until this date.
Tribal leaders intervening
There are several reports of COVID-19 patients being stigmatized whereby an infected individual is seen as bringing shame to the honour of the family. In an isolated instance, when medical crews wanted to escort an infected young female to a quarantine facility in Eastern Baghdad, her family asked tribal leaders to step in, who in turn threatened the medical crew, and managed to keep the young female at home. Due to this stigmatization, families are also trying to hide any suspected cases of the COVID-19. Similarly, medical crews are receiving death threats from tribal leaders, as a result of which quarantine efforts are decreasing as medical personnel refuse to risk their lives.
Reports have also emerged that loved ones of those deceased as a result of the COVID-19 are finding it hard to bury the bodies. In northeastern Baghdad, tribal figures prevented a team of health ministry officials from burying four bodies in a cemetery the state had specifically designated for COVID-19 victims. When the delegation tried to take the bodies to another burial ground southeast of Baghdad, dozens of local townspeople turned out in protest. Ultimately, the bodies were returned to the morgue, over fears that the respiratory illness could somehow spread from the corpses to nearby population centres, despite there not being any scientific evidence to corroborate this claim. While the Grand Ayatollah Ali Sistani, the country’s top Shia’a cleric, has said those who lost their lives to the disease must be wrapped in three shrouds and insisted authorities facilitate burials, rejections of burials have continued, including in the two shrine cities of Karbala and Najaf, where one of the world’s largest cemeteries is located. While this has been the case when the country has only recorded about 40 deaths, fears are mounting on what will happen once the number of deaths increase.
Like in Europe and elsewhere, the economic impact from COVID-19 is enormous in Iraq. Many people do not have proper employment and are dependent on daily income jobs (e.g. in construction). In northern Iraq, the borders from Turkey have been sealed since 1st March, which has also affected the import of food stuff, leading to a sharp increase in prices. The head of the Human Rights Committee, warned of a famine in country as a result of the curfews imposed in several governorates as part of the fight against coronavirus, stating that Iraqis are left with insufficient daily sustenance due to a lack of salaries. Military and security forces also closed five marketplaces in Baghdad on 28 March, further exacerbating the situation in the capital.
The COVID-19 crisis is still in the beginning stages in Iraq, in comparison to Europe. Apart from its related economic impact, Iraq suffers from the recent oil-war started by Saudi-Arabia, leading to a global decline in oil prices. 90% or more of the national budget of Iraq depends on oil revenues. It seems highly unlikely in the current circumstances that authorities will be able to support their citizens in these difficult times. A direct impact is visible in the (likely) inability of the government to pay civil servant salaries.
Closure of banks has led to sudden interruption of cash assistance, resulting in increased difficulties for vulnerable households to meet their basic needs, including the ability to buy hygiene items, medical supplies and food. Cash assistance is needed to meet people’s needs and directly support the functioning of local markets and traders’ capacity to restock items which are now disrupted.
As stated above, there are probably many more cases of COVID-19 infections than those publicly confirmed. Also, because of fake news, many people don’t take the virus seriously. Several personnel with official badges abuse their badges to ignore the curfew, driving around as taxis. A partner in Basra reported a lockdown for an entire hospital, in order only to deal with COVID-19. The Iraqi health care is not the worst, but is most likely not prepared for large influx of very ill people in need of intensive care. The government is also ill prepared for dealing with burying deceased citizens – they are not properly taken care of, and there are even videos of deceased being mocked by those responsible for their burial.
Hospitals and public medical facilities also lack in their hygiene standards, coupled with outdated equipment. These are the main reasons why the wealthier citizens visit private clinics and those with lesser resources resort to visiting private medical shops for treatment. Many of these shops are administering broad-spectrum antibiotic injections claiming to be able to cure most infections, despite the shop owners being not medically licensed to write prescriptions or offer medical treatments.
Issues hidden behind closed doors
An extremely worrying trend is the sharp rise in forms of domestic and sexual violence. Our partner contact in Kirkuk has shared the rates are rising quickly as people are forced to remain inside their houses. Women are most at risk of violence from their intimate partner in Iraq, thus being forced to stay with them inside their house will inevitably lead to rises in cases. Lack of response to sexual and gender-based violence ((S)GBV), specifically domestic violence, from police and the security sector is very worrying. We don’t have statistics about this as it is difficult to collect, but is an issue at the front of our minds that we intend to monitor as closely as we can.
Due to the rural primitive nature of culture in the areas of the southern Iraq and some areas in Baghdad, the way the infected persons are treated differ according to their gender, and here where the hammer falls harder on women and girls. One case in Sadr city, a heavily populated area in the east of Baghdad with deep roots to southern governorates and militias having the most influence, a women was suspected to have a Coronavirus infection but the medical crews couldn’t find her as she was hidden by her tribe. Some claim that she was never seen afterwards which is a similar scenario to what happens after a women is accused of dishonoring her family and tribe which often ends in ending the victim’s life discretely.
What does this mean for our partners and NGOs in Iraq
While a number of governorates have implemented or are in current communication with field teams about NGO exemptions to enable the provision of life-saving assistance under a COVID-19 response. However, the main issue is the lack of formal streamlined communication with NGOs about what is needed to obtain these exemptions resulting in different processes per governorate. For example, there have been exemption letters issued for actors responding to the flood in Ninewa; a call for humanitarian actors to contact the Governor in Salahaddin; and in Kirkuk, there is ongoing commitment to ensure humanitarian activities continue. As a result of the inter-governorate travel restrictions, many NGOs are also unable to transport vital goods from their central warehouses to areas in high needs. In Basra, however, our partners have been asked to abide by the curfew, and are therefore unable to deliver the vital aid needed by at-risk families who have lost employment as a result of the pandemic.
In a survey conducted by the NGO Coordination Committee for Iraq (NCCI) on 16 March, 93% of a total of 57 international and national NGOs in Iraq reported that their operations had been effected by the COVID-19, with 39% sharing that they had suspended their activities. About three quarters of the NGOs also cited their inability to reach out of camp beneficiaries as an obstacle to implement activities. In terms of staff movement, 63% shared that their activities have been impacted as a result of the reduction in the ability of national staff to move, while 35% cited that the availability of international staff has been adversely impacted by local and global travel restrictions.
Various messages and slogans are also being promoted by NGOs to raise awareness for the public. Examples of these include:
- For yourself and your family, stay at home!
- Please contact the relevant authorities immediately if you start experiencing symptoms of the COVID-19
- Being cautious is important! Please closely follow advise given by the health departments
How are the partner’s responding
Together with youth groups from Basra, our partner, the Iraqi Al-Firdaws Society, led an educational campaign targeting poor areas which suffer from lack of services, especially the health one and how to protect people from the COVID-19. The campaign included distribution of hygiene materials, detergents, masks and plastic gloves in addition to awareness leaflets on how to deal with cases of infection and how to avoid touch with people in public places and how to maintain personal hygiene and using disinfection materials to preserve people’s safety. However, since the curfew was extended to include NGOs in Basra, the team has been unable to carry out with its campaign, as well as other regular activities or monitoring and evaluation initiatives.
Furthermore, since a new phase of HSS programming just commenced in country, this time is being utilised to draw up budgets and detailed planning for the upcoming four years.
What more is needed
Thankfully, our partners have not been impacted in terms of financing or personnel, as donors are also sympathetic of the situation. However, more is needed in terms of specific COVID-19 response. There is a general shortage of hygiene supplies as well as sterilisation equipment in the market, as even public health institutes are reporting a dire shortage of masks, gloves and other protective material. Extensive awareness sessions are also needed in rural areas, as there is limited outreach in terms of warning them on the dangers of the pandemic, and the need for social distancing.
How is the Human Security Survey adapting
For this year, it was planned that the first round of data collection in at least two targeted governorates would be completed before Ramadan (~ 24th April 2020), however, all field operations have been suspended until it is safe for our respondents, enumerators and partner staff to interact face to face. As this survey is done once every year, we do expect to meet our target for this year once the situation normalises.
Together with our partner, the Iraqi Al-Amal Association, a pilot study has also gone live to validate the quantitative findings we have for the incidence of SGBV in the three targeted governorates of Kirkuk, Basra and Salahaddin using remote data techniques. Once the findings are validated, the study will also test out advocacy messages relating to gender, peace and security, in these targeted governorates.
The team is also liaising with other institutions through which we can validate HSS findings on the perceptions of safety and security by targeting university students, again through remote data collection techniques. The proposed study will also engage with these students, who are the future Iraqi leadership, on how they want the future of the country to look like, and how this future needs to be achieved.