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ABSTRACT
During ISIS occupation of the Northern Iraqi city of Mosul between June 2014 to June 2017, healthcare workers remaining in Mosul continued to provide medical services. Little is currently known about Iraqi healthcare workers’ personal and professional lives in the ISIS healthcare system, and how these individuals adapted. This study sought to explore their experiences during occupation through thematic analysis of qualitative data from twenty interviews conducted immediately after ISIS withdraw from Mosul in August 2017. Participants were sampled from healthcare facilities still in operation after liberation and included healthcare workers of varying disciplines, age and gender. Participants described major changes to their personal and professional lives under ISIS and an extremely limited perceived ability to negotiate the challenges of providing healthcare in the ISIS system. They described terrifying working environments, the strict separation between the sexes, restricted movement, and continuous monitoring by the Al-Hesba morality police. Infractions of ISIS law and subsequent punishment, deaths and kidnappings, changes in personal relationships, poverty and the disrupted schooling of children were also discussed. The importance of protection by supervisors, access to additional money and transportation were highlighted. Understanding these hardships may help support the recovery of health workers experiencing similar situations.
Abbreviations: HCW: Healthcare Worker; PHCCs: Primary Health Care Clinics; ISIS: Islamic State of Iraq and Syria
Acknowledgements
The authors would like to acknowledge the hard work and sacrifice of the healthcare workers of Mosul, Iraq during the violent years of 2014–2017. Also to be acknowledged is the bravery of the data collectors who entered Mosul in the early days after liberation in order to collect this data. First author Georgia J. Michlig was responsible for the research design, preparation of materials, qualitative analysis and primary preparation of the manuscript. Senior Author Dr. Gilbert Burnham was responsible for defining the research questions, funding, facilitating IRB approvals, coordinating the international team and revisions of the manuscript. Riyadh Lafta oversaw the Iraqi field team, provided feedback on materials and analysis and approved the final manuscript. Maha A. Al-Nuaimi directly supervised in the data collection efforts in Mosul, translated and transcribed all interview notes from Arabic to English, provided feedback on materials and analysis and approved the final manuscript.
Disclosure statement
No potential conflict of interest was reported by the authors.
Data availability statement
The data generated and analysed during the current study are not publicly available due to the sensitive nature of its content and concerns surrounding privacy expressed by participants but are available from the corresponding author on reasonable request.