Doctors Without Borders/Médecins Sans Frontières (MSF) logistics team leader Robert Onus recently returned from seven months in Iraq, working as part of an MSF team providing humanitarian and medical aid to refugees, internally displaced people, and local inhabitants near Dohuk. From securing supplies and managing logistics to rehabilitating health centers, here he describes his experience.

Complex Logistics

"There was a big supply component to what I had to do—75 percent of the supplies we needed for the country were coming through Dohuk, where I was based. We had to manage importation and exportation, local purchasing, warehousing, and transportation to the various other projects.

Another major part of my work was the rehabilitation and construction side of things, as we were preparing to hand over the health center in one of the refugee camps near Domiz to the local authorities. As part of this process, we had to rehabilitate some old buildings, move offices, build new latrines, upgrade the waste management area and various other bits and pieces.

But the most challenging aspect was managing the logistics for the mobile clinics project we were running in Ninewa. This project was based in an area close to the frontlines between ISIS and the Kurdish forces and, as it was a long distance from our main office in Dohuk, we effectively had to start from scratch, building a new base, office, and housing in a small town in the area. Finding a house seems simple enough, but in this area seven out of ten houses had been damaged or destroyed in the fighting and many remained booby trapped or contained unexploded ordnances.

Once we found a house that we could actually rent, we had to do the rehabilitation to meet the needs of the project. All of this took place in a small village where most people had left due to the war and to which we had limited access and there were only limited supplies available.

A Double Life

It is hard to describe life here. On one side it is simple, common, and unremarkable. I lived half of my life in Dohuk, a modern city with modern amenities. And then I spent the other half of my time working in this rural area close the frontlines in a small village with only basic conditions.

The area near the frontlines is a vast farmland not dissimilar to north western New South Wales, Australia, where I come from. Rolling hills are covered in wheat and herds of sheep shuffle across the countryside, usually held in check by a young boy sitting sideways on a donkey, his face completely covered by a red and white scarf to hide from the sun.

The conflict in the area we were working seemed to ebb and flow, but it would usually remain on the other side of the small mountain range to the south of where we were based. The sound of coalition jets, sporadic towers of smoke across the mountains, military convoys, and seemingly infinite checkpoints were the only signs that we were in the middle of a war zone.

Challenges

At a personal level, the main challenge was certainly the quantity of work we had to achieve across the various projects we were running. The needs are infinite and it is only a lack of resources and the danger associated with accessing certain areas that limit what you could or might do. Regardless of whether I worked 12 or 14 or 16 hours a day, the amount of work I had to do seemed to grow from one day to the other.

For me the most difficult element was trying to imagine the long-term solution to this war. Of course it’s not our mission in MSF—we are here to deal with the medical problems faced by the people, not trying to find the political solution. Yet in previous projects, such as in the Ebola epidemic, it was hard but we knew we could find the solution. In this conflict, we are bringing support to people who don’t have anything—but who can say when the general situation here will improve.

Common Hardships

There are camps for refugees and internally displaced people scattered all over the Iraqi Kurdistan autonomous region. In Dohuk Governorate, where I was based, there were 18 camps alone that housed displaced people. The conditions vary from camp to camp but all suffer the same basic hardships—most people are living one family in a small tent with temperatures fluctuating from below freezing in winter to well over 100 degrees in summer, with only the most basic access to water and sanitation, food, and shelter.

This article was originally published on 24 February 2016 in MSF's blog, Voices From the Field.