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Cordaid NL
Health care Iraq

Mental health and psychosocial support in Tal Afar

Cordaid has been implementing mental health and psychosocial support (MHPSS) services across Iraq for the past five years. One of our areas of intervention is the city of Tal Afar in northern Iraq within the governorate of Nineveh, some 65 kilometres northwest of Mosul.

After a two-day battle, Tel Afar was captured by ISIL (the Islamic State of Iraq and The Levant) in 2014 and the city was not recaptured back until mid-2017.

During the conflict, a lot of people fled from their homes either walking or by car, seeking a safe refuge from the wrath of the terrorist group. The pre-conflict population was estimated at 200,000, however by April 2017, 30,000 people had fled the city, according to the United Nations High Commissioner for Refugees.

“Most of the treatments that are required in Tal Afar are for cases of depression. Depression requires an extended period of treatment and constant follow-up.”

Dr. Othman, Cordaid’s MHPSS Specialist in Tal Afar General Hospital

One of the patients in Tal Afar General Hospital, where Cordaid provides MHPSS services, described his journey fleeing from the ISIL invasion to a camp for displaced persons as follows: “I live in a land of peace that did not live a peaceful day. I fled to a camp with rockets firing behind my back and returned to my destroyed house and my burnt crops.”

The aftermath

Five years after the extremist group has been militarily defeated, their impact still reverberates through the city. The psychological distress people feel is significant. The destruction of their homes, their city, and the unnerving search for safe shelter. Forced displacement and the loss of dear ones. The constant stream of news, and the lack of news of the whereabouts of near ones. The acute stress of years ago still takes a heavy toll on people’s mental well-being. Until this day, Tal Afar citizens are reliving the traumas they experienced during the invasion days.

Mental Health and Psychosocial Support

To respond to people’s needs, Cordaid started providing mental health and psychosocial support in Tel Afar in 2019 and continues doing this in 2022.

“We provide individual sessions of psychosocial support and psychotherapy. We also provide support in problem management, and we prescribe 35 types of medication for free”, says Bushra, Cordaid’s Social Worker in Tel Afar General Hospital.

Ever since 2019, Cordaid has gained its reputation among the citizens, authorities, and humanitarian networks in the Tal Afar area. We have had multiple cases referred to our team, as mental health and psychosocial support services are not common in Tel Afar.

“For a brief period, I had to get the medication from elsewhere. They were awfully expensive, and the quality was bad.”

A patient in Tal Afar General Hospital

“I have visited other places and I was advised to come here, at Tal Afar General Hospital”, one of the patients confides. “I was told Cordaid is providing the support I need, including the medicines.”

Why our services are free of charge

Before Cordaid’s intervention in Tal Afar, patients had to travel to other cities for specialized mental health care and psychosocial support. A limited number of specialists had started working in Tel Afar, but a lack of experts and of the needed medications raised the prices of MHPSS services. Given the long-term treatment that is often required, people could simply not afford them.

Tel Afar General Hospital. Psychiatrist Dr. Othman prescribes medicines free of charge for the patient. © Cordaid / Danyal Delzar Habeed

“Most of the treatments that are required in Tal Afar are for cases of depression. Depression requires an extended period of treatment and constant follow-up,” explains Dr. Othman, Cordaid’s MHPSS Specialist in Tal Afar General Hospital.

Depression is an illness that can prevent people from going to work, or seeking a job. A vicious circle then looms. Without a steady income, and with the unaffordable prices of medication that needs to be taken over a lengthy period, people usually tend to stop seeking medical support. This is one of the reasons Cordaid provided all its services free of charge.

“The medication and psychosocial support people provided me here, was extremely helpful. The medication is free of charge and of good quality. For a brief period, I had to get the medication from elsewhere. They were awfully expensive, and the quality was bad. Many of the medicines were of unknown origins, some even without expiration dates. Before Cordaid’s support we had no choice but to use what was available”, another patient in Tal Afar General Hospital explains.

Making a difference for more than 1800 patients

Apart from a short two-month gap in the winter of 2019/2020, bridging two project funding periods, Cordaid has been providing MHPSS services for 3,5 years in Tal Afar. Throughout those years, we have supported more than 1800 patients, provided more than 8,000 individual and group therapy sessions, and distributed over 17,000 pharmaceutical products.

In Tal Afar, Cordaid’s aim is to continue supporting patients in dealing with the traumas of conflict and carving a future of their own. Day by day. We also provide this MHPSS support in other parts of Iraq, and indeed in other conflict-affected countries. And we urge decision-makers and donors of the international and humanitarian communities to give more priority – and funding – to mental health and psychosocial support in societies ridden by conflict than it gets now.