At Iraq's Zelikan camp, a clinic run by ECHO's partner Première Urgence Internationale treats people displaced by fighting in and around Mosul. Photo by: Peter Biro / EU / ECHO / CC BY-ND

The smoke was visible long before Fanny Mraz, Iraq country director for Handicap International, arrived at internally displaced camps in Qayyarah last week. The Islamic State group had set fire to the desert towns dozen or so oil wells and a sulfur plant as they fled the city in August. Now three months later, a dark black cloud still covers the city and the handful of camps around it. Whether IDPs and residents experience trouble breathing depends on which way the wind might be blowing on a given day. At least 1,000 people had sought medical treatment from the toxic fumes by late October.

That was the first of several shocks for Mraz, she told Devex by phone several days after her visit. Meeting with camp managers, she saw the strain the humanitarians feel as they respond to the crisis. Speaking with IDPs, she observed a high number of disabled residents.

“When the first wave of IDPs arrived, the humanitarian community was able to answer to basic needs. But now it is more and more difficult,” she said. “Some nonfood items like mattress and blankets — they’ve started having some difficulties. As to the specific services [in the camps]: they are very low to nonexistent.”

A month into the military campaign to retake Iraq’s second city of Mosul from the Islamic State group, the humanitarian challenges are becoming clear. Aid groups had warned for months that the operation could provoke one of the most serious humanitarian crises in recent memory, and they began prepositioning supplies accordingly.

That anticipation has given the operation an advantage — so far. “Because we had the advantage of forewarning, this situation may be one of the best prepared responses to a humanitarian emergency … that we have seen in a long time,” a senior U.S. administration official told reporters in a call on Nov. 7.

Still well short of the worst case scenario of 1 million displaced, however, the challenges are mounting. Here are four areas of particular concern for groups working on the ground.

1. Security checks are more humane than in past operations, but delays and family separation remain concerns.

Families fleeing military operations must pass through several layers of security before they reach displaced camps. IDPs cross a series of mustering points run by forces working to oust the Islamic State group from Mosul, either the Iraqi Security Forces or the Kurdish Peshmerga.

In past operations to liberate ISIS territory, checkpoints have been a source of human rights concerns. Many of those fleeing areas controlled by the Islamic State group areas are Sunni Muslims. They have faced increased — and at times undue — scrutiny from the Shia-dominated ISF and the Peshmerga, who fear some collaborators or Islamic State fighters could try to slip through as civilians. While the security threats are real, sectarian confrontations and human rights abuses stand to further polarize the society and exacerbate the same grievances that the Islamic State group has used to rally support.

This time around, international players pushed hard to make sure the checkpoints are efficient and humane. The U.S. government, United Nations, as well as international NGOs have all devoted significant lobbying power to this point.

The U.S. official speaking to reporters on the Nov. 7 call said the U.S. government’s approach to discussions had been threefold: To standardize procedures, with guidelines distributed in Arabic and Kurdish to the troops on the ground; to ensure international monitoring at the checkpoints; and prioritize “conduct in a way that’s respectful of different sectarian issues.”

Thanks to that advocacy, both the Iraqi government and the Kurdish regional government “understand that vetting is a big deal and if they don’t get it right, it actually could exacerbate the problem,” a second U.S. administration official told reporters.

Aid groups on the ground agreed that the checkpoints are moving more smoothly this time, though there are still some concerns.

Most pressing for humanitarians, some IDPs are getting stuck at the checkpoints while security forces try to verify they aren’t a threat. “It can take a few days for some of them” to pass through, said Hani El Mahdi, country director for Catholic Relief Services. His organization is providing emergency assistance such as water to those waiting in security limbo.

Most of those fleeing are unable to carry any belongings or supplies will them, so “they arrive at those checkpoints almost desperate for assistance,” he said. “They are deprived of everything, and in need of food, milk for the children, water — a lot of assistance.”

This prolonged clearance process can at times lead to family separation. Men are screened separately and with greater scrutiny than women and children, who can at times proceed to camps more immediately. UNICEF is among those working to set up procedures to reunited children with their families in IDP camps.

2. IDPs face an extraordinary threat from unexploded ordnance and IEDs. Humanitarian actors are also preparing for any possible chemical weapons use.

The Islamic State group has controlled Mosul and many surrounding villages since June 2014, which is ample time to booby-trap the city. Humanitarian groups say Mosul and its environs have been rigged with a mix of conventional mines and improvized explosive devices meant to hit incoming military forces and fleeing and returning civilians.

Demining groups are worried about exposure at every stage of the military campaign. As civilians flee, they may pass through areas that have been planted with IEDs or mines. IDPs often travel through active conflict zones where leftover or unexploded ordnance still litters the ground. Both threats will also linger when civilians start to return to liberated areas.

Based on previous liberations of former Islamic State group territory, Thomas Hugonnier, Handicap International's head of emergency response operations in Iraq, expects Mosul to be littered with threats. IEDs are particularly concerning because they are intended to blend in. “A very simple item such as a cooking pot could be a bomb — fatal,” he told Devex. “They are located many times in basic service facilities, some close to schools, close to health centers, sometimes also close to private houses.”

Handicap International is hoping to soon begin a contamination survey of any areas secure enough for them to reach. The first step will be to mark any potentially hazardous objects or areas so that people know not to approach them. Then will come the difficult task of attempting to dismantle the items, hopefully without exploding them. While there are clear international protocol for disposing of regular military ordnance, IEDs are complex. Each is made differently, so the work of disarming them is tedious and technical.

The threat of chemical weapons is also on everyone’s minds. The Islamic State group has deployed chemical weapons more than 50 times in Syria and Iraq since 2014, according to an IHS Conflict Monitor report obtained by The New York Times.

Analysts fear the group could launch an attack as forces approach Mosul. Liberating troops are also already finding chemical weapons components en route to the city; often they don’t know how to properly dispose of them, risking soil and water contamination. In one case earlier this month, Human Rights Watch documented militia forces dumping a munition in the Tigris River near Qayyarah.  

“We are taking very prudent preventive measures” to prevent any potential attack, or mitigate its impact, the first U.S. administration official said in response to a question from Devex. He said the U.S. and international partners have targeted ISIS facilities thought to contain chemical weapons “to try to destroy as much as possible in advance.” Additionally, all incoming military forces are equipped to protect themselves in the event of an attack, he said.

With many unknowns, HI and others are also focusing on education about the risks, hoping to reach IDPs, remaining populations, aid workers, and above all, children, who are the most likely to accidentally approach a dangerous item.

3. Everyone needs psychosocial support.

One of the things aid workers say separates the situation around Mosul from previous humanitarian emergencies is the extent of trauma among IDPs. “Most of the people affected by the crisis need psychosocial support,” said Mraz of Handicap International.

There is no one profile or group that stands out; it’s nearly everyone. Handicap International is starting to deploy teams to IDP camps to provide immediate psychosocial “first aid,” as well as longer-term group sessions and individual treatment for severe cases. “In our work, we support women, children and men — and all these categories are appreciating these services and telling us it helped them to cope with the situation,” Mraz said.

The extent of the need speaks to the difficult situation in which IDPs have been living for more than two years. Areas controlled by the Islamic State group have faced strict social controls, frequent violence against civilians, and often deprivation of services such as water and electricity have been offline at times.

That is added to the now immediate trauma of fleeing in haste from their homes. “There is both the violence they have been living, and then the fact that they left their area from one day to another, they often couldn’t bring anything and they are unsure when they will be able to go back or whether will find their house or will be safe if they do return,” said Mraz.

4. Winterization will be a major challenge for all of Iraq’s IDPs.

Winter is coming to Iraq, and none of the IDP camps around Mosul are fully prepared. Aid groups on the ground told Devex that the current funds available for relief aren’t likely to be sufficient to get them ready.

Shelter is a major concern. The U.S. administration officials said they expect that camps will have the capacity to host 250,000 people by mid-December, but the quality is likely to vary significantly. “There will be emergency sites that will provide shelter but will not meet international standards immediately,” the first official said.

Even more challenging will be reaching those IDPs who have taken shelter outside of formal camps. Some 25 percent of those who have fled Mosul are staying elsewhere, often with relatives or friends. At times sheltering in newly liberated villages, they find accommodation in abandoned or damaged structures that are ill-equipped for the cold.

IDPs from Mosul are also just one piece of the challenge. “We don’t want to forget that there are 3.4 million IDPs just since 2014,” said El Mahdi.

“This is a huge number and many of them they are still stranded either in unfinished buildings or in camps or in transitional shelters. With the coming winter they will definitely need assistance.”

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About the author

  • Elizabeth Dickinson

    Elizabeth Dickinson is a former associate editor at Devex. Based in the Middle East, she has previously served as Gulf correspondent for The National, assistant managing editor at Foreign Policy, and Nigeria correspondent at The Economist. Her writing also appeared in The New Yorker, Wall Street Journal, New York Times, Politico Magazine, and Newsweek, among others.