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As Doctors Without Borders/Mdecins Sans Frontires (MSF) continues to provide lifesaving emergency and surgical care to men, women, and children wounded in the ongoing battle for Mosul, teams are also extending their response to cover gaps in hospital care left by the severe destruction of the local health system.

"Most hospitals in Mosul have been damaged or destroyed," said Marc van der Mullen, MSF head of mission. "In western Mosul, medical services are severely disrupted and the ongoing fighting is causing many injuries and deaths. In eastern Mosul, medical facilities slowly get back on their feet but there are gaps in medical services such as post-operative care, mother and child care, and inpatient care, so MSF is working on addressing them."

Today, MSF works in six medical facilities in and around Mosul, providing lifesaving emergency and surgical care including mother and child health care, as well as providing long-term post-operative care to those in need of follow-up and rehabilitation following major surgery. The teams also provide care for children suffering from malnutrition, as well as primary and mental health care in the newly established camps for people fleeing Mosul.

Through a strategy of advanced medical posts (AMP), which can be quickly opened and moved according to rapidly changing medical needs, MSF provides lifesaving stabilization and emergency care to people wounded in fighting in western Mosul. Over the last month, MSF received 175 patients in its two AMPs in western Mosul and referred them to other medical facilities with surgical capacity, such as the MSF trauma hospital in Hammam al-Alil, south of the city.

Today MSF is working to broaden its medical services and setting up facilities with surgical capacity, including for emergency maternal care, as well as an inpatient pediatric department. The objective is to fill urgent gaps in medical services to provide for the most vulnerable population groups until health authorities can resume services.

Hundreds of thousand of people are still trapped in western Mosul. The patients who reach MSF facilities report that water and food is running low, that the few supplies available are extremely expensive, and that access to health care is almost impossible.

In eastern Mosul MSF works in a former retirement home retrofitted into an emergency room, operating theater, and maternity and inpatient departments. Since the facility opened at the beginning of March, the team has treated 4,376 patients, more than half of whom were emergency cases, and performed 93 Caesarean sections.

Also in eastern Mosul, MSF opened a 15-bed maternity unit on March 19 to provide basic emergency services allowing women to deliver safely. Since the opening, the team has brought 130 babies safely into the world.

MSF also opened a 24-hour emergency room In a third facility in Eastern Mosul Hospital that has so far received 336 patients. The team is currently setting up a surgical unit and a 32-bed ward, which will be ready in the next few days.

Since its opening, 1,904 patients have been received in MSFs field trauma hospital in Hammam al-Alil, which was the closest surgical facility to western Mosul for more than a month. Fifty-five percent of the patients were women and children and 82 percent were war-wounded. To date, the MSF team has performed 160 major surgical procedures. MSF also supports the primary health care center in Hammam al-Alil, carrying out about 500 consultations per day both for the local population as well as for the people displaced from Mosul hosted in a nearby camp.

At the hospital in Qayyarah, MSF treats medical and surgical emergencies. Since January, more than 5,657 patients were admitted to the emergency room. The team in the emergency room sees patients wounded in airstrikes and explosions or by mortar fire. A four-bed intensive care unit was recently opened to provide care for burns victims, patients in shock, and other critical cases.

As the Iraqi army advanced into western Mosul, families were able to escape. MSF teams started seeing children with acute malnutrition, a result of food shortages in the besieged area. To treat malnourished children, mainly babies under six months, MSF set up a 12-bed intensive therapeutic feeding center in Qayyarah Hospital. In Hammam al-Alil, MSF runs an ambulatory nutrition program and refers most severe malnutrition cases to Quayyarah.

With thousands of people severely wounded in the fighting, many face long months of convalescence and rehabilitation. Long-term post-operative care will therefore be one of the main medical needs in the coming weeks and months. "A persons recovery does not end with their trauma surgery," says MSF medical coordinator Chiara Burzio. "They often need many months of therapy, both physical and psychological, to allow them to rebuild their shattered lives. Our patients will bear the scars of the battle of Mosul for the rest of their lives, but our team is helping them to adjust to their new reality, and hopefully return them to their families as healthy as possible."

In Hamdaniya, southeast of Mosul, MSF provides long-term post-operative care with rehabilitation and psychosocial support in the hospital in collaboration with Handicap International. Since March 15, MSF has admitted 100 patients, about 45 percent of whom are women and children. This 40-bed facility is the only one providing such a package of long- term post-operative care in all of Ninewa Province.

According to the United Nations, over 500,000 people have been displaced from Mosul. In 17 sites west of Erbil that host such people, MSF mobile teams provide primary health care, treatment for chronic diseases (mainly diabetes and hypertension), and psychological and psychiatric care. MSF's mental health program focuses on severe cases and its activities include psychological and psychiatric consultations, group therapy sessions, psychosocial counseling, and therapy for children. Since the beginning of 2017 the team has carried out 14,098 medical consultations and 8,238 mental health consultations.

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Iraq: Shoring Up a Ruined Health System in Mosul - Doctors Without Borders

Their trial by fire in March 2016 came just hours after they landed on Army CH-47 helicopters under cover of darkness in Makhmur, Iraq.

Paul Szoldra/Business Insider

CAMP PENDLETON, California Maj. David Palka had seen combat in Iraq and Afghanistan, but roughly 90% of the Marines under his command, tasked with setting up a remote fire base in northern Iraq in 2016, had only heard the stories.

Their trial by fire in March 2016 came just hours after they landed on Army CH-47 helicopters under cover of darkness in Makhmur, Iraq. Getting off the helicopters at around 2 a.m., the Marines were in what was essentially open farmland with a large protective berm of dirt around their small perimeter.

"By 0900, we received the first rocket attack," Palka told Business Insider.

As a captain, Palka had led the Marines of Echo Battery, 2nd Battalion, 10th Marine Regiment when it was attached to the 26th Marine Expeditionary Unit from October 2015 to June 2016.

On Monday, Palka was awarded the Bronze Star medal (with combat V), the fourth-highest combat award, for what his battalion commander called "sustained valorous leadership." He'll also later this week receive the Leftwich Trophy, presented annually to a Marine company or battery commander who displays outstanding leadership.

Palka and his unit's foray into Iraq toset up an artillery supportbase had was shrouded in secrecy. But new details have emerged from that mission, showing that they were under constant threat and directly attacked more than a dozen times during their two and a half months there, according to interviews and documents reviewed by Business Insider.

"When they got the call, they were ready," Lt. Col. Jim Lively, the commander of Battalion Landing Team, 2nd Battalion, 6th Marines, and Palka's battalion commander at the time, told Business Insider.

Courtesy of David Palka

When Palka and others in his advance party left their helicopter on March 12, they marked the first American boots on the ground in Iraq to set up aquasi-permanent basesince US forces left in 2014.

At what would be named Fire Base Bell in honor ofStaff Sgt. Vincent Bell, a Marine who died in Afghanistan in 2011 Palka and his Marines began to establish security and build bunkers to protect from enemy fire.

The base was initially protected by 60 infantry Marines from Echo Company 2/6 armed with rifles, machine guns, and mortars, along with an Army unit providing radar equipment that would detect and zero in on rockets fired from ISIS positions. Field artillery Marines brought four M777A2 Howitzers to the base just days later.

The base was small and had no creature comforts, and troops dug holes where they would man their guns, fight, and sleep.

Courtesy of David Palka

"It was austere. There was the constant threat 24/7," Palka said. "My other deployments, you'd come back to a [forward operating base]. Or we'd remain on a FOB and shoot fire support in support of maneuver. We didn't have an adjacent unit to our left and our right. We were the only general-purpose ground force forward. There was no wire."

The Pentagon tried to keep the presence of Marines in Iraq quiet, but those efforts were thwarted one week after Palka arrived.

On March 19, Bell was hit once again by rockets fired from ISIS positions about15 miles away.

"It was no surprise that we were rocketed," Palka said, noting that military planners had determined that Russian-made 122mm Katyusha rockets were the weapon of choice for ISIS at the time.

"I had received indirect fire on previous deployments, but nothing that large," he said.

The first rocket impact that day was a direct hit on the first gun position on the line.

"As soon as it impacted, it was obvious there were casualties," he said.

Staff Sgt.Louis Cardin, 27, was killed, and eight other Marines on Gun One were wounded. Immediately, the other Marines ran toward the rocketed position to give medical care, despite a second rocket landing a few hundred meters away.

"It was amazing to see them," Palka said. "The manifestation of all of our training coming to fruition."

Courtesy of David Palka

Meanwhile, the Army counter-battery radar site homed in on where the rockets came from. And Palka, according to a military document summarizing his performance, calmly assessed casualties, called for medical evacuations, and executed an artillery counterfire mission of seven rounds back at ISIS's firing point. The document said the enemy's rocket position was "effectively" suppressed.

"Dave kept the team focused while they did the evacuation of casualties," Lively said. "They ran the counter-battery mission as the fire base was attacked."

Echo Battery's mission in Iraq was to set up a small outpost that could provide indirect fire support to Iraqi troops on the front lines. Field artillery Marines kept busy doing just that. Over slightly more than 60 days at the site, the unit fired more than 2,000 rounds, including high-explosive, illumination, and smoke.

Those efforts made it a big target, as ISIS shot more than 34 rounds at its position during that time. All told, the unit was attacked on 13 occasions, which included rockets, small arms, and suicide attacks.

"This was as kinetic as anything that I had experienced before," Palka said.

Courtesy of David Palka

On two occasions, the base was attacked in a coordinated fashion by about a dozen or so ISIS fighters armed with explosive vests, small arms, machine guns, and grenades.

The first, which came just two days after Cardin's death, began with an ISIS fighter detonating his vest against an obstacle of concertina wire.

The Marines fought back over three hours on the night of March 21, eventually killing all the ISIS fighters with no American casualties. The artillery Marines, just over 2,000 feet from the enemy positions, fired illumination rounds as the grunts on the perimeter engaged with their rifles and machine guns.

"I'd say that ISIS and the enemy that we encountered in Iraq this past time ... they were more bold the fact that they would infiltrate the forward line of troops and attempt to engage a Marine element with foreign fighters," Palka said. "Their weaponry and their tactics were more advanced. They were more well-trained than any other force that my Marines had directly engaged on previous deployments."

While Echo Battery fired its gunsalmost daily, it expended much of its ammunition in support of Iraqi forces gearing up for the assault later that year on ISIS in Mosul, Iraq's second-largest city. Ahead of the October offensive, the unit fired off more than 1,300 rounds in support of Iraqi troops attempting to take back villages on the outskirts of the city.

"Our mission was to provide force protection fire support to Iraqi security forces, which we did," Palka said.

Besides being the first back in Iraq, the unit had several other firsts, including the Corps' first combat use of precision-guided fuses, which make artillery rounds hit with pinpoint accuracy, and the successful employment of the Army's TPQ-53 radar system alongside Marines, which helped it quickly identify where rockets were coming from so they could be taken out.

"There's nothing I can put into words about how I feel about the Marines in that unit," Palka said. "Words don't do it justice. There's something that you feel and sense when you walk into a room with them."

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Previously Unknown Battle: US Marines vs ISIS in Iraq - Scout

DUBAI Iraqi fuel oil exports have soared since January despite a reduction in the country's crude production in line with OPEC supply cuts, industry sources said, in what could be a way to boost output of refined products and maintain oil revenues.

Iraq on average exported between 80,000 and 160,000 tonnes of fuel oil per month in 2016, data collected by Thomson Reuters Oil Research showed.

But volumes sold to Asia have jumped this year, with Iraq's global exports of fuel oil reaching more than 500,000 tonnes in March alone, according to Reuters data.

The soaring exports of high-quality straight-run fuel oil (SRFO) are an attempt to support revenues amid the OPEC cuts in which Iraq reluctantly agreed to participate, saying it would reduce crude output by 210,000 barrels per day (bpd).

Iraq has processed more crude through its refineries, turning it into fuel oil for export, five industry sources with knowledge of the matter said.

"The Iraqis have been processing more crude internally than exporting it, hence there are more fuel oil exports," said one Middle East-based industry source, speaking on condition of anonymity as he was not authorized to talk to the media.

A manager at an Iraqi-headquartered energy trading company said: "The Iraqis have been working on optimizing fuel oil exports ... in a move to compensate for the OPEC (crude) cuts."

Other Middle East trade sources said Iraq had been blending the high-quality fuel oil it produces with either crude or naphtha before exporting it.

The effect has been felt as far as Singapore, Asia's main oil-trading and storage hub. Trade data compiled by Reuters shows imports of Iraqi fuel oil at 0.94 million tonnes in the first quarter of 2017, nearly double the 0.48 million tonnes imported during the whole of 2016.

One characteristic of high-quality fuel oil is that it can be used as crude which, according to traders, is what is happening with Iraqs supplies.

"This stuff (the fuel oil), it's going straight into refineries," said one Singapore-based fuel oil trader, adding that Shell's 500,000-bpd Pulau Bukom refinery in Singapore had taken several cargoes of Iraqi fuel oil.

The fuel oil, like crude, is then refined into other products such as jet fuel, gasoline or diesel. Shell declined to comment on the details of its commercial agreements.

Traders said some of the high-grade fuel oil had also been shipped to the United States.

Fuel oil is a byproduct of crude oil refining. High-quality variants such as SRFO can be further refined into higher-value gasoline and diesel, while lower-quality fuel oils are typically used in large marine vessels and power plants.

Iraq's bulging fuel oil exports have contributed to a glut. In Singapore, premiums on fuel oil prices came under pressure in the first quarter as inventories hit a near eight-month high. Likewise, fuel oil inventories in the Amsterdam-Rotterdam-Antwerp hub soared to their highest since records began in 1995 in the first quarter, as fewer shipments were sent to Singapore's already burgeoning storage tanks.

(Additional reporting by Rania El Gamal; Editing by Henning Gloystein and Dale Hudson)

LONDON/HAMBURG U.S. agribusiness Archer Daniels Midland Co said on Thursday that its operations would expand overall in Europe this year, even as the company restructures parts of its global trading operation.

WINNIPEG, Manitoba U.S. President Donald Trump's criticism of the protected Canadian dairy system has emboldened American farm groups to tackle other longstanding agriculture irritants, as the countries move toward rewriting trade rules.

LONDON El Nino conditions are developing across the Pacific with an increasing probability that a full-fledged El Nino episode will occur during the second half of 2017.

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Iraq's fuel oil exports soar despite OPEC supply cut - Reuters

The family of a Dallas police officer accused of shooting dead an unarmed teenager claim he is the perfect father figure who may have been suffering from PTSD when he opened fire.

Honor student Jordan Edwards, 15, was shot in the head when US Army veteran Roy Oliver took aim at a moving car full of teenagers in the aftermath of a Saturday night party.

The Balch Springs (TX) Police Department initially claimed the vehicle was reversing towards officers in an aggressive manner until body camera footage revealed the the vehicle was driving away when Oliver began shooting with his rifle.

The Dallas County District Attorneys Office is deciding whether to bring charges against the Iraq veteran who was fired this week amid a national outcry and calls for him to be arrested for the high school freshmans murder.

Olivers family, however, have spoken out in his defense, suggesting the divorced father to a baby boy and girl, both aged one, would never recklessly endanger the life of kids.

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Parents: Texas Cop Who Killed Teen Is Iraq Vet With PTSD - LawOfficer.com

Gloves Come Off in Turkey After Erdogans Constitutional Referendum

Turkish President Recep Tayyip Erdogan was further empowered by the passage of a constitutional referendum last month that granted him sweeping powersand now hes acting like it. Since the passage of the referendumwhich has since been upheld by the Council of State, Turkeys highest administrative courtTurkey has cracked down again on people suspected of having ties to the Gulenist Movement, which the government has accused of plotting the attempted coup in July 2016. Last week, Turkish authorities carried out raids across the country to arrest more than 1,000 people and said they were looking for 2,200 others. The Turkish government also suspended more than 9,000 police officers for alleged ties to Gulen.

Erdogan is asserting himself in Syria as well. Last Tuesday, Turkish planes bombed Kurdish positions in Iraq and Syria, touching off several days of cross-border clashes. Turkish officials said they were targeting groups with ties to the Kurdistan Workers Party (PKK), which the U.S. and Turkey have both designated as a terrorist organization. U.S. forces are again running interference between the two nominal allies in the counter-Islamic State coalition; over the weekend, U.S. troops, prominently displaying large American flags on their vehicles, patrolled the border with Kurdish forces in an effort to deter the Turkish military from targeting them. The U.S. military had previously used a visible presence to break up clashes between Turkish-backed Free Syrian Army rebels and U.S.-backed Kurdish rebels in the area around Manbij in March. U.S. forces were also photographed protecting a senior leader of the PKK, Sahin Cilo, for whom the Turkish government has offered a $1.1-million bounty.

U.S. forces are again running interference between the two nominal allies in the counter-Islamic State coalition...

Erdogan has said that he plans on trying to convince President Donald Trump to reduce U.S. support for the Kurds when he meets with the president later this month and has threatened to target Kurdish forces again. But the U.S. military sees the largely-Kurdish Syrian Democratic Forces (SDF) coalition as an indispensable part of the upcoming offensive against the Islamic State in Raqqa. SDF fighters are advancing in Tabqa, to the west of the Islamic State stronghold, but more clashes with Turkish forces would distract from the push deeper into eastern Syria. "We are seriously concerned to see U.S. flags in a convoy that has YPG [a Kurdish militia] rags on it. We will mention these issues to President [Donald Trump] during our visit to the United States on May 16," he said on Sunday.

Iraqs Qatari Hostage Crisis Is Over But Can Another Be Prevented?

In December 2015, armed men abducted 26 members of a Qatari hunting party in southern Iraq. Among those abducted were members of the Qatari royal family, the al-Thanis, and suspicion fell on Iranian-backed Shia militias operating in the area. The incident made the international news wires briefly at the time and then largely disappeared from the headlines. But while the story went quiet, the Qatari hostages became pawns in an elaborate international negotiation that is only now coming to light.

It is clear now that from the very start, the hunters abduction was linked to the civil war in Syria, the New York Times reports. The hunting party, it is now known, was being held by the Iraqi branch of Kataeb Hezbollah. Over the past 16 months, Iran has used the hostages, held by one of their Iraqi proxies, to pressure Qatar to compel their rebel proxies in Syria to accept a ceasefire agreement. In addition to convincing their rebel partners in Syria to allow the Assad regime humanitarian access to besieged towns, Qatar is believed to have paid a hefty ransom to Kataeb Hezbollah. The arrangement also involved payouts to extremist groups, including Hayat Tahrir al-Sham (formerly the al-Qaeda affiliate Jabhat al-Nusra), Hassan Hassan wrote in The National. Last month, when the Assad regime began implementing an agreement to facilitate the relocation of groups under rebel siege in Fuaa and Kefraya and regime siege in Madaya and Zabadani, Qatar had a plane standing by on the tarmac in Baghdad awaiting the release of the hunting party. The 26 captives were handed over to the Iraqi Interior Ministry, and then to the Qatari embassy.

The Iraqi government has appeared frustrated with the way the hostage negotiations played out. Prime Minister Haider al-Abadi called the abductions an insult to Iraq and its people and said that the Qataris had traveled to Iraq legally and should have been protected by the Iraqi Ministry of the Interior. He also criticized the payouts to militias. Some analysts have suggested that this is evidence that Abadi is chafing at Irans assertiveness in Iraq, but Qatari officials have suggested that this is disingenuous and say that Abadi was kept apprised of the negotiations, including the delivery of a large ransom payment.

Syria has created a dense network of proxies tied back to the regional powers of the Middle East. These transnational webs create liabilities, and what happens in Syria doesnt necessarily stay in Syria.

Syria has created a dense network of proxies tied back to the regional powers of the Middle East. These transnational webs create liabilities, and what happens in Syria doesnt necessarily stay in Syria. The Qatari hostage crisis in Iraq is over, but it demonstrates a willingness from Iran to work through its proxies to obtain leverage in other battlefieldseven at the expense of the sovereignty of one of its partners, Iraq. And if the Iraqi government couldnt prevent the abduction from happening in the first place, and couldnt secure the Qataris release in their 16-month captivity, it seems unlikely that Baghdad could stop something similar from happening again. As Hassan Hassan concludes, there is no question that the deal denigrates the government in Baghdad The deal empowers extremists from both Sunni and Shia sides, fuels conflicts and strengthens Irans hands in the region.

Is Saudi Arabia Really Going into Hodeida?

After weeks of discussion about a pending offensive by the Saudi-led intervention force in Yemen to retake the Houthi-held port city of Hodeida, including hints about an escalated U.S. role, the plan is now in doubt. Last Friday, former U.S. Ambassador to Yemen Gerald Feierstein, now at the Middle East Institute, told Al-Monitor that he has been told the Saudis are looking for a political offramp that could restart negotiations with the Houthis and ousted Yemeni President Ali Abdullah Saleh to resolve the civil war more broadly. They are thinking more creatively about how do we achieve this objective without having to resort to military [solutions] and breaking a lot of crockery, he said. The ousted Yemeni government of President Abdu Rabbu Mansour Hadi reportedly proposed that the Houthis cede control of the port of Hodeida to the United Nations at a donor conference last week as an alternative to a military offensive.

But on Monday, Zeid Ra'ad al Hussein, the U.N. high commissioner for human rights, said that he is under the impression that an attack is still being prepared, reiterating his concerns about the potential for a humanitarian catastrophe. Those concerns have also been raised by rights groups and experts who have argued that the fighting could restrict access to aid and cause a famine. Other experts have also warned about the opportunity the prolonged civil war has given to al-Qaeda in the Arabian Peninsula (AQAP), which has fought alongside U.S.- and Saudi-backed pro-government fighters against the Houthisa fact confirmed by the leader of AQAP, Qasim al-Rimi, in a message released over the weekend.

The Saudi-led intervention force and the Yemeni government are facing strains within their coalition that may be prompting the new ambiguity about the Hodeida offensive. Hadi recently fired two prominent southern officials with close ties to the United Arab Emirates, including the governor of Aden, prompting street fights last week. The move appeared to be an effort to rein in southern secessionists, but now seems to have inflamed tensions at the local and regional level instead.

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Middle East Ticker: Turkey Cracks Down at Home and Abroad, Iraq Caught in Middle of Syria's Proxy War, and Saudi ... - Lawfare (blog)