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MSF is continuing to provide medical care, including for trauma, and mother and child care, in areas throughout northern Iraq.

Mosul

Inside Mosul city

MSF opened a 15-bed, 24/7 free-of-charge maternity hospital in Karama, in east Mosul, on the 19 March. Since then, the MSF team made up of both expat and Iraqi midwives and obstetricians has assisted 200 women to give birth safely.

MSF opened a 24/7 emergency room in Al Taheel hospital on 26 March. The team has also set up a surgical unit (with one operating theatre currently running, but a second will soon be online), and a 32-bed post-operative ward in order to provide medium-term care to those suffering from violent trauma injuries in and around Mosul. People with older injuries in need of surgical care, surgical follow up, and other types of surgical issues are also treated in this facility. Since opening, over 330 patients have been received in the emergency room, and 30 surgical interventions have been carried out.

In north-east Mosul, MSF works in a hospital set up inside a former retirement home. The ER opened in February, and has been running 24/7 since 1 March providing emergency, surgery, and maternity services (including caesarean sections), and an in-patient department (IPD) with 50 beds. Since the opening of the hospital until early May, the MSF team has treated 4,376 patients, over half of whom (2,286) were urgent cases, and 93 caesarean sections were performed since the maternity unit opened. As the level of access to healthcare is improving in East Mosul, the hospital has seen a drop in activities in the past weeks, especially in terms of lifesaving medical care. As a result, MSF is re-evaluating the project strategy.

Outside Mosul city

Hammam al-Alil is the closest internally-displaced persons (IDP) camp to the south of Mosul, and is located around 30km south of the current frontline. The town has received a big influx of IDPs from western Mosul since start of the military offensive, with more people arriving every day and settling in different camps in the area, or are sent elsewhere after they are screened by security forces.

MSF opened a field trauma hospital with emergency room, two operating theatres, an ICU/recovery room, and IPD on 16 February; for more than one month this hospital was the closest surgical facility to West Mosul. The emergency room received 2,689 patients from 19 February to 19 May, with more than half of them women and children, and more than two-thirds were war-wounded. So far the team has performed 245 major surgical procedures and 56 minor procedures.

Since 15 April, MSF has been supporting the local Department of Healths primary healthcare centre (PHCC) in Hamman al-Alil, and had already carried out a total of 12,232 consultations by 19 May for both the local population and the IDPs hosted in the community. In the PHCC we perform dressings for wounded patients, including those still being followed up after being discharged from our trauma centre. In Hammam al-Alil, MSF also runs an ambulatory therapeutic feeding centre for children suffering from malnutrition, with a rapidly increasing cohort made up primarily of small babies aged less than six months

MSF is providing long-term post-operative care with rehabilitation and psychosocial support in Al Hamdaniya hospital, in collaboration with Handicap International. Activities started on 15 March and to date, MSF has admitted 189 patients, nearly half of whom were women and children. The facility now has 40 beds in order to respond to the huge need for post-operative care and is almost constantly full, receiving new patients who need post-operative follow-up as soon as those who complete their follow-up are discharged.

In December, MSF opened a 32-bed hospital in Quayyarah, 60 km south of Mosul, with an ER and an operating theatre to provide surgical and emergency medical care. The facility has now been extended to cater for the growing and diversifying needs. The team has treated 6,000 patients in the ER as of 1 May, around 10% of whom were admitted to the in-patient department which currently has a 50 bed capacity. A total of 1,130 surgical interventions have been performed since December 2016 until 1 May. A four-bed intermediate care unit was opened in mid-April to provide care to patients in critical condition, and seven observational beds and two resuscitation beds are also now available.

In March, MSF set-up a 12-bed intensive therapeutic feeding centre (ITFC) in Quayyarah to provide care to children recently displaced from west Mosul or Shirkat region, as well as those from IDP camps in Hammam al-Alil and Quayyarah. The majority of the patients in the ITFC are less than six months old. The centre regularly works over capacity and during one week in late May had three babies per bed.

Since February, MSF has been running a mental health clinic for patients admitted to the hospital, as well as for patients referred from Quayyarah camps. The team includes a psychiatrist, two psychologists, and two psychosocial counsellors.

Camps for displaced people

Following the offensive launched into West Mosul in mid-February, the total population of the four camps west of Erbil hosting internally displaced people from Mosul sharply increased to 80,000 people by the end of March. Soon after, the displaced people started leaving the camps to move in with relatives, or rent houses in retaken areas of East Mosul, and the overall population decreased to approximately 70,000.

Today, mobile MSF teams are providing primary health care, treatment for chronic diseases (mainly diabetes and hypertension), as well as psychological and psychiatric care in two of these camps, Chamakor and M2. Activities in M2 are currently more focused on care for non- communicable diseases, with MSF planning to handover primary health care activities by the end of May. MSF has already handed over the treatment of non-communicable diseases in Debaga camp, given the number of IDPs leaving and starting to return to their homes or moving in with relatives in East Mosul.

A team of a psychiatrist, psychologists, and counsellors is also providing health care to those suffering from moderate to severe mental health conditions. Activities include psychological and psychiatric consultations, group therapy, psychosocial counselling, and child therapy. MSF teams currently provide mental health care across 14 sites, and are always extremely busy.

Since the beginning of the year, the team has carried out more than 15,000 medical consultations and 9,000 mental health consultations in the IDP camps near Mosul.

Hawija

Hawija District, one of the four districts of Kirkuk governorate, remains the second largest territory controlled by Islamic State (IS) in Iraq, but the timeline leading to the military intervention to retake the area is not yet known. Hawija is surrounded by more than 200 rural villages and the entire district combined had an estimated population of 288,000 in June 2014, but a large proportion has now reportedly fled.

In late 2015, increasing numbers of civilians began fleeing the hardship of life under IS and in June 2016, a militia group cut the last trade road, isolating the district from other IS-held territories and from the rest of Iraq. Since then, living conditions have become dire for the estimated 70,000 people remaining in Hawija district. Due to the siege, food is scarce and prices have skyrocketed. Health facilities have been damaged by airstrikes and local looting, and both health workers and medical supplies (drugs, equipment, and materials) are drastically lacking. It is expected that the military offensive will further disrupt access to basic services and worsen the already critical humanitarian situation.

Of the estimated 88,000 IDPs that have reportedly left Hawija since August 2016, around half are displaced within Kirkuk Governorate, where the vast majority live in Kirkuks six IDP camps. A further 30,000 have fled to neighbouring Salah Al-Din governorate. People reported that the main reason for leaving is the lack of food and drinking water.

Since November 2016, MSF has been operating two mobile clinics at Maktab Khalid checkpoint and at Debes screening site to respond to the immediate needs of those fleeing Hawija. Primary health care, first aid, psychological trauma care, and referrals to Kirkuk hospital ER are being provided. MSF has also renovated the water and sanitation facilities in the two sites and distributes water. In Daquq IDP Camp, MSF runs a non-communicable diseases clinic and mental health activities. MSF also supports the emergency rooms of the two main Kirkuk hospitals and has conducted emergency response workshops including specific training on how to deal with injuries to the abdomen and chest, as well as on advanced trauma responses in preparation for mass casualties which may arrive as a result of any future Hawija offensive.

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Iraq: Crisis Update northern Iraq, June 2017 - ReliefWeb

MARK KARLIN, EDITOR OF BUZZFLASH AT TRUTHOUT

Most Americans have to keep a tight budget, why not the Pentagon? (Photo: David B. Gleason)

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If you, like most people, feel bad if you lose your wallet with a few dollars in it, imagine what it would be like to lose track of more than a billion dollars. The latter is the reality for the Pentagon, which has lost track of at least $1 billion in military equipment and weapons in Iraq. A May 24 article in Mother Jones states:

In June 2014, Iraqi forces dropped their weapons, shed their uniforms, and abandoned their posts as ISIS militants stormed into and captured Mosul. More than a year later, the United States began funneling $1.6 billion worth of new weaponry and other support to the beleaguered Iraqi army. The arsenal included tens of thousands of assault rifles, hundreds of armored vehicles, hundreds of mortar rounds, nearly 200 sniper rifles, and other gear.

What happened to much of it is now a mystery. According to a government audit obtained by Amnesty International, the US Army admits that it failed to accurately track this recent infusion of arms and other military supplies.

The now-declassified Department of Defense audit, obtained through a Freedom of Information Act request, reveals that efforts to keep track of weapons being sent to Iraq have been plagued by sloppy, fragmented, and inaccurate record keeping. The audit concluded that the Army unit in charge of transferring materiel to the Iraqi government "could not provide complete data for the quantity and dollar value of equipment on hand"including large items such as vehicles.

This isn't the first time US taxpayer-funded military aid has been unaccounted for. Mother Jones quotes an Amnesty International researcher:

"If you do look back at previous audits, almost word for word, you get the same recommendations about the fact that they can't centralize records, they've got records spread across different spreadsheets, it's very difficult for them to locate weapons as they pass down the chain," says Patrick Wilcken,Amnesty International's arms control and human rights researcher. He notes that some Iraqi supply records are hand-written paper receipts.

Passing down the chain means the US doesn't know who is in possession of equipment and weapons. This oversight is especially significant since ISIS has captured US military hardware sent to Iraq.

Pentagon apologists can argue that $1 billion is a drop in the bucket in the context of the $574 billion 2018 military budget. In fact, the total expenditure on the US war machine is even higher: The Motley Fool presents evidence that $574 billion dollars is just a base figure that does not include all the other line items that flow into military spending: "Add it up, and we spend more than $250 billion on defense and security programs, on top of the Pentagon's $574 billion base budget -- about 44% more than you may have thought we were spending." However, that is a testament to the gargantuan size of military allocations, not an excuse for lost military equipment and weaponry.

Given that Trump wants to increase the massive military base budget by $54 billion, there is no incentive to be more accountable with supplies donated to "allies" in US wars. Yet to Americans in need, a billion dollars is vital assistance, not just sloppy accounting.

There are other ways the Pentagon is not accountable with budgetary allocations. According to a May article in The Washington Post, it has created a slush fund by overcharging for fuel:

The Pentagon has generated almost $6 billion over the past seven years by charging the armed forces excessive prices for fuel and has used the money called the bishops fund by some critics to bolster mismanaged or underfunded military programs, documents show.

Since 2015, the Defense Department has tapped surpluses from its fuel accounts for $80million to train Syrian rebels, $450 million to shore up a prescription-drug program riddled with fraud and $1.4 billion to cover unanticipated expenses from the war in Afghanistan, according to military accounting records.

The Pentagon has amassed the extra cash by billing the armed forces for fuel at rates often much higher sometimes $1 per gallon or more than what commercial airlines paid for jet fuel on the open market.

It is shameful that while the social safety net is being severely threatened, the Pentagon is getting away with rampant financial malfeasance.

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A Billion Dollars Worth of Weaponry Go Missing in Iraq - Truth-Out

WASHINGTON, May 30, 2017 Partnered forces in Syria and Iraq are continuing to make progress in defeating the Islamic State of Iraq and Syria, a Pentagon spokesman said today.

Syrian Democratic Forces yesterday cleared more than 130 kilometers of terrain in the Raqqa valley and in the vicinity of Tabqa, Navy Capt. Jeff Davis told reporters.

The SDF is closing in on Raqqa, he said, pointing out that in the northern Raqqa valley, the SDF has cleared to within four kilometers of Raqqa.

Davis noted pro-regime forces are conducting patrols west and north of At Tanf, in the vicinity of the deconfliction zone where the United States is working with partners.

"The coalition dropped leaflets over the weekend demanding that the pro-regime troops withdraw from this deconfliction zone," he said.

Counter-ISIS Strikes

The coalition continued strikes against ISIS targets in Raqqa over the weekend, to include ISIS tactical units, vehicles, a tunnel, a mortar system, a weapons cache, a vehicle-borne improvised explosive device factory and a fighting position, Davis said.

Iraqi forces have surrounded the old city in west Mosul, Davis said, noting today is the 100th day in the campaign to liberate west Mosul.

Iraqi security forces made small gains along the forward line of troops yesterday, bringing to 577 square kilometers the gains since the west Mosul offensive began Feb. 19, he said.

"They continue to slowly advance against heavy resistance in the last few ISIS-held neighborhoods," Davis explained.

In the campaign for west Mosul, coalition forces continue to support and conduct strikes on enemy positions and potential vehicle-borne improvised explosive devices, striking about 85 vehicles in the last two days inside west Mosul to protect partnered forces, Davis pointed out.

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Partnered Forces Continue to Make Progress in Syria, Iraq - Department of Defense

The National

Iraq attack shows ISIL's depravity The National Both were also making a similar point: that ISIL, as much as it is being driven out of Mosul and other places in Iraq, remains a force to be reckoned with. Last year's attack on Karrada came a week after Iraqi forces seized the city of Falluja from ... and more »

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Iraq attack shows ISIL's depravity - The National

Sometimes called the most dangerous dam in the world, the Mosul Dam could kill hundreds of thousands of Iraqis if it were to burst.Video provided by Newsy Newslook

A general view shows the Mosul dam on the Tigris River on Oct. 31, 2007.(Photo: Ahmad Al-Rubaye, AFP/Getty Images)

WASHINGTON Iraq's massive Mosul Dam risks devastating failure withoutadditionalurgent repairs as the government keeps stallingover how toproceed with the critical reconstructionafter this year.

A ruptureof the 370-foot-high structure wouldput 4 million people at risk by sending floodwaters racing more than 200 miles downstream as far as the capital of Baghdad, engulfingvillages, destroying farms and causing up to $20 billion in economic damages, the U.S. Army Corps of Engineers estimates.

The Iraqi governmenthas delayed a decision on whether to renew acontract with an Italian engineering firm managed by the Corps of Engineerswhen it expires after this year. It may try tomake the critical repairs itself to save money at a time when it is feeling a cash squeeze because of the cost of the war to expel the Islamic State from the country.

Lt. Gen. Todd Semonite, commander of the Army Corps, told USA TODAY he fears the government is "going to be too optimistic" about the level of repairs needed and may not renew the contract.

The government is running out of time to make a decision.Im kind of expecting in another couple of months well either get a decision or probably not get a decision, which means by default then ...well unplug, Semonite said.

Iraq's government faces deep political divisions that often delaycritical decisions. The financial squeeze adds to the indecision. When youre fighting a war and oil prices are where they are, you dont have a lot left over to fund public works, said William Watts, an analyst at Dunia Frontier Consultants.

The current contract with Trevi Group is worth$300 million, some of which isfunded with World Bank and other loans. The dam will require at least another years worth of intensive work before it is stabilized, the Corps of Engineers estimates.

The risk that the dam poses is still extremely high and it will be still at the end of this first year, said Eric Halpin, an Army Corps dam safety official.

Construction of the dam, which provides irrigation and hydroelectric power, was completed under the regime of Saddam Hussein in 1985. The dam a half-mile wide at its base was properly constructed but built on a foundation of water soluble materials, according to the Army Corps.

Ever since it was built, workers regularly have to drillholes and pumpgrout a mixture of cement, water and clay into the holes to strengthen thefoundation.But maintenance declined in recent years, raising concerns of a massive failure.

The dam had beenseized by the Islamic State in 2014 when the militants first invaded Iraq, but it was quickly taken back by Iraqi forces. Soon afterward, engineersdiscovered the dam was in bad shape,not only the result of damage caused by the Islamic State but also from prior years of neglect.

The work to stabilize the dam began a year ago. Corps officials believe that after an additional year of intensive work tostabilize the structure, Iraqcan focus on routine annual maintenance.

We think at the end of the second year well be safe enough where then youll certainly bring down the risk,Semonite said.

One key reason for renewing the contract is that the Italian firm and U.S. engineers employ new techniques and technology to the repair work,whichIraqi workers still need to learn.

The key part of transitioning from the Italian firm to the government of Iraq is that all of those new things new technology and materials are understood and can be executed correctly (and) effectively by the Iraqis, Halpin said.

Analysts say Iraq's fractured government needs to come together and recognize the need to spend money on the repairs.The Mosul Dam requires that the whole Iraqi government ...focus on the issue," said Lukman Faily, former Iraqi ambassador to the United States. "That is not happening now."

It shouldn't be a political issue," he said. "It's a humanitarian issue."

Consultant Watts said Iraqs government may approve the contract at the last minute.A lot of times things do come down to the wire, Watts said.

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Mosul Dam risks devastating failure as Iraq government keeps stalling - USA TODAY