Kurdish Relief—a nurse’s view

Abstract

The discussion of the delivery of health care to Kurdish refugees in Northern Iraq by a Surgical Support Team member from the United Kingdom focused on the inadequacy of supplies and the compensations made in order to provide health care to Kurdish children. Because supplies were provided for the military Marine brigade there were no specialized items for children. This handicap was accounted for by grinding antibiotics and remeasuring to the appropriate dosage for children. The pediatric staff included a pediatrician 2 pediatric nurses 2 midwives a psychiatric nurse and a general nurse none of whom had any relief experience. Blankets were cut down to size. Diapers were created by opening out gauze swabs and wrapping them with cotton wool; plastic sheeting held the diapers in place. Foam sheeting from equipment crates was used as waterproofing on mattresses. Infusion stands were made from string and bent wire attached to metal ceiling struts. Water was either bottled and fit for drinking treated until it was drinkable but nasty tasting or undrinkable stream water. Sanitation was provided in a morning sweep of the floors with a solution of Presept. Handwashing was done in a bowl with dilute chlorhexidine which was changed daily. Presept tablets were used to cleanse reusable items. Childrens medical conditions varied from everyday childhood complaints to gross dehydration and malnutrition. There was oral and perineal candidiasis meningitis kwashiorkor marasmus malaria cholera and typhoid. Corrective surgery on 6-month-old children was performed for hernias and cleft palates. The one case of leukemia was untreatable and referred to a general hospital. Rehydration was performed with intravenous intraosseous or intraperitoneal lines and rehydration salts. Good venous access was not always possible. Incubators were needed but unavailable. Parents were taught and encouraged to help with the administration of oral fluids and medications but there was a great need for constant supervision. A wide cross section of social classes was represented. Those better educated quickly grasped the information while others were confused by instructions. Children arrived by walking or military transport with entire families. Off-duty Marines played with children in mutually satisfying activities but the children did not appear happy even when presented with teddy bears.