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GENERAL SITUATION (5 April)

Baghdad and surroundings

For the residents of Baghdad, the sustained bombardments and the ground offensive of the last few days has driven home the point that the war is going to reach the capital itself - unlike in 1991. The immediacy of physical danger is much more tangible and the detonations of artillery fire on the outskirts of the city have sent many people fleeing to city districts they perceive to be safer.

Traffic in town on Saturday morning was frenetic. Seeking a safer refuge, entire families were moving from their homes to those of relatives in other parts of the city, although no-one quite knew which area would be "safe".

There was great concern about the short-term medical and water needs of hospitals and water installations in the southern towns of Baghdad Governorate (Abou Ghraib, Maymoudiyah, etc.) and in the surgical hospitals of Hilla, Kerbala and Al-Anbar. The ICRC received worrying reports on the situation in Mahmoudiyah, where the hospital was said to be no longer capable of dealing with the influx of injured patients, in particular since it was no longer possible to refer patients to hospitals in Baghdad for treatment and surgery owing to military operations on the access roads. The ICRC in Baghdad was unable to gain access to these areas.

Today, Sunday 6 April, the ICRC was continuing emergency activities in Baghdad, as follows.

Emergency medical treatment

Heavy artillery fire and military operations overnight from Friday to Saturday brought in a steady influx of war-wounded at a rate of about 100 patients an hour to the Al-Yarmouk hospital up to midday on Saturday. They were given emergency first-aid treatment and were subsequently transferred to other hospitals around town for further treatment and surgery when necessary.

No-one is able any longer to keep accurate statistics on admissions and transfers of the war-wounded, as one emergency arrival follows another in the hospitals of Baghdad. Ambulances are picking up the wounded and running them to the triage areas and on to hospitals. Some of the wounded try to reach the nearest hospitals by foot.

All the hospitals are under pressure and medical staff are working without respite. Despite the intense and desperate activity, hospital staff are still managing the situation. Doctors who had spontaneously offered their assistance are reinforcing medical teams in the emergency units. Dressing and surgical equipment was still available yesterday (5 April) in sufficient quantities.

Given the reduced water pressure and supply from the majority of the treatment plants, hospitals in Baghdad had not been permanently supplied with piped water and are in urgent need of stocks of supplementary water. The ICRC water bags pre-positioned over previous days and weeks had mainly been used up by yesterday (5 April) in the five main surgical hospitals of Baghdad, and an additional 30,000 one-litre bags will be distributed to those locations as soon as possible. Additional stocks of water in bladders (used for cleaning, washing and other purposes) are being provided by water trucks to Al-Kindi and Al-Kharh hospitals and this activity will be extended as from today to other hospitals.

The emergency purification units and the compact water treatment unit installed by the ICRC in previous weeks have been operating since Thursday night to provide emergency water to the four hospitals of Medical City, as the nearby Wathba water treatment plant has been out of operation.

Without the emergency operation of the ICRC units and the use of some of the 35,000 one-litre water bags pre-positioned in those hospitals, there would have been a serious hygiene problem in the sectors and units of Medical City.

Water and habitat

...in Baghdad

Emergency assessments were carried out on Saturday in various sectors of Baghdad City to evaluate the impact on water production and supplies to hospitals as a result of the lack of power supply since Thursday evening. Most hospitals and water installations are now powered by back-up generators for most of the time .

The ICRC is receiving many reports of technical problems and requests for service kits, spare parts and repairs. Repairs were carried out at Al-Wathba water-treatment plant and at Doura water-treatment plant, which supplies water to Al-Yarmouk surgical hospital.

...and outside Baghdad

Reports from Al-Anbar governorate indicate that the three generators supplied last week by the ICRC have been installed and successfully put into operation, benefiting more than 60,000 people deprived of water supplies since 29 March.


BASRA

The convoy that transported medical materials to Basra on 4 April returned to Kuwait on 5 April. It was carrying the mortal remains of the British Independent Television News (ITN) correspondent, Terry Lloyd, located at a hospital in Basra. The remains were handed over to the British authorities. Despite repeated attempts, the ICRC has so far not been able to establish the whereabouts of two other ITN journalists reported missing.

According to latest reports from the field, ICRC delegates will remain at the delegation today and local colleagues are staying with their families.


Herewith a summary report from our medical delegate on the situation in Basra over the last week (as at 5 April):

General situation last week in Basra, and ICRC activities

Most of the bombing was taking place either late evening or early morning. There was little movement in the streets at night but activity during the day appeared to be increasing, with vehicles circulating and shops opening. Fresh supplies of fruit and vegetables were reaching the city.

The ICRC paid regular visits to three surgical reference hospitals. The situation was so far under control, with sufficient supplies of most drugs. The medical staff appeared to be well prepared to face emergencies, being very competent and experienced. However, some of the nursing staff, especially the women, were not at work in recent days because of the crisis. Some surgical materials, especially catheters and anaesthetic materials, as well as blankets and sheets, were in short supply and were brought in by the ICRC on 4 April. During the first three days of fighting around Basra, the hospitals were reporting admissions of about 100 war-wounded a day. More recently, the number was down to between 15 and 25.

The big problem was clean water supply: hospitals either did not have enough water or had to use untreated water. The ICRC, via public contractors, is now trucking in 10,000 litres of treated water per day per hospital.

On Saturday 5 April, supplementary water trucking continued, using four ICRC tankers. The ICRC also planned urgently to install at each hospital large bladder tanks, which had been provided by UNICEF and were brought in on the convoy of 4 April.

There were no indications of a public health crisis such as outbreaks of epidemics. However, an increase in cases of diarrhoea was noted.


ARBIL

Local ICRC staff reported shelling during the night from Saturday to Sunday in Dohuk. They visited Dohuk hospital this morning and reported that it had during the night admitted 11 war-wounded patients, who were receiving treatment. For the time being, the hospital was able to cope with the demands being made on it.


Visits to Iraqi POWs held by the coalition

As of Saturday 5 April, some 3,700 prisoners had been seen by ICRC delegates. Additional Iraqi POWs continued to arrive at the coalition camp in southern Iraq, which now holds about 4,500 POWs.

Unfortunately, the ICRC was not yet given the possibility to visit coalition POWs held by the Iraqi authorities.


Re-establishing family links

On Saturday, 56 families in Baghdad made use of the ICRC's satellite telephone to contact their relatives abroad and to give them news on their health and whereabouts.

(Please see http://www.familylinks.icrc.org for information on this programme).