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Protection of civilians: weapons, harms and challenges Stories from Iraq

All photos © Emily Garthwaite / Article 36

At the heart of every conflict remains a harsh reality: civilians continue to bear the brunt of violence. The significant normative progress made in the protection of civilians has not translated into practice for millions of conflict-affected civilians. As wars are waged, civilians and essential civilian infrastructure are harmed by gunfire, bombings and other common methods of warfare; communities and economies decimated; land contaminated by explosive remnants of war. Hospitals, schools and other essential infrastructure can take years to repair or rebuild; the physical and mental health of affected people and communities is often compromised indefinitely; and people forcibly displaced by violence struggle to return home.

In November 2019, Article 36 visited Kurdistan in northern Iraq to talk to people affected by conflict - in particular, by the use of explosive weapons in towns, cities and other populated areas - about their experiences. Our visit took place two years after Iraqi forces and the international coalition had declared the conflict with the transnational jihadist group Islamic State (ISIS) complete. ISIS had taken control of Mosul and Tikrit in Spring 2014, and shortly afterwards announced the formation of a caliphate: at its peak, Islamic State controlled over 45,000 square kilometers of territory in Iraq and Syria. After a brutal campaign to regain the territory, culminating in the months-long battle for Mosul in 2016/17, the Iraqi government announced that ISIS had been routed.

More than a million Iraqis are still displaced, and the lives of many more continue to be impacted by the harms caused by the weapons and methods of warfare used by both ISIS and the Iraqi and coalition forces that eventually defeated them. At the same time, refugees from neighbouring Syria continue to populate the camps in northern Iraq, with little hope of returning home. We spoke with both resident and displaced Iraqis, as well as with recent arrivals from Syria who were fleeing the Turkish military offensive launched there just a month prior.

These are their stories.

*Please note, the stories below include graphic and distressing content

"Sometimes I feel like I can’t breathe"

Failing to protect health

Protecting civilians is first and foremost, about preventing or minimising death, injury or ‘harm’ from military action. So when death and injury of civilians occurs, it is one of the clearest indicators of a failure to fully protect civilians in conflict. Yet civilians continue to be the primary victims of conflict: conflict is one of today's greatest global health challenges, while killing and injuring people continues to be central to the role and purpose of weapons, whether they are bullets or bombs.

The two most commonly-used weapons in conflict are small arms (guns) and explosive weapons (for example aircraft bombs, artillery shells and mortars). Both can be deadly or incapacitating. Gunshot wounds cause central nervous system damage, massive organ destruction, blood vessel damage and haemorrhage, while those who are close to an explosive weapon when it detonates are almost inevitably killed by the blast force or heat. Explosive weapons fragments and collapsing buildings pose additional threats to the lives and safety of people in the vicinity or nearby. This was the experience for Ali Zanoun, one of only two known survivors of an international coalition airstrike on a building in Mosul that killed more than 100 people.

I could see my children broken into pieces of flesh, and I could see my wife burning alive.

Ali (pictured) lived through the months-long battle to re-take Mosul, frequently moving with his extended family in search of safety. His family were killed in an airstrike in Mosul: he spent 5 days trapped in the rubble surrounded by the bodies of over 20 family members.

"The clashes were really intense, using all kinds of weapons – mortars, artillery, being launched from really far away. Airplanes started bombing the neighbourhood, destroying house after house. I saw one airstrike hit seven houses where civilian families were living.

After my family saw what happened to other civilians we were afraid, so we left the house we had been sheltering in and went to a friend's house about 60 metres away. We had to go by foot with the kids through our neighbourhood to get there – we weren’t able to see much, and each family with kids lost track of one or two children on the journey between the homes. It was terrible, the flesh of people who had been killed was strewn about the streets. It was awful for our children to see this.

On 17 March 2017, several rockets hit the home we were sheltering in. I was conscious for most of the time: I could see my kids broken into pieces of flesh, and I could see my wife burning. And I was buried to my chest in rubble.

I stayed like that for five days. All of my limbs were broken. It took me an hour to remove the rubble around my right hand, and then I put my arm in a blanket. At night it was so cold, so in order to sleep I tried to shift the rubble around me to block off any draughts, but every time there was an airplane or artillery strike the rubble moved and I had to start all over again. For those five days trapped in the rubble, the hardest thing to deal with was the smell. It was very difficult to stay alive: even though god made me live, the smell of dead bodies was really too much."

After he was rescued from the rubble, Ali was taken to a hospital in Erbil. He had 64 surgeries in the space of a few months, and now, several years later, he still has not regained the use of his right arm. He is in constant pain, and his ears ring continually.

Ali and his family's story is by no means unique. The scale of death and injury he describes are common where heavy explosive weapons are used in populated areas such as cities, towns and villages. Despite this, the practice remains a common feature of warfare: Yemen's conflict, raging since 2015, has seen extensive use of airstrikes, rockets, mortars and other explosive munitions; in eastern Ukraine, the widespread use of explosive weapons has inflicted serious and lasting harm on the population; and most recently heavy artillery fire and missile strikes have destroyed hospitals, schools, homes and infrastructure in the disputed region of Nagorno Karabakh. Syria's decade-long conflict has seen extensive use of heavy explosive weapons and the resulting death and destruction.

The harms civilians suffer as a result of conflict-related violence are often long-term and debilitating. Brain injuries, as well as other common injuries such as amputations, can result in lifelong impairments made all the more difficult to manage in contexts where health services are often decimated. Access to high-quality and ongoing rehabilitative care in such cases can help survivors of shootings, bombings, shelling and other weapons-related injuries, yet this is often impossible in conflict and post-conflict settings.

When ISIS took control of Mosul, Hashim (pseudonym - pictured below) tried to flee with his family to Erbil, but were unable to pass through the checkpoint to the city. During the final battle for Mosul, Hashim and his family took the opportunity to flee again but were caught in an IED explosion.

I spent 7 or 8 days in hospital – because of nerve damage they decided to amputate my leg above the knee because it was going bad.

"There were so many airstrikes, mortars and artillery attacks. At some point it became almost normal. Then one night a bomb hit our roof, and it completely caved in. No-one was injured - we all ran from the house and stayed in a neighbour's house for six or seven months. We were starving – no one had food, because the city was surrounded. In every street ISIS had a kitchen and cooked food but it was very little – for 6 members of my family, we had 6 spoons of rice and 6 spoons of soup. Eventually, with my siblings and our mother, we decided to flee Mosul.

We split into two groups and all carried white flags - pieces of fabric tied to firewood. We spotted the Iraqi army and waved our flags - they motioned for us to come towards them so we did. My brother and sister in law were at the front of the group and started to pass, and I was at the back behind the children – and then the IED exploded. I felt something like a wind and something cut off, then I saw my niece and nephew cut in two and burning and my brother injured with shrapnel, shouting ‘my children, my children,’ and I saw my sister in law, wounded and crying out for her children too. The four children and their parents all died. The children died straight away, and their parents on the way to the hospital. I spent 7 or 8 days in hospital – because of nerve damage they decided to amputate my leg above the knee because it was going bad. I now have a prosthetic leg from the ICRC."

Hashim and his mother rented several houses in Mosul after ISIS was routed, but with many houses destroyed, rents increased and they fell into debt as he struggled to regain his livelihood. He and his extended family now live in a camp for internally displaced persons in northern Iraq.

Conflict-related violence not only erodes a society's capacity to meet the health needs of those directly and immediately effected, but often strains healthcare services to the point of overwhelm. Explosive weapons cause extensive damage to buildings, infrastructure, equipment and ambulances when they hit or detonate nearby, while small arms fire can be devastating to the normal operations of a hospital by killing medical workers and damaging specialised equipment and ambulances. In Iraq, at least half of the health facilities in the majority of conflict-affected cities were damaged or destroyed by the conflict with ISIS, with the damage to these cities’ hospitals alone estimated to be worth $1 billion.

Even where healthcare infrastructure is not directly affected by violence, the destruction of services vital to its successful operation (such as electricity, water, sanitation, and transport routes) can severely erode the capacity of a healthcare system to respond to traumatic injuries and to maintain standards of ongoing care. Medical staff are drawn away from other specialties into trauma or other directly-conflict related practices, diminishing capacity in other areas of medicine including reproductive and gender-specific healthcare. This exacts a heavy toll: in Syria, for example, almost 46% of population deaths over the decade-long conflict have been due to chronic diseases such as cardiac conditions, diabetes, cancer or respiratory diseases such as asthma – higher than the number of deaths caused as a direct result of trauma injuries. As conflict rages, infectious diseases spread due to reduced availability of sanitation and hygiene at a time when the ability to conduct preventive health measures such as immunisation programmes is severely compromised.

It is widely recognised that conflict-related violence has a notable gendered impact, including in the context of population health. Women are exposed to specific health risks such as miscarriage or death during childbirth due to stress and inadequate healthcare, while their ability to access specialised healthcare can also be severely compromised by conflict. This has been the experience of Amena, Gulstan, Farida and Gulstan, a group of friends who fled the city of Ras al Ain in northern Syria when Turkish airstrikes began in autumn 2019. They first stayed within Syria in the town of Hasakah, where they slept on the street and in schools for over two weeks, before crossing the border into Iraq. When we met, they were living in a refugee camp in northern Iraq and continued to suffer the health impacts of their experience including mental trauma. Several of the women suffered reproductive health problems during or after their flight and continued to struggle to access adequate healthcare in the camps.

Amena was 24 when she was forced to flee her home in Ras al Ain. She has two children aged six and five, and was pregnant with twins when the airstrikes began.

As we fled we saw dead bodies, and blood everywhere, blood running through the streets like it was a river.

"We heard Turkey was going to bomb our area, but we didn't believe it, we thought it was just talk in the news. Then on 4pm on the 8th September 2019, it happened – the airplanes started bombing Ras Al Ain. They bombed everywhere – they were just randomly targeting everywhere suddenly, and everyone fled. Some people were so frightened they even forgot their children and had to go back and get them. It all happened so quickly.

Before the Turkish airstrikes began, I was pregnant with twins. When we fled, the stress made me miscarry. After I lost my twins I continued bleeding and had so much pain in my back. When we arrived at the camp I went to see the women’s doctor here and begged for a thorough exam, but all they had were basic painkillers. I have continued to experience pain in the weeks we’ve been here and sometimes I feel like I can’t breathe, but I no longer go to the clinic as there is nothing they can do. As women we don’t have underwear or anything for when we have our period – we don’t have anything to use. Our husbands also have old injuries that need more treatment, but there is no help for them."

The experience of the group friends took a toll not just on their physical health, but also on the mental health of themselves and their children. They spoke of feeling trapped and helpless, and of losing hope for not only their own futures but the futures of their children. They also spoke of the enduring fear they suffer:

"Right now in the tent the children are laughing, but so often they are sad. We have suffered a lot with so many things. When we were fleeing Ras al Ain we saw dead bodies, blood everywhere, blood in the running through the streets like it was a river. We fled that situation with blood everywhere. I don’t want the children to grow up in this situation. The children know everything, they have seen too much – if they hear a plane overhead they will go inside because they think an airstrike is coming and they are afraid. And us too - I feel afraid whenever there is an airplane overhead, I get a feeling of panic – I am more afraid than the children, and everyone is crying and shouting."

Like Amena, many of the people we interviewed cited mental health problems stemming from their experience of conflict. At the individual level, this manifested as feeling constantly fearful and anxious, experiencing nightmares and a loss of hope, and feeling confused or overwhelmed. For some, mental health problems manifest in physical symptoms such as headaches and chest, abdominal or other pain, insomnia, changes to menstrual periods, or fainting. One interviewee told of how her pre-teen daughter lost all of her hair. Though the mental health impact of conflict is garnering greater attention in conflict-responses, low awareness about mental health disorders and stigma continue to make both assessing and treating mental health conditions challenging.

"I was just too scared to send him to school"

Failing to protect education

Like health, education is fundamental to the full protection of civilians in conflict. It is both a right to be protected during conflict, as well as a social institution that in itself is something deserving of protection and that plays a protective role for children and young people during violence. Yet conflict and violence continue to deprive millions of children of an education. The Global Coalition to Protect Education from Attack (GCPEA) documented a systematic pattern of attacks on education, including the bombing, burning and destruction schools and universities. Military use of schools as bases, barracks, detention centres or armament stores can similarly deny children of their right to an education, turning schools into targets for attack and putting the security of pupils and teachers at risk. According to the European Commission, the education of 75 million children between 3 and 18 around the world has been disrupted by humanitarian emergencies and protracted crisis.

I was afraid for him, because I just had him now, so I didn’t send him to school.

Surya and Ibrahim, a mother and her son, are from Aleppo. Several years into the Syrian conflict, and distressed by near-constant airstrikes, they left Aleppo for Hasakah and the crossed into Iraq in search of safety.

"When we were in Hasakah, if I heard about an airstrike somewhere else I felt so worried for my son Ibrahim. After our experience in Aleppo, it really disturbed me hearing about any airstrikes at all. So I decided to leave Syria and come here to Iraq. My son Ibrahim had previously gone to school in Aleppo, before it became too dangerous. In Hasakah, even though it was safe, I was still afraid for him, because I just had him now, so I didn’t send him to school. I kept him at home as I was just too scared to send him. In Aleppo there were cases of kidnapping of children so I was really afraid for my son. The constant worry really affected me mentally, and the whole time I just wanted him where I could see him."

In Iraq, over half of the educational institutions in conflict-affected areas were damaged by the conflict, with almost a fifth completely destroyed, and in their 2021 Humanitarian Needs Overview, UNOCHA estimated that 1.3 million IDP and returnee children aged 3 to 17 years still faced obstacles to accessing education. One IDP with five daughters ranging from five to fifteen, as well as one son, explained how the family's lack of identity documents as well as school certificates was preventing her older children from getting a full education: "When we fled, I thought we would be able to go back to our home after one week, but it has been four or five years we have been away now. My children want to study but they need their certificates from their last school in the village in order to be accepted into the next grade, and I can’t afford the transport back to my village. If I have any extra money it is used for food. The general directorate of education will also have a copy of their certificates, but again I can’t afford to get them. I try to help them study at home so that they can at least read and write."

Sahala (pictured) lives with her husband and six of her nine children in Tulaband village, which was on the frontlines of the battle with ISIS. They fled when ISIS attacked the village, and returned over three years later when the school reopened.

For the first year after the liberation there was no school, no health centre...

"When we came back we did not have electricity at first, and only water from the well. We decided to return when the school was open again for the children to go. For the first year after the liberation there was no school or health centre. We returned back, when these services were open again - they weren’t open before mainly because there were not enough staff to run them. When we got back, the destruction in the village was so sad to see. We are facing a very hard economic situation and we can’t afford to rebuild the house. I don’t know how I feel about the future. I hope maybe one day things will be better than they were before."

The effects of conflict and violence on education are not just immediate or short-term: it causes long-lasting harm to children, communities and broader society. Beyond physical violence directed at educational facilities, students and staff, the impact of conflict can also be felt indirectly through steep reductions in public spending on education, shortages of learning materials or trained staff, broader economic pressures on families and wider patterns of displacement and disruption.

"I feel as though we have no future"

People in flight

At the end of 2019, nearly 80 million people were forcibly displaced, the highest number on record. In Iraq, over 6 million people were displaced by the conflict with ISIS, with 1.3 million remaining displaced in 2020 according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). Some 70 per cent of IDPs have been displaced for over five years, and 92 per cent for over three years. Among those who have returned to their areas of origin, the vast majority continue to have serious, often acute, humanitarian needs.

We met with Nazir (pictured below) and his family in a small village in Northern Iraq. They are Yazidis who had lived for generations in Sinjar region, but fled when it came under attack from ISIS.

We took turns sipping small amounts of water from the lid of a bottle to make it last

"My family and the families around us fled into the mountains. It was summer time so the weather was very hot and we didn’t have any water. There was only one small spring in the mountains for everyone - we fetched water when we could, as did our children. We took turns sipping small amounts of water from the lid of a bottle to make it last. There was no food, nor milk for the children - they were crying from hunger and tiredness. The children kept crying until they could cry no more. Many people got sick. My aunt and father died upon arriving to safety - they never recovered from the strain on their bodies.

After 12 days we heard that there was a safe route out of the mountains - we walked from 8 in the morning until we reached trucks that would take us to safety at 2pm. There were many people walking the same way as us. The trucks first brought us to an IDP camp but the camp was full... then heard about the unfinished houses lying empty in this village and so we came here. Living in these unfinished houses is not good for our children, and conditions are very difficult. There’s only one school at the mountainous end of the village, so it takes a long time for the kids to walk to school, and soon winter will be coming which will be even worse."

Though they have found a degree of shelter, life remains hard for the family: "I have no idea what the future will hold for me and my family. I feel as though we have no future - our houses were burned and destroyed in our home area, and only one family has returned to the village. We are hoping for security in our area and compensation for what we have lost but I don’t know what will happen."

Alongside large numbers of IDPs, Iraq is also host to around a quarter of a million refugees and asylum seekers from Syria's decade-long civil war in extremely difficult conditions. Nafia (pictured below) and her family -- including two of her children, Alan and Mohammed who has developmental disabilities -- hail from Qashmili, a city in northern Syria near the border with Turkey. When Turkey launched a military offensive across the border in October 2019, the family feared being the targets of increasing militia violence as well as being harmed by airstrikes.

After we crossed the border, we finally felt safe.

The bombs started to fall in our neighbourhood. Our son Mohammed, who has a mental disability and is mute, was very scared and was screaming when the airstrikes were happening. We were really scared during the bombing... the sound of the was so loud, the kids were very scared. Mohammed did not understand what was happening, when there were airstrikes all we could do was hold him tightly.

The four of us decided we should leave, mainly for Mohammed but also because the situation was dangerous. It was not an easy journey with our disabled son – he is always afraid when there are loud noises. But after we crossed the border, we finally felt safe.

In the camp, we understand that it is difficult for the camp management to provide us with all we need and we are patient. They are building a school, and the NGOs are giving us food and water. But, there is a shortage of medicine. I love Syria, but we would need there to be security to go back, and that means for our sons not be conscripted into any armed forces or militias as well.

Like Nazir and Nafia, many of those who have been displaced by conflict strong desire to return home and resume their previous lives but fear continued insecurity. Cycles of violence and a lack of political solutions to conflicts prevent many from returning to their home countries, while the destruction of their homes, infrastructure and the lack of essential services - particularly education and healthcare - are also factors that make return less likely. Consequently, for those around the world who have been forced to flee their homes due to conflict-related violence, displacement is increasingly protracted.

These testimonies provide only a small snapshot of the harms civilians suffer during conflict, and the ways in which the use of particular weapons types -- in the case of Iraq (and Syria), the widespread use of explosive weapons -- contribute to displacement. The people we interviewed emphasised the horror of the violence they saw, the difficulty and danger of their flight in search of safety, the long-term and often unseen impact their experience had on their physical and mental health, and the frustration and despair they felt at the interruption of their children's education. They also talked about everything they lost when they left their homes - from family members and a sense of community tot heir belongings and items of emotional or practical value (such as education certificates). Many experienced multiple displacements before arriving at the refugee and IDP camps in which we met. All expressed trepidation over what the future would bring.

All photos © Emily Garthwaite / Article 36

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