Healthcare and Nutrition in Camps/Urban Settings
Iraqi Refugee Health Profile
In a rapid survey by the Syrian Ministry of Health and the United Nations Children’s Fund (UNICEF) in 2007, the immunization coverage among Iraqi children <5 years old in Syria was 89% for diphtheria-pertussis-tetanus (DPT) and Haemophilus influenzae type B (third dose), 82% for measles, and 81% for hepatitis B 20. Upon arrival in Jordan, 52% of Iraqi refugees with children <5 years reported receiving vaccinations 21. Some immunizations that are currently given to refugees in Iraq, Syria, and Jordan can be found in the Current Immunization Schedules.
In Iraq, approximately 80% of babies were delivered by skilled attendants (doctor, midwife, or nurse), and 18% by traditional birth attendants 9. In Syria, close to 70% of expectant Iraqi mothers delivered in hospitals in 2006, and 93% of births were attended by a physician 22. The information from Syria states the situation before the current civil war, and may not reflect the current situation there. Over 15% of expectant Iraqi mothers in Syria did not receive antenatal care, and 40% of expectant Iraqi mothers in Syria also did not receive tetanus vaccine 22. In Jordan, 94% of Iraqi women who gave birth delivered in a health care facility. Ninety-one percent of pregnant Iraqi women sought antenatal care during their most recent pregnancy, and 48% of them also sought postnatal care. Among the women who did not seek postnatal care, the most common reasons included not perceiving a need for a postnatal visit or not wanting care 21. Knowledge of family planning methods and birth spacing was shown to be high among adult Iraqi refugees in Jordan 23. However, knowledge of family planning and general reproductive health among adolescent Iraqi refugees was low; most group discussions with adolescents yielded knowledge of only one contraceptive method or way to prevent sexually transmitted infections (STIs) besides abstaining from sex 23.
The most commonly used method of family planning among Iraqi refugees interviewed in Jordan was withdrawal (32%), followed by oral contraceptive pills (30%), IUD (22%), rhythm/calendar (21%), and the male condom (21%) 23. Access to family planning is almost nonexistent for poor, unmarried, and adolescent Iraqi refugees. This leads to unsafe abortions or abortions illegally performed by doctors 7. Little information is available regarding the family planning situation for Iraqi refugees in Syria.
Iraqi refugee women living in Jordan reported domestic violence as a common occurrence. The stress of living in cramped quarters, the trauma of violence and loss experienced in Iraq, and a lack of employment have all contributed to extensive domestic violence. Additionally, marital rape was reported 24.
Many Iraqi refugee women and girls witnessed or are survivors of sexual violence in Iraq, especially rape by armed groups and civilians 24. Since the Second Gulf War, there has also been an increase in trafficking and sexual exploitation. As many as 15% of Iraqi widows seek “temporary marriages” or transactional sex work for protection and/or financial support. Additionally, approximately 4,000 Iraqi females, many of whom are children, have disappeared and are believed to have been forced into sex work 24.
In Iraq, medical care and psychosocial support for the survivors of sexual violence are not available, so most rapes go unreported 24. Cultural barriers such as stigma and shame also impede Iraqi rape survivors from reporting their attacks 7.
Since the Second Gulf War, chronic food insecurity has become one of the biggest issues affecting Iraqis. As of 2007, only 32% of Iraqis had access to safe drinking water, and lack of adequate sanitation has contributed to diarrheal disease outbreaks, including typhoid and a large outbreak of cholera in October 2007 and more recently 3.
The Iraqi Ministry of Health reported that over half of Iraqi women and children suffer from malnutrition and anemia, contributing to high maternal and infant mortality 30. In 2011, prevalence of acute malnutrition measured by mid-upper arm circumference among Iraqi refugee children <5 years old was 1.7% in Jordan and 4.5% in Syria 5. Food insecurity seems to be of greater concern in Syria than in Jordan. Among Iraqi refugees resettled in San Diego from 2007-2009, 16.5% of children <5 years old and 29.6% of women of childbearing age were anemic 26. In 2012, a CDC survey of Iraqi refugees in 4 US states showed that 9% of participants and 13% of their household members reported having anemia 8.
- United Nations High Commissioner for Refugees. UNHCR Iraq Fact Sheet. 2010. Accessed November 2013. http://www.unhcr.org/pages/49e486426.htmlExternal
- Queensland Health Multicultural Services. Community Profiles for Healthcare Providers: Iraqi Australians. Queensland Health. [Online] July 8, 2011. [Cited: September 13, 2011.] www.health.qld.gov.au/multiculturalExternal.
- Giese, Amanda. An Assessment of the Health of Iraqi Refugees in Chicago. Heartland Alliance. 2010.
- Harper, Andrew. Iraq’s Refugees: Ignored and Unwanted. 869, 2008, International Review of the Red Cross, Vol. 90, pp. 169-190.
- Doocy, Shannon, et al. Food Security and Humanitarian Assistance Among Displaced Iraqi Populations in Jordan and Syria. 2, 2011, Social Science & Medicine, Vol. 72, pp. 273-282.
- Ghareeb, Edmund, Ranard, Donald and Tutunji, Jenab. Refugees from Iraq: Their History, Cultures, and Background Experiences. Center for Applied Linguistics. 2008. COR Center Enhanced Refugee Backgrounder No. 1.
- Women’s Commission for Refugee Women and Children. Iraqi Refugee Women and Youth in Jordan: Reproductive Health Findings, A Snapshot from the Field. 2007.
- Taylor, Eboni et al. Physical and Mental Health Status of Iraqi Refugees Resettled in the United States. Springer, Journal of Immigrant and Minority Health, August, 2013. Web. August, 2013.
- Iraq Family Health Survey 2006/7 (World Health Organization). Accessed 2012, at http://www.emro.who.int/iraq/pdf/ifhs_report_en.pdf).rmCdc-mediaExternal
- Terrazas, Aaron. Iraqi Immigrants in the United States. Migration Information Source. [Online] March 5, 2009. [Cited: September 9, 2011.] http://www.migrationinformation.org/USfocus/display.cfm?id=721External.
- O’Donnell, Kelly and Newland, Kathleen. The Iraqi Refugee Crisis: The Need for Action. Migration Policy Institute. 2008.
- Wisconsin Department of Health Services. Tips for Health Care Providers about Iraqi Refugees. 2010.
- Stratis Health. Iraqis in Minnesota. Stratis Health. [Online] 11 1, 2009. [Cited: September 13, 2011.] http://www.stratishealth.orgExternal.
- Saadi, Altaf, Bond, Barbara and Percac-Lima, Sanja. Perspectives on Preventive Health Care and Barriers to Breast Cancer Screening Among Iraqi Women Refugees. 2011, Journal of Immigrant & Minority Health. PMID 21901446 .
- IRC Commission on Iraqi Refugees. A Tough Road Home: Uprooted Iraqis in Jordan, Syria and Iraq. New York : International Rescue Committee, 2010.
- Frelick, Bill. “The Silent Treatment”: Fleeing Iraq, Surviving in Jordan. [ed.] Peter Bouckhaert, Christoph Wilcke and Sarah Leah Whitson. Human Rights Watch. November 2006, Vol. 18, 10.
- Schinina, et al. Assessment on Psychosocial Needs of Iraqis Displaced in Jordan and Lebanon. International Organization for Migration. 2008.
- Centers for Disease Control and Prevention (2012), Electronic Disease Notification System (EDN).
- US Department of State, Bureau of Population, Refugees, and Migration (PRM), Worldwide Refugee Admissions Processing System (WRAPS).
- Joint Appeal by UNFPA, UNHCR, UNICEF, WFP, and WHO. Meeting the Health Needs of Iraqis Displaced in Neighbouring Countries. 2007.
- World Health Organization/UNICEF/Johns Hopkins University. The Health Status of the Iraqi Population in Jordan: 2009
- United Nations High Commissioner for Refugees; United Nations Children’s Development Fund; World Food Program. Assessment on the Situation of Iraqi Refugees in Syria. 2006.
- Women’s Refugee Commission. Baseline Study: Dcumenting Knowledge, Attitudes and Practices of Iraqi Refugees and the Status of Family Planning Services in UNHCR’s Operations in Amman, Jordan. 2011.
- Chynoweth, Sarah. The Need for Priority Reproductive Health Services for Displaced Iraqi Women and Girls. 31, 2008, Reproductive Health Matters, Vol. 16, pp. 93-102.
- World Health Organization, Regional Office for the Eastern Mediterranean (EMRO) website. Accessed September, 2012. http://www.emro.who.int/External
- Ramos, M, et al. Health of Resettled Iraqi Refugees–San Diego County, California, October 2007-September 2009. 2010, Morbidity and Mortality Weekly Report, Vol. 59, pp. 1614-1618.
- World Health Organization. Tuberculosis Profile: Iraq. World Health Organization. [Online] January, 29th 2013. [Cited: January 29th, 2013] www.who.int/tb/dataExternal.
- Yanni, E, et al; The Health Profile and Chronic Diseases Comorbidities of US-Bound Iraqi Refugees Screened by the International Organization for Migration in Jordan: 2007–2009. Journal of Immigrant and Minority Health; DOI 10.1007/s10903-012-9578-6
- World Health Organization. Non-Communicable Disease Profile: Iraq. World Health Organization. [Online] September 12, 2011. [Cited: September 12, 2011.] http://Infobase.who.int.
- International Rescue Committee. The Health of Refugees from Iraq. 2009. http://www.rescue.org/iraqi-refugeesExternal.
- Darwish-Yassine M, Wing D. Cancer epidemiology in Arab Americans and Arabs outside the Middle East. Ethn Dis. 2005;15 (1 Suppl 1):S1-5–S1-8.
- 32. Michigan Department of Community Health. Color me healthy: a profile of Michigan’s racial/ethnic populations, May 2008. 2011. Accessed on 22 Jan 2011 at http://www.michigan.gov/documents/mdch/ColorMeHealthyProfileMay2008_2362457.pdfCdc-pdfExternal
- Shah SM, et al. Arab American Immigrants in New York: health care and cancer knowledge, attitudes, and beliefs. J Immigr Minor Health. 2008;10:429–36.
- Alhasnawi, Salih, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). 2, 2009, World Psychiatry, Vol. 8, pp. 97-109.
- United Nations High Commissioner for Refugees. 2013 UNHCR country operations profile – Iraq. http://www.unhcr.org/pages/49e486426.htmlExternal