Erbil's new physical rehabilitation centre gives new lease of life to Iraq's disabled

In the suburbs of Erbil, 41-year-old Marfou Mohamed Dee patiently paces back and forth. 

Fitted with a prosthetic lower limb to replace his missing left leg, and an orthosis for his right foot, Marfou put on his new prosthesis. For Marfou, it's the fourth time he had needed treatment since a long post-amputation recovery process began in 2010.

"The [new] 14,630 sqm structure, one of the biggest in the Middle East, provides physiotherapy services, including prosthetics and orthotics, wheelchairs, walking aids and other necessary services"

Originally from Al-Qa'im, a town located near the Syrian border in the Anbar governorate in Western Iraq, the 41-year-old has come to the final stage of a programme at the Red Cross's new physical rehabilitation centre in Erbil which will help him restore his mobility, a long time coming after Marfou first became a mine victim more than 24 years ago.

Stepping into a private room, he shared his misadventure with The New Arab.

Back in January 1998, as he took out his sheep to graze one day near a phosphate factory in the surrounding area of his town, Marfou saw an unusual-looking object, placed on a small can on the ground. Curious to see what it was, he kicked what proved to be an explosive remnant of war - traced back to the 1991 Gulf War- triggering the device.

“I was only 17 then. After what happened, my mental health was very bad. I wasn’t feeling normal in my life”, as Marfou recalled the difficult period following the incident.

Finding work has been a real struggle for him, and not just because of his impairment.  “There’s no work in my province, and the only existing activity in my village is farming which is physically impossible”, said the middle-aged man who worked shifts at a grocery store before his accident. 

Months after his leg amputation, the pain returned to his legs. He then travelled to Baghdad in December of the same year in order to get his first artificial limb, which he used for a ten-year span until it broke, prompting him to seek specialised treatment elsewhere.

Two years later, he resorted to the ICRC-run centre where he was provided with a new prosthetic leg. He would need to renew it every three years. Initially accommodated at the centre’s dormitory, he had to stay with his uncle living in Erbil after the dorms closed with the arrival of the COVID pandemic.

Over time, thanks to the high-quality service and support of his family and friends, Marfou has since reintegrated into society. He is now married and has five children.

“The treatment here is very good. The staff are very professional and supportive”, said the long-time patient after being taken care of by ICRC staff for 12 years. Today, he is ready to turn the page. After finishing his prosthetic training, aside from a six-month follow-up visit, the Iraqi man can finally go back to his hometown where he plans to cultivate his small plot of land.

"It is estimated that more than 600,000 Iraqis are in need of physical rehabilitation services, with over 200,000 of them requiring prosthesis and/or orthosis"

On the 15th of March 2022, the Red Cross opened its new Physical Rehabilitation Centre (PRC) in the Kurdistan region’s capital of Erbil, north of Iraq, the biggest in the country.

The 14,630 sqm structure, one of the biggest in the Middle East, provides physiotherapy services, including prosthetics and orthotics, wheelchairs, walking aids and other necessary services.

The centre also offers mental health and psychological support to people with disabilities to promote their continued inclusion in society, counselling for families, as well as vocational training and grants to start small businesses where appropriate.

“Addressing mental health and psychosocial well-being is important to help those with physical disabilities to better cope, and to make them feel more included, within society”, Avin Yassin, Communications Manager at ICRC Iraq, told The New Arab.

At a cost of $5.5 million, the brand-new centre is equipped to serve 6,000 people with disabilities per year who live in the Kurdish region and the neighbouring governorates of Nineveh, Kirkuk and Diyala. This figure includes internally displaced persons (IDPs) and refugees, mainly from Syria.

Services offered at the PRC are free of charge and funded by the ICRC’s private donors.

In an effort to make up for the scarcity of skilled practitioners in the physical rehabilitation field, the ICRC also initiated a full 4-year programme at the Prosthetic and Orthotic College in Erbil, in collaboration with Erbil Polytechnic University. There, students from all over Iraq are being taught and trained to become prosthetic and orthotic technicians and physiotherapists.

The ICRC founded its first rehabilitation centre in 1996, among the five facilities first supported by the humanitarian organisation across the country.

While striving to support the rehabilitation sector through the provision of devices, technical assistance and training over many years, the Red Cross has now decided to step up its capacity and resources after realising that there was a huge demand for physical therapy services country-wide.

Avin told the story of Zainab Mahmoud, a young Iraqi woman from Mosul, northern Iraq, who lost a leg when a mortar shell exploded in her bedroom while she was sleeping during the war in Mosul.

Her husband divorced her and her family abandoned her because of her injury, causing much suffering and financial insecurity to her. Following her amputation, she went to the old PRC [physical rehabilitation centre] in Erbil in 2018 and received her first artificial leg. She had very little self-confidence, was unwilling to talk, and felt ashamed to use her prosthetic leg in public.

"According to the Iraqi Ministry of Health, around 15% of the Iraqi population (or 6 million people) live with disabilities"

Later, Avin took initiative and approached Iraqi social media influencer Zainab Al Eqabi, who also lost her leg during Iraq’s war. The Red Cross brought her to Mosul to meet Mahmoud and empower her after all the stigma she endured. A video with the two Zainab made by ICRC Iraq’s team in 2019 was widely shared on social media.

“After one year, I got in touch with the young Zainab to see how she was doing and found a different person”, Avin remembered smiling, “she had become an open, self-empowered woman”.

Zainab has moved on with her life. A mother to a girl child, she has been working in an ice cream shop in Mosul for the last two years.

It is estimated that more than 600,000 Iraqis are in need of physical rehabilitation services, with over 200,000 of them requiring prosthesis and/or orthosis.

Based on ICRC data, between 1996 and 2022, the Erbil-based PRC has provided physical rehabilitation services to 16,407 people, including over 8,200 amputees. As of last year, 34% of the amputee service users were mine victims while 26% of them had injuries caused by other conflict reasons.

Ana Rodrigues, a physiotherapist working at the ICRC's centre in Erbil, said that incoming disabled patients include war-wounded as well as people affected by diabetes and vascular diseases whose limbs were amputated due to lack of access to healthcare. “Besides those with direct conflict-related injuries, we shouldn’t forget there are others who have been left with injuries because they live in a conflict area and didn’t receive the needed treatment”, she pointed out speaking to The New Arab.

According to the Iraqi Ministry of Health, around 15% of the Iraqi population (or 6 million people) live with disabilities. A substantial portion of the disabled has conflict-related injuries. A UN report on children and armed conflict in Iraq published earlier this year found that explosive remnants of war and unexploded devices are the leading causes of casualties among Iraqi children, in many cases leaving them with lifelong disabilities.

“Patients come with the expectation to go back to their previous lives”, Rodrigues noted, “the moment you fit them with a leg, they stand and start to walk, it’s halfway there for them”. “What we provide here is a ‘first step’ that in turn enables them to access education, work, and be part of society”, she continued and hinted at common problems found among the physical disabled such as pain, fear, sleep disorder, and worry about the future.

The physiotherapist explained, further to the initial assessment of the amputee’s disability, a treatment plan is drawn up, the appropriate device is then manufactured, with training on how to use it the final step. A patient who gets a new limb is required to come to the centre for training every day, or every other day or so, depending on their availability and financial capability.

For those patients who are in need, cash assistance is provided to cover transportation costs to visit the centre on a case-by-case basis, determined by income and travelling distance.

ICRC’s communications manager said that whoever wishes to visit Erbil’s physical rehabilitation centre is welcome to call to make an appointment, and just needs to present their ID to be served. 

Alessandra Bajec is a freelance journalist currently based in Tunis.

Follow her on Twitter: @AlessandraBajec