Today marks a year since the World Health Organization declared the coronavirus outbreak a global pandemic on March 11, 2020. On this day, let's look at how UNDP in Iraq was quick to respond to the critical health needs highlighted by the overwhelming stress on Iraq’s health system. 

In response to the COVID-19, the Government of Iraq began to implement measures in February last year, amid its existing political, economic, security and social challenges. This included containing and preventing the virus's further spread, boosting the health system, engaging with communities, and revising travel norms. 

While Iraq is still reeling and building back from the ISIL conflict, the Coronavirus outbreak added more pressure on its healthcare systems. Tackling multiple crises at once, there was a growing need to provide isolation wards and life-saving medical equipment for patient care to reduce the stress on the health facilities and save lives.

"This virus has put pressure on various units within the same health facility as efforts have been focused on treating patients with COVID-19 whereas other patients, some with critical conditions, also need to be served," says Dr Haider Al-Muqdami, Director of Baqubah General hospital in Diyala since 2015. "Unfortunately, some patients come to the hospital very late after contracting the virus, which severely damages their respiratory system and complicates their recovery," he adds. 

UNDP leveraged existing mechanisms and in-house resources to respond swiftly and ensure quality implementation in a rapidly evolving and complex context. Through UNDP Iraq's flagship Funding Facility for Stabilization, USD 40 million was mobilized for COVID-19 response with funds from new contributions and donor-approved re-purposing of funds. What enabled UNDP to act quickly was the dedicated team who continued to be on the ground under very difficult circumstances, along with a robust operational system.

Since the stabilization programme's inception in 2015, the focus has been on rehabilitating critical infrastructure and supporting the restoration of essential services across the five governorates liberated from ISIL. UNDP quickly operationalized by setting up a Service Centre that ensured agility, adaptability, and flexibility in delivery. 

"During the early days of the outbreak, we were agile enough to quickly spot the immediate gaps in the health system. As the development partner of choice in Iraq, we proved our responsiveness and ability to deliver quickly and efficiently," says Zena Ali Ahmad, Resident Representative, UNDP Iraq. "This has only been possible thanks to the dedicated team on the ground who have worked quickly and efficiently, under extremely challenging circumstances, and to our partners and donors for extending the much-needed resources" she adds.

Using tried-and-tested methods, UNDP Iraq’s COVID-19 response includes building, rehabilitating and equipping 16 COVID-19 isolation wards across the country. Based on discussions with the Ministry of Health (MOH), and in full coordination with WHO, UNDP initially targeted nine locations but scaled its operations up to 16 wards across 15 locations -- Amara, Baquba, Basra, Diwaniya, Dohuk, Erbil, Fallujah, Hillah, Karbala, Kirkuk, Mosul, Najaf, Nasriya, Ramadi, Tikrit and Samawa. 

"Our response is integrated into the UN-wide response and aligned with the World Health Organization's preparedness plan. As isolation and timely management of positive cases is a vital step towards limiting transmission, UNDP focused on building or rehabilitating airborne infection isolation rooms and equipping them to provide optimal respiratory care. Every step of the way, we have worked in close coordination with our partners to ensure synergy and coordination, especially between UN agencies and the Ministry of Health," says Dr Ali Yasari, UNDP Iraq's Project Manager who led the planning of the response. 

The building of the isolation wards started with an initial assessment of the infrastructural gaps, followed by an assessment of the identified sites, and finally choosing an implementing contractor through an open, competitive bid process driven by the existing service centre. 

In fragile contexts when timelines and efficiency are essential, Karina Schejbalova, Project Manager at UNDP Iraq, talks about the approach to establishing the wards. "We already had engineers on the ground, so we were able to re-strategize and focus on the isolation wards. The expansion into other regions of Iraq forced us to think outside the box with regards to designing the wards, while also tapping into the existing talent pool of engineers we had worked with previously. There are a lot of engineers in Iraq, and it makes our work much easier that we can rely on our staff on the ground,” shares Karina who is also an engineer by profession. “We took extra measures to ensure safety and movement access of all the teams that were involved,” she adds.

In some cases, such as the isolations wards in Tikrit Teaching Hospital in Salah al-Din, existing infrastructure that was damaged during the conflict was rehabilitated. In other instances, such as the wards in Najaf, the facilities are being built from scratch.  

Twenty-four-year-old Sajjad, a former restaurant worker and now construction worker employed to help build 20 isolation units at the site of Al-Hussein Hospital in Karbala, knows well the responsibility of supporting the national response to COVID-19. "I feel a sense of achievement when I am consistent, perform well and complete high-quality work. Once this period passes, I hope we can be stronger – overcoming bigger issues and becoming a more resilient society."

To date, 238 airborne infection isolation rooms have set up across the 16 locations. Also, 180 ventilators and patient monitors, ten defibrillators and 180 suction devices have been delivered to eight healthcare facilities. In contrast, cumulatively, 8,160 N95 respirators have been provided to facilities across eight governorates. The provision of medical equipment and essential personal protective equipment (PPE) for the remaining locations is in the pipeline.

UNDP was quick to respond to the people of Iraq thanks to generous and prompt support by Belgium, Canada, Denmark, Finland, France, Germany, Japan, Netherlands, Sweden, United Kingdom and the United States of America.