Kirkuk District, Iraq — July 26, 2006 — The doctor feels lucky — he is temporarily stationed in a district that is safer than in his hometown of Mosul. There, doctors are targets of violence. Their attackers believe the doctors are rich or that they are working for the enemy. Many have died. Several of the doctor’s colleagues have left Mosul but he, with a wife and six-month-old child, has nowhere else to go. When he reaches the Kirkuk district, however, he is reminded about the plight of fellow Iraqis and inspired to help as many as he can.

In Kirkuk, villagers are too poor to afford the most basic of services: transportation to the nearest town, gas for heating and to boil water, and fuel to run the tractor for work in the fields. The treacherous dirt road makes this village of mud houses and thatched roofs almost inaccessible in the rainy season or in winter. Most of the people are farmers, and even with the rainy season there has been less rainfall this year; the harvest will be meager. None of the children, who make up more than half of the population, attend school. Health services are far; sometimes that distance is the difference between life and death.

International Relief and Development, Inc. (IRD) is funding a project to send doctors to this village and other remote areas. Mobile Medical Units, consisting of a doctor and three assistants, travel from village to village in Kirkuk, aiming to reach almost 26,000 people.

Many of the people seldom see a doctor. Since the midwife in the district died eight years ago, the women are forced to travel to the hospital in other towns for delivery. The children usually see a doctor only when they come out of the womb.

“Every person I see here should go to the hospital," says the doctor on one of the teams.

Some have typhoid, chronic diarrhea or fever related to respiratory problems. Others have allergy-related bronchitis and pneumonia. Many others have diabetes and don't even know, he says. Children regularly die of snake and scorpion bites.

“They die on the way to town. We should set up some first-aid treatment here. Some of them are educated and know how to give basic medicine," the doctor says.

One woman knows what it means to be far away from health care. The last time she went to the doctor was to give birth to her two-year-old, the last of her 11 children. Her daughter, 26, was not so lucky. When she went into labor there was no car available to take her to the hospital. Instead she took a tractor. By the time she arrived, her baby had died.

The doctor inspects mostly women and children who gather in a crowd around him and his three assistants. He asks their names and listens to their complaints. He inspects them briefly, feeling their pulse or taking their blood pressure, before uttering a few words of advice. He scribbles a prescription for nearly everyone. Chronic problems reign and could worsen into something serious; most of those problems would not exist if they had better water, hygiene and sanitation.

IRD, funded by USAID’s Office of Foreign Disaster Assistance (OFDA), provides his team with the means to give villagers a basic check up, vaccines, and awareness on preventive health measures. The governorate Department of Health provides vaccines while IRD provides transportation and support through financial incentives and training. The teams focus on the vulnerable under-five age group, pregnant women and those of reproductive age, issuing polio, hepatitis B, measles and a handful of other required vaccines.

A child getting a vaccine wails, more out of fear than pain. The next child starts to whimper as he is brought closer to the doctor. After a brief diagnosis of the child's respiratory problems, the doctor utters words of warning to the mother: "If not treated, it will transform into pneumonia.”

The pictures that the doctor hands out have greater value than words because many villagers are illiterate. The children's family will rely on the few who can read to tell them what is written.

“If you can build a school for us and fix the road, then we can send our children to school and then we can read and write," one woman says.

The water they use for drinking, washing and cooking is dirty and is the source of most of their health problems. Kirkuk district residents have no choice but to use that water from one of two wells nearby. A concrete slab protects the wells from eroding dirt, but the villagers share the water with donkeys, sheep and cows.

“What do you expect from us?” one man asks. “Sometimes we see feces but we drink it (water). Why are people telling us to kill all chickens for avian flu? This is a disaster. We are living with animals. I think we’ve become part of animals.”

Even more experienced of relief workers share their concerns.

“This is one of the villages that really needs help," says the officer in charge of health projects in the area. "I don’t know how they are able to live.”