Falluja: One Year On

Falluja: One Year On

Doctors for Iraq (DFI) is a group of doctors who have experienced and witnessed the destruction of the infrastructures of the health system in our country after the invasion in 2003, and who have endeavored in every way possible to relieve the suffering of our fellow Iraqis.

We are mostly junior doctors at the beginning of our careers but when we saw the appalling health situation in our country after the invasion, we individually volunteered to go from hospital to hospital and area to area to provide medical care to those in need. However, we soon realized that we needed to organize ourselves and work in a team. So in October 2003 we held a conference and formed Doctors for Iraq, a Non Governmental Organization (NGO) with 100 doctors volunteering to become established members. We had, and continue to have, many partners in the different governances of Iraq who will work with us when we need them.

What motivates us is our ambition to serve our country, improve the health situation for our fellow citizen and to develop solutions to the problems we face in the field. We also think that it is important that the young people in Iraq can have a role.


There are seven directors on the Iraqi board of Doctors for Iraq:

  1. President of board of directors :
    Dr. Wajdi M. Al-Rawi
  2. Deputy of board of directors :
    Dr. Eehab S. Al-Rikabee
  3. Secretary General :
    Dr. Salam Taha Al-Obaidi
  4. Members of board of directors
    · Dr. Ahmed Abdul-Rahman ( Killed in the hospital while doing his work )
    · Dr. Hani s’ood
    · Dr. Layla Khaleel

    Currently, we have 214 established members.



Falluja is a large Iraqi town 90 kilometres west of Baghdad, the city is situated on the western bank of Euphrates. Falluja is a densely populated city of an estimated 300- 400,000 inhabitants.
Falluja is known as the city of mosques because of the large number of mosques in the area and has a distinctive Arab Sunni identity. The majority of people living in the city were traders or farmers living off their land.

Since the invasion and occupation of Iraq in 2003 the city of Falluja has been subjected to fierce and heavy military attacks. These attacks have caused widespread devastation and destruction causing huge damage to the infrastructure of the city. The biggest military assaults on the city took place in April and November 2004 , the attacks ate are known as the ‘siege of Falluja’.

The cities water, sanitation and electricity supplies were severely disrupted as a result of these military attacks. Health services have been devastated with medical facilities attacked and targeted. A huge humanitarian crisis emerged as the siege developed military curfews were imposed on the cities residents. Food and water was denied to civilians- the military used this as a weapon during the conflict. These military attacks left the city with hundreds and thousands of people homeless and displaced. The attacks caused thousands of civilian casualties mainly women and children.

Doctors for Iraq had medical staff working inside the city during the April and November 2004 sieges. Members witnessed serious breaches of the Geneva Convention and human rights. These breaches have been embedded in our minds and the minds of civilians brutalised and traumatise by the illegal acts of aggression carried out by US/ Iraqi forces.

November 2005 marked the first anniversary of the second siege of Falluja. One year on facts continue to emerge about the nature of the force used against the cities population and the magnitude of the breaches of international human rights law. However the majority of facts around the siege remain undisclosed.

Doctors for Iraq is an independent non governmental organisation focusing on health and human rights issues in Iraq. We were established in 2003 with the basic humanitarian principles and guidelines determining our activities inside Iraq. We are a non political organisation working to strengthen the health system in Iraq for the benefit of all Iraqis.

Doctors for Iraq has produced this briefing note to outline some of the key issues that have arisen from both the military attacks on Falluja in 2004.

Breaches of medical neutrality

The simple definition of medical neutrality according to the guiding principles of the World medical association, the British Medical Association (BMA) is the bilateral obligation on parties participating in a military conflict and health professionals to protect and respect the rights of health workers and patients, the wounded and sick. Sick and wounded patients must be given free access to healthcare at all times in the conflict.

  • Basic medication and food and water must be provided for civilians in need.
  • Health workers are obliged to treat patients regardless of age, gender, ethnic background or religious / political persuasion.
  • Health workers are obliged to uphold medical ethics and human rights.

The following are the main breaches of medical neutrality that Doctors for Iraq has documented during the two sieges of Falluja:

Harassment and inhumane treatment of medical personal, the sick or wounded

During the sieges of Falluja US soldiers occupied the main hospital in the city arresting doctors and handcuffing medical personal. The military treated doctors inhumanely. Myself and another doctor were trying to transport a patient from Falluja to Baghdad. The soldiers stopped our ambulance even though we had informed them in advance that we would be trying to move the patient. We were told to leave the ambulance and place our hands on our heads and kneel down. Snipers positioned their guns towards our heads. We were forced to remain in this position for several hours. We were denied the right to check on our patient and ensure that he was ok.

Discriminatory practice directed against the sick or wounded, including the withholding of healthcare or provision of only inferior standards of care

During the first siege of Falluja one of our ambulances was trying to transport a family of three, two women and one man near Abdul Aziz Asamari mosque near the centre of Falluja when US soldier shot at the ambulance and injured the driver. He managed to escape from the ambulance- but the vehicle was forced to remain in the area for three days with the patients inside the ambulance. After four days we were able to bring the ambulance back to the hospital- the three patients had bled to death inside the ambulance.

Punishment of medical personal for providing care consistent with medical ethics

As medical ethics dictate doctors and medical staff must treat all patients equally. In Falluja US soldiers entered the theatre room of a hospital when two doctors were operating on a patient. The soldiers were armed with guns and forced the doctors out of the theatre room accusing them of treating insurgents.

Refusing doctors access to sick or wounded people

During the two sieges of Falluja the US army announced that if any ambulance were found operating in the area they would be targeted. The US military to date has no evidence of ambulances being misused by paramedics and medical personal. Curfews were put in place along with checkpoints preventing doctors from moving around freely to treat the sick and wounded. Patients were also prevented from reaching field clinics in these areas. An old woman in the district of Shohada (second siege) was prevented from accessing medical care for her son who sustained injuries when the ceiling of his house collapsed on him causing both his legs to become crushed amd huge amounts of bleeding. The old woman was unable to take her son to seek medical attention because of the curfew- he bled to death in front of her.

Military attacks on medical personnel or units

During both sieges of Falluja field clinics inside the city were targeted and bombed despite the military being given information about where the clinics had been set up and the clinics being clearly marked. This happened in the second siege when US soldiers bombed a field clinic in Nazal district- the main field clinic where medical aid from outside the city is stored. The clinic is known to the US military as doctors had contacted the military to provide them with information about the whereabouts of the field clinic. One patients was killed and many doctors and medical staff were injured along with the medical store inside the city being destroyed.

Use of medical personnel or medical units for military purposes

During both assaults on Falluja – US soldiers targeted and occupied the cities general hospital on the east bank of Euphrates- cutting the main bridge between the hospital and the rest of the city, isolating the city from its only hospital. US/ Iraqi soldiers have taken over the hospital and used it as a military camp for long periods of time during the siege.

Illegal heavy weapons used inside Falluja

During both sieges of Falluja the US army used different types of weapons and ammunition causing random widespread damage to civilians living in crowded areas. Some of the weapons used are illegal under the conventions of warfare.

These weapons have been used in densely populated areas and districts, even with prior knowledge that civilians remain in these areas the US army used these weapons.
The majority of victims affected by these attacks were women and children. Doctors for Iraq documented the usage of these weapons through interview with members of the organisation working in the city, eyewitnesses, families of victims and through photos and video footage.

Doctors for Iraq is concerned about all aspects of the attacks on Falluja. The use of illegal weapons is just part of our concern. The entire military action and all its horrific consequences on thousands of civilians will have a long term impact on many generations. All violations of international law must be investigated equally and thoroughly.

Chemical agents and Napalm

During the second siege of Falluja- US soldiers used chemical agents such as white phosphorus and napalm inside the city. Doctors for Iraq gathered information at the time from doctors working in the area and some eyewitnesses showing the aftermath of these chemicals being used. Recent media reports show how white phosphorus was used inside Falluja. At the time the US military denied using any chemical agents- now they admit to using white phosphorus but deny the use of napalm.

Napalm is gel fuel bomb that explodes when it reacts with the ground producing a huge fire with substance that sticks to exposed skin causing it to burn on impact. Napalm produces heat as fierce as 300-350 c he napalm bomb produces smoke that irritates and damages the repertory system – in some cases it can cause suffocation. Doctors for Iraq is trying to establish if white phosphorus has been combined with napalm to produce a lethal bomb that can generate heat of up to 3000c.

US soldiers prevented aid workers from entering the city- they were only allowed inside Falluja three days after the end of the siege which raises questions as to why there was a delay. Aid workers and doctors gathering bodies from inside residents homes after the siege. Many of these bodies were of women and children who had died in their beds and in their homes without any bullets entering them. Many of the bodies showed signs of suffocation.

Doctors for Iraq has photos and footages of bodies with significant burns to exposed skin. In some cases only the bones remained as all the skin had melted away.

Cluster bombs

Cluster bombs are illegal and cannot be used in densely populated areas. These huge bombs are dropped from the sky and fragment into smaller bombs that can spread over a wider distance. These bombs are highly dangerous as each small bomb produces a massive shell that has a devastating impact on the human body. Some of these bombs don’t explode on impact and can be activated after they have been dropped which is why so many victims of cluster bombs are children who come across cluster bombs. As a doctor I saw the results of these bombs – and how they destroy the body’s vascular anatomy and how it’s almost impossible to repair the damage to the body.

The cluster bomb was used during the first and second sieges of Falluja in areas crowded by civilians such as Jolan quarter in the north east of Falluja and Shoda quarter in the south east. As a doctor I remember the third night of the seieg of Falluja when the US army was facing difficulties entering the Jolan quarter of Falluja- they used cluster bombs and I and my fellow doctors ended up trying to treat people shattered into pieces by these bombs. The majority of patients that I tried to treat were women and children.

Collective punishment:

Denial of food and water to civilians

During the two military attacks on Falluja the US and Iraqi army siege the city and created a number of checkpoints in and around Falluja preventing trucks with food iteams from entering the area outside of the city. Food aid trucks from Saglawiya, Garma – the main agricultural areas close to Falluja were prevented from entering the city.

The military enforced a curfew preventing shops from opening and civilians from buying food from markets. This had a massive impact on people as the siege continued for over two weeks.

During the first siege in the main hospital in Falluja doctors and nurses couldn’t access food and I along with a team of medics ended up living on a diet of sugar and biscuits for several days.

During the first siege families living in Askari quarter were trapped in their homes for two weeks unable to leave as the military attacks intensified. Doctors for Iraq tried to transport food and water to residents in this quarter. When we placed containers with water outside peoples homes US soldiers would shoot at the containers.

During the second siege of Falluja – eyewitnesses and documented people being forced to eat grass or uncooked wheat to survive.

US troops cut the electricity and water supply to the district of Falluja during both sieges despite knowing that tens of thousands of people remained in the city. This happened in Jolan, Askari and Shohida quarters of Falluja.

Random arrests

During the second siege of Falluja US soldiers told families o leave the city making them pass through military checkpoints. At these checkpoints men aged between 18-35 were randomly stopped and detained- taken to unknown detention centres. In many cases families are still kept in the dark about why and where their loved ones are being detained and why they are being detained.

US soldiers entered districts where they were met by fierce resistance. Whilst carrying out raids on houses in these eyewitnesses report the mass arrest of young men with no specific charges. These men were also detained in unknown facilities in Iraq.

ID Cards, check points and profiling

After the second siege of Falluja the US army issued special identity cards for the residents of the city. People are being forced to carry cards with iris recognition technology, a scanned photo of the individual and personal information imputed onto the card. US soldiers prohibit anyone who refuses to carry this card from entering the city.

After the second siege of the city the US army formed four major checkpoints around the city. These checkpoints have become a symbol of the humiliation of the people of Falluja. People are often searched in an aggressive manner, verbally abused and humiliated at these checkpoints. Doctors including myself have witnessed this kind of behaviour first hand.

These check points have become mechanisms to control the entire population of the city and many local residents have described Falluja as being like ‘one big prison’.

Urgent Recommendations:

  1. We are calling on the EU and the UN to investigate the usage of illegal weapons and chemical substances inside the city of Falluja during the second siege.
  2. We are calling on the EU and UN to undertake an international investigation into the human rights violations that have been committed inside Falluja.
  3. Doctors for Iraq is calling on the European Union and the UN to pressure the Iraqi government and the US administration to lift the siege of Falluja. To dismantle the humiliating checkpoints and ensure that Iraqi civilians living inside the city have a free and safe passage in and out of the city.

For more information on Doctors for Iraq or on Falluja please contact:
This briefing note was compiled by Dr Salam Ismael, Doctors for Iraq, December 2005.

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