[This post is being published out of order: the story is from March 2013]

From September to November 2012 and again for two weeks in March 2013, I worked in Domiz Refugee Camp, a few kilometres outside Duhok, in the Kurdistan Autonomous Region of northern Iraq.

A view of the city of Duhok, Duhok Governorate, Kurdistan Autonomous Region, Iraq:

At the time, the camp was expanding like a child who outgrows her clothes faster than her parents can buy new ones. The local government institutions and local and foreign humanitarian organisations were struggling to keep up with the needs of the ever-increasing numbers of refugees crossing the border from Syria. They made a serious effort, though. There was even a garbage service in place, though the truck sometimes encountered difficulties getting around the camp:

Some areas of the camp had sprung up haphazardly during one of several sudden surprise influxes of refugees. Having not been planned out ahead of time, these areas had worse conditions than most of the camp, like these makeshift latrines installed in an area that flooded as soon as the first rains fell:

In the final weeks of my first stay in Duhok, I had the great fortune of being invited by the Directorate of Health (DoH) to offer my input on the design for a new health centre to be built by the Kurdish government and jointly managed with MSF (Médecins Sans Frontières aka Doctors Without Borders) in Domiz Refugee Camp. I met with their engineer, and over the next two weeks we passed designs back and forth by email until we had a final version that satisfied everybody.

The construction process was managed entirely by the DoH. The Yazidi contractors they hired were soon breaking ground and setting the foundation for a new health centre in a spacious area on a hill overlooking the camp, a significant improvement on the cramped, makeshift health centre housed in prefabricated containers right across from the UNHCR refugee registration offices in one of the busiest and most crowded parts of the camp:

The cramped pharmacy in the old health centre:

Starting the new health centre:

By the time I left Domiz Camp on 28 November 2012 the foundation work was just about done but, sadly, I wouldn’t be there to see the rest of the centre built. I spent the next six months splitting my time between Kirkuk and Hawija. These two cities were a world apart from peaceful Duhok. Suicide bombers, exploding vehicles, roadside bombs, and armed attacks were commonplace in these two cities, though they were never aimed at us. However, in March 2013 our entire team was relocated from Kirkuk to Erbil (the incredibly safe capital of Iraqi Kurdistan) for security reasons for about three weeks. Rather than twiddle my thumbs at a desk in Erbil, I returned to Duhok to lend a hand for two weeks. Arriving back to the camp after a three and a half month absence, the first thing I wanted to see was the new health centre, now in use:

The new health centre was a tremendous improvement, but the camp population hadn’t stopped growing, so the building was already a size too small by the time it opened. Part of my job during my short stay would be to order prefabricated sandwich-panel portable buildings and install them on the health centre grounds to house some of the health services such as a planned child malnutrition ward. I made the simple floorplans with advice from the medical team, ordered the buildings, and soon afterwards we began receiving them:

Just a few metres from the health centre, there were a series of modular tents left behind by a German medical organisation. MSF was using these tents as temporary medical facilities while we planned to build something more permanent:

On 16 March I was at the camp, as usual. It was a breezy morning, and as the hours went by the breeze became a strong wind. As the wind increased in power, the tents began swaying. I would learn later that day, on closer inspection, that the German medical organisation had not installed the anchors correctly for the guy lines. Not knowing this, in the early afternoon I and a couple of helpers set about weighting down the tents with cement breezeblocks and checking that the guy lines were taut.

Well, the wind kept howling and pretty soon it was a full-blown blustery day in Domiz Refugee Camp. I noticed a slack guy line at the corner where the larger consultation tent met the stabilisation tent, so I bent down to tighten it. As I was doing this, I caught a sudden rush of movement in my peripheral vision to the left of me, and instinctively dropped to the ground. My body naturally rolled without any conscious decision to do so; I watched canvas flying over me, metal poles passing just inches from my body, as the enormous consultation tent lifted, flipped, and twisted. It carried the smaller consultation tent, stabilisation tent, and central hall with it through the air, along with dozens of cement blocks we’d added for weight, and the medical examination tables, desks, and chairs that were inside. I was relieved to be unhurt: just a little dirty from the fall, my shirt torn, and my phone no longer in my pocket – an acceptable outcome, considering the circumstances. I took a photo of my torn shirt when I got home:

One of the health centre cleaners was deeply saddened by the destruction and needed a moment to settle her emotions:

I made a sketch of the tent setup for my incident report at the time. In the photo below, I’ve marked a small circle where I was working on the rope when the 6 x 10 metre consultation tent flew over me. The tents labelled 1 through 4 ended up in the area marked “4 tents mangled”:

By late afternoon we’d given up hope of getting anything productive done with the tents that day, so we readied ourselves to leave. We climbed into the vehicle but, as we began to drive away, I spotted a man walking among the tents so I got out and spoke with him. I could tell he was hiding something, so I asked him to open his jacket. He did so, revealing the electrical cabling he was trying to steal. He returned it and left, and as I walked back to the vehicle a loud noise took over the skies, and out of nowhere grains of sand began hitting my face. I rushed to the car and within seconds we were in the middle of a sandstorm. We opened the vehicle doors to let in some refugees caught in the storm nearby, then watched as the 6 x 10 metre triage/waiting tent stood up on end for a moment before flying across the yard and catching on a streetlight. In the sketch above, it’s tent number 5 that flew to the top left corner of the sketch – over 50 metres.

In this photo, the tent doesn’t appear very large, but have a look at the people to the left and note that it’s caught on a full-sized streetlight:

At the end of the blustery day, only two tents remained standing, one of which was damaged and later repaired with poles salvaged from the wreckage. Here, between the two remaining standing tents, you can see the large footprint of the consultation tent that flew over me:

Removing cement breezeblocks from inside the destroyed tents:

Cleaning up after the storm:

Tent poles and posts sheared off:

As we cleared the rubble, we found my phone wrapped up inside the remains of the consultation tent a far distance from where I’d been standing. The phone, which I’d bought in 2011 in Côte d’Ivoire, still works to this day (2015).

We took down the isolation tent (which, though still standing, was damaged), found replacement poles among the wreckage, and put it back up next to its last surviving relative:

The tents weren’t the only things to be tossed around like children’s playthings. The prefab malnutrition building pictured earlier had tried to escape during the storm:

I measured the distance from point to point and made the sketch below, showing that one corner of the malnutrition building shifted 8 metres (~26 feet), while the other corner shifted 11 metres (~36 feet) as the building slid and rotated. respectively.

Immediately following the sandstorm, dozens of people were rushed to the health centre, mostly suffering from breathing problems caused by inhaling sand, and a small number of injuries from flying objects. The refugee homes were mostly untouched, as they were lower to the ground and securely fastened.

By noon the following day, it was perfect spring weather in Domiz Refugee Camp:

Like the ill-fated tents, this kid flipped head over heels to get over the fence, showing me his parkour skills:

Lastly, here are two random happy photos. A father with his children taking a break from setting up his new tent on a cement base, and a pair of siblings I bumped into a number of times in the camp:

[This post is being published out of order; the photos and experiences are from September-November 2012]

I arrived in Iraq in early September 2012, expecting to be sent to Kirkuk after some initial briefings at our coordination office. I had been hired to spend six months living in Kirkuk, working semi-remotely to support our project in Hawija, where MSF is supporting some activities of the local hospital. Unfortunately, there were a series of bombings in Kirkuk just before I landed in Iraq, so the team was temporarily relocated. Rather than have me sit twiddling my thumbs in the coordination office, waiting for the dust to settle in Kirkuk, we agreed that I would lend a hand up north in Domiz Refugee Camp for a week or two, as the young MSF project there had never had an expatriate logistician. The team would drive down to Erbil each weekend for some rest, so I would only need a few days’ worth of clothing. I packed my bag appropriately, leaving most of my stuff at the guesthouse in Erbil, and hit the road. Little did I know, those two weeks would stretch into three months.

In April 2012, as fighting in neighbouring Syria intensified and spread, Domiz Refugee Camp was set up to receive some of the people who’d begun fleeing across the border the month before. The camp is located in the Kurdistan Autonomous Region in northern Iraq, about 10km southwest of the city of Duhok as the crow flies, or 15km as the tarmac lies (for unknown reasons, various websites and Google Earth say that the camp is northeast of town, but this is definitely incorrect).

Initially planned to hold about 5000 people, the camp rapidly surpassed that figure, straining the limited resources available to the mostly-Kurdish Syrian refugees living there. MSF was warmly welcomed into the camp in the spring of 2012 to help manage the healthcare needs of the growing refugee population.

The refugees living in Domiz camp were incredibly hospitable to me. Each day that I was there, I made an effort to take a walk and say hello to people in the different neighbourhoods within the camp, and on these walks my colleagues and I were almost invariably invited to sit down for a hot drink and some friendly banter. One day, we even got invited for a meal of epic proportions in the tent of one of the first families to arrive in the camp months before. This family became known in the camp for taking in new arrivals who had not yet been assigned a tent in which to sleep or given a food ration to feed their children, and hadn’t enough cash to get by in their first days.

It was a surreal experience for me, to sit alongside my assistant and the Field Coordinator assistant, the Directorate of Health ambulance driver, and two of our MSF drivers, in a yellow tent extended upwards with makeshift low cinderblock walls, eating a multi-course meal that would easily excite Anthony Bourdain, in the oldest sector of a rapidly expanding refugee camp for Syrians in Iraq. While the family had limited resources, they worked very hard to help themselves and others, and the meal was their way of welcoming us and thanking us for the work MSF was doing in the camp.

While such a grandiose meal was uncommon, we were offered hot drinks everywhere we went. Strong Arabic coffee – black and bitter, with a thick sludge of grounds to leave behind at the bottom of the little porcelain cup, and the initially unfamiliar cardamom pungency which took me by surprise the first time it rose to my nostrils – dealt a caffeine slap that would have spun my head through a full 360° turn if my neck were only capable of it.

The more frequently offered option – sweet tea, a deep orange river with brown swirling currents steamily streaming into tiny glasses already a quarter to a third with white sugar – had a gentler effect on my heart rate, though too many glasses in one day risked triggering a hyperglycaemic headache.

I soon appointed myself unofficial camp tour guide for any new MSF staff and visitors arriving in the project, taking them on walking tours of the key sectors of the camp, highlighting the rapid evolution of the camp and our activities, and, most importantly, taking time to sit down with camp residents for tea or coffee, no matter whether the new MSF arrivals felt they had the time to spare or not. Most people were excited at the opportunity, but when the occasional person felt otherwise, a simple phrase solved the problem every time: “They’ve invited us in for tea; we don’t need to stay long, but it would be incredibly rude to refuse the offer altogether.”

Armando, a Mexican MSF doctor who organised triage training for the health centre staff, was particularly keen to visit with camp residents:

During the time that I was working in Domiz camp, it was through drinking tea that we learned about the challenges faced by its refugee inhabitants.

We also heard interesting information and rumours that were going around, some of which could affect the refugees’ healthcare needs. Sitting in tents brought us closer to the community, and helped the community members feel more at ease seeking healthcare at the primary health centre that MSF operated in the camp.

We put a human face on what appeared otherwise to be a strange company employing foreigners to do who knows what. We learned what people did and did not know about the nongovernmental, charitable nature of MSF, and shared information about the healthcare options available to them, free of charge, including referrals and free transport to the local government hospital for some treatment options that we didn’t offer in the camp.

With this information, we could adjust our strategy for community health workers and counsellors doing outreach work within the camp. We also increased our own security: the community respected us for the work we were doing in the health centre, but also for the way we interacted with them closer to their homes, always waving and smiling as we walked or drove around, joking with the children, listening during our tea drinking sessions, and advocating for their non-medical needs to the relevant organisations working in the camp.

Although Domiz is far nicer than Dadaab (the world’s largest refugee camp), living in a refugee camp is not easy, and conditions are tough. It rains heavily and snows every winter in Duhok governorate. It’s incredibly hot (average high of 41-42°C in July-August) and dusty every summer there. With no end in sight for the war in Syria, Domiz Refugee Camp may remain home for a long time to come for the refugees who welcomed me so warmly during my short stay there.