Mobile Hospital – From an idea to a mission

The mobile hospital is our biggest project so far. Two and a half years have passed since the idea came into being. We built a mobile hospital based on 4-wheel-trucks in a DIY way. For this, we got an incredible amount of support from everywhere, but we also had to overcome many difficulties.

January 2018 we will finally reach our destination in Syria. Time to look back.


The situation in Rojava

Streets and buildings are destroyed, dwellings and hospitals are obliterated. Many people have died or fled, there is still fighting going on. Medical care is wiped out. Volunteers without any expertise are treating patients, mortality is high. Especially among those wounded in war.

This was the scenario encountered by our teams in Rojava in early 2015. Our medical training missions were in full swing, but the best training is useless if there is a lack of equipment, supplies and suitable space. Also, for people living in remote areas, there is no way to get to a hospital in the first place.

Kobane in 2015, mostly in ruins. Yet there were still people living in the city. Photo: Christoph Löffler
In northern Syria we were giving volunteers medical training in order to rebuild a working rescue service. Photo: Christoph Löffler

For this reason, three years ago we formed our plan to build a mobile hospital. It would have to be flexible and suitable for all terrains. It should be running without supplies as long as possible, meet the specifications of a hospital and be as cost-efficient as possible at the same time. We spent many a night developing the concept: What should the hospital be able to do? How could we realise the technical requirements such as supply of water and energy? How could we accommodate patients and staff?

First Steps

The first step was to secure funding. This we could only achieve with your help! For this reason we started a crowdfunding campaign in late summer of 2015 which we could successfully finish a short time later. At the same time we were applying for capital with foundations, the German foreign ministry and humanitarian funds. We were travelling as far as Finland hoping to find support for our project. But all was in vain. None of these institutions showed any political will to support the self-governing people in northern Syria. Instead, all were afraid of positioning themselves in an unclear situation.

On the other hand, civil society proved to be much more supportive. We travelled a lot, giving lectures and canvassing for partnerships. We were supported by a large number of associations, initiatives and individuals – many of them complete strangers who invested time and money in order to bring our project forward. MV for Kobane played an important part by organizing their own fundraising campaign for our project in Mecklenburg-Vorpommern. With those proceeds we already could buy a Magirus Deutz from the THW (Federal Agency for Technical Relief) as the first vehicle for our mobile hospital in November 2015. This model is of robust constructions, there are many spare parts available and you can do most repairs on your own, making it perfect for our purposes.

A rough diamond: Our first truck for the mobile hospital. Photo: CADUS

Pimp my truck

We started to do the conversion work in a draughty workshop during winter. We could rely a lot on volunteers who helped with our tasks: Removing boxes, cleaning, sanding, welding, painting.

We could buy a former fire brigade rescue vehicle with the money collected by MV for Kobane. The mobile hospital was complemented by a retired military trailer, later we could add an all-terrain vehicle to be uses for supply runs and, if necessary, as a getaway car. After hundreds of man hours all vehicles were repaired, certified, registered and ready to go by the turn of the year 2016/2017.

It took a great many hours of manual labor to refurbish the vehicles. Photos: CADUS

Besides the conversion work we were also selecting and procuring equipment of all kind, from tools such as spades and screwdrivers to generators, medical supplies and cots. We got a large inflatable tent meant to serve as operating theatre, and people donated additional tents which we could use as surgeries and accomodations for patients and crew.

In the morning of 21st of January 2017 we rehearsed the buildup for the first time in snowy Berlin. The whole team had gathered around the mobile hospital after spending so much time with planning and assembling. Finally we could set it up and reap the fruit of our labour. By night everybody was happy: In spite of all adverse circumstances we had created something great with the help of many committed people.

The rehearsed buildup was a great success. To finally reap the fruit of our labour! Photo: CADUS

Of course we wanted to share this success with the public, so we sent out invitations for the official presentation and christening of the mobile hospital on 26th of January. Even Bela B. graced us with a surprise visit. We got some press coverage and intensified our preparations for the journey to Syria.

Bela B. gracing our press conference with his presence. Photo: Mareike Günsche

Not a daily sight: A mobile hospital being christened. Photo: Mareike Günsche

A hard road

Reaching Syria was no easy task. The political situation was getting worse all the time. Crossing the border was always difficult, now it became nearly impossible. And the vehicles had to get as far in the first place.

A few possibilities were discussed.
First option: Travelling across Eastern Europe, over the Black Sea, Armenia, Iran, Northern Iraq and then finally Syria. We would have to cross the mountains in winter – that's not an easy route and means a trip of almost 6000 kilometres (3700 miles) putting a strain on the crew and the vehicles. Also, the fees for crossing into Iran would be expensive. Rather bleak prospects.

Next option: The route via Turkey. Considering Ankara's war against it's own Kurdish population in Eastern Turkey as well as constant threats and a total embargo against Rojava, we were sure that our humanitarian Transport would have no chance of reaching its destination.

Our mobile hospital stowed away and ready to go, shortly before the journey to Iraq. Photo: CADUS

Finally we found a solution: We would load our mobile hospital on even bigger trucks and have them transported to Iraq via Turkey. If there was an official request from Iraq, the transport would be regarded as a delivery of goods and could not be stopped without reason. In early March 2017 wie finally got a date for the embarkation, now the customs office had to inspect our load. Unfortunately, it turned out the Berlin Wall still exists for German customs and our garage was located on the wrong side of the Spree (irony alert!), so the officials couldn't inspect the trucks and departure for Iraq was delayed for another week.

More delays

Arrival was delayed for a few more weeks. Our trucks were stopped at the Iraqi border due to problems with the documents. Meanwhile, on the 15th of March CADUS team members were detained and questioned at the airport in Turkey. Their phones were confiscated and analysed, making a call was not allowed. After 16 hours of waiting and being interrogated, our people were deported for „endangering public safety“. How exactly four people working for an aid organisation would endanger safety, Turkish authorities kept for themselves.

We were glad to hear our people were fine and and felt vindicated in our decision not to drive through Turkey with our mobile hospital by ourselves.

Arrival in Iraq

In the middle of April we finally got good news from the border: The trucks could go on. All diesel had vanished from their tanks miraculously (you're welcome anyway). We were working hard to find a way to cross the Syrian border and to deploy the mobile hospital. We were eager to finally be able to help the people and to continue training medical personnel.

In Erbil we checked vehicles and equipment once again prepared the mobile hospital for its first deployment. Photos: CADUS

Unfortunately, there was still no way to cross the birder legally. Political tensions between Iraqi and Syrian Kurds had grown worse.

At the same time, Iraqi central government, supported by the Peshmerga and the US-led coalition, was waging a fierce war against the so-called „Islamic State“. As always, civil population suffered most from the fighting, being caught up between the lines. Medical help was nowhere to be found. In light of this situation – and because of an entreaty by WHO – we changed our arrangements and planned for an initial mission in Iraq. We had the equipment and the personnel to help, so a refusal would have been unethical.

Our mission in Mosul was the hardest so far. Photo: CADUS

Parts of our mobile hospital deployed in Hawija. Photo: CADUS

However, during the following stops in Mosul, Tal-Afar, Hawiija and Anbar, we never set up the complete mobile hospital. In our TSPs (Trauma Stabilization Points) we only use a small part of our equipment for the emergency care of severely injured patients. The missions are tough and we are being confronted with many terrible situations, but in the end we could save hundreds of human lives to this day. We proved ourselves under difficult circumstances.

Rojava, we are coming!

Along the way we were always looking for a possibility to finally bring the mobile hospital to Northern Syria. Und not the time has come finally. After the intense fighting in Iraq has come to an end, it looks like we can transfer our trucks to Heyva Sor a Kurd in January 2018. Two and a half years after the first ideas and plans, after realisation and the first missions, our mobile hospital can finally arrive at its destination and provide the people there with the needed medical care.

Even though we are always expecting delays and changes of all kind, we're doing everything to stay on schedule. We are already very proud of our mobile hospital and our crews and we want to say thank you to all associations and organisations as well as all volunteers and donators who made this project possible.

UPDATE 12. Feb 18: We already had this in mind, as we wrote this words: we didn´t manage the hand over yet. We are again dependent on the VISA procurement. They meant to be ready, but like (mostly) everytime there are some delays. Why easy going, when there is a more complicated way? But we´ll keep going and inform you!

In the meantime, we're already working on a mobile hospital 2.0. This time, it will be based on shipping containers. We are busy planning and a few days ago we got the container. So, we carry on with our projects!

To get the container into the garage was a bit difficult but now we can take off again. Photos: CADUS

We will keep you updated about the mobile hospital and its missions as well as our mobile hospital 2.0.
Until then we wish you a great start into the new year!

Your CADUS-Team

Author: by Jonas Grünwald

By CadusPR

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