Two women sit across from each other on hospital beds. One woman wears a headscarf, jeans and a leather jacket and holds a patient form in her hand. The other wears a nikab.
Our colleagues will continue to provide the best possible care for patients on site - but from the summer onwards, they will only do so under their own direction. Foto: CADUS

Big changes are on the horizon at CADUS in 2023

The year 2022 was full of ups and downs - in the world, and also for us. The events have changed both us personally and CADUS. We want to tell you about this intense time and its consequences for our organization here. As one of the most profound changes, we will completely withdraw from the Middle East region.

The CADUS concept is multifaceted, and anything but simple

CADUS is always active in very different contexts: in the broad field of humanitarian aid sometimes side by side with regional initiatives, and sometimes as an implementing partner of actors such as the WHO or the German Federal Foreign Office. Direct medical and technical assistance alternates with sustainable training programs and long-term cooperation with regional partners. In addition, we have set ourselves the task of developing innovative concepts and analyzing and debating the causes of humanitarian emergencies. This is a lot, and has led not only to interdisciplinarity and diversity of methods within our organization, but also to heated debates and disputes over direction time and again.

There have been discussions not only within CADUS, but also among the employees of the hospital in al-Hol during the founding phase of the new organization (symbol image). Photo: CADUS

Due to this mix, at the beginning of 2022, there were two operational departments with different spheres of activity at CADUS: the Emergency Response (ER), and Middle East (ME). The Headquarters (HQ), the main office in Berlin, formed a third, non-operational part of CADUS.

At the beginning of 2022 the world looked different

The Middle East team started 2022 with a stronger staff, planning more long-term projects and collaborations for Northern Iraq and Northeastern Syria. To make these types of projects possible, the focus in the previous two years had already been on building solid structures and processes. During the same period, the Emergency Response Team concentrated on establishing short-term operational capability with a focus on expanding emergency response equipment. While Middle East was mainly involved in managing the field hospital in Al Hol and coordinating the camp's ambulance service, the Emergency Response team went on several short missions in the context of refugee, migration, and pandemic. Due to the different orientations of the departments and sometimes opposing priorities, interaction and cooperation were more and more conflictual.

Since March 2019, CADUS has been running a hospital at the al-Hol refugee camp at great expense to provide 24/7 care to local people. Photo: CADUS

CADUS has been operating in conflict and war zones almost since the organization was founded. A challenging field of activity, which goes hand in hand with a high level of stress, and in which small mistakes can have fatal consequences. Until the beginning of 2022, the Middle East team in particular had to carry this baggage. With Russia's attack on Ukraine on February 24, 2022, the situation escalated not only in the world, but also within the organization. We were all extremely affected by the start of this war, and the new situation meant a massive increase in stress, especially for the Emergency Response Team as it prepared for deployment.

Interdepartmental conflicts that had existed for some time were exacerbated by the acute stress. It became increasingly apparent that the two operational teams had moved in very different directions. The three managers of the departments represented different and hardly compatible ways of working, which could not be brought together in this crisis situation, both internal and global. Gradually, this conflict spread to the entire workforce. As a sad consequence, many employees left the organization.

An end in sight - and a new beginning

Ultimately, we were unable to resolve the existing conflicts. The approaches of the two teams are too different and the capacities for working through the conflicts are not available. So what to do when we can't continue together?

In Iraq, we mainly provided training and continuing education for medical personnel, as here in Mosul together with the Viyan organization. Photo: Viyan

After a long back and forth with many ideas, approaches and unfortunately also dead ends, the board took a decision: CADUS will give up its projects in the Middle East region and focus on short-term emergency response. The Middle East team will no longer exist in the future, the department will be closed, and CADUS will leave the region on June 30, 2023. This is of course far from satisfactory for everyone, but it is clear that a decision had to be made.

What will happen now with our projects in Northern Iraq and Northeastern Syria? While smaller, completed training programs have been carried out in northern Iraq and the cessation of our activities there is a regrettable but not critical cut, the situation in northeastern Syria is quite different with regard to the Al Hol field hospital. The hospital is considered a critical infrastructure in the field of health care and provides stable jobs for 65 employees under the management of CADUS. With the withdrawal of CADUS from the region, all of this is at risk. And yet.... this end also means a new beginning.

The solution is localization

Our colleagues in Northeast Syria are working at full speed to find a solution to this critical situation. While CADUS has been trying in vain from Berlin to find an international organization that would be willing to take over the highly complex project "Field Hospital Camp Al Hol", a great plan has been forged on the ground: the foundation of a new, locally based NGO, consisting of the staff of the hospital, who will continue to run it.

The traces of our work are still visible in the hospital. Soon this will be continued by the newly founded local organization Sîlêr. Photo: CADUS

Even this path is far from easy - otherwise the path of localizing humanitarian aid would probably have been taken long ago. But with the pressure created by the current situation on the one hand and the energy of our colleagues on the ground on the other, suddenly much seems possible. And so "Sîlêr - Crisis Response" (SCR for short) was born.

While jobs are being reduced and suitcases packed in Berlin, a new chapter is beginning in Northeast Syria with an organization that will not only continue to run the field hospital, but will also be available for general emergency and disaster relief in the region. Sîlêr (pronounced Shlee-er) is still under construction, and there are quite a few bureaucratic hurdles to overcome. But we will keep you up to date, and will of course let you know as soon as there is any news.

Author: by Corinna Schäfer

back to the previous page