Human Rights Watch

For Sunnis, Lives Curtailed; for Yezidis, New Accounts of Brutal Rapes

(Beirut) – The extremist armed group Daesh should urgently release Yezidi women and girls they abducted in 2014, Human Rights Watch said today, following new research with recent escapees who were raped and traded between members before they fled. Daesh also routinely imposes abusive restrictions on other Iraqi women and girls and severely limits their freedom of movement and access to health care and education in areas under its control, Human Rights Watch said today.

In January and February 2016, Human Rights Watch interviewed 21 Sunni Muslim Arab women from the Hawija area of Iraq and 15 women and girls from the Yezidi minority ethnic group, all of whom had fled Daesh-controlled areas, most in late 2015. Several of the Yezidis, abducted by Daesh in mid-2014, had spent more than a year in captivity. They described being forcibly converted to Islam, kept in sexual slavery, bought and sold in slave markets, and passed among as many as four Daesh members. Human Rights Watch first documented systematic rape of Yezidi women and girls in early 2015.

“The longer they are held by Daesh, the more horrific life becomes for Yezidi women, bought and sold, brutally raped, their children torn from them,” said Skye Wheeler, women’s rights emergencies researcher at Human Rights Watch. “Meanwhile, Daesh’s restrictions on Sunni women cut them off from normal life and services almost entirely.”

The Sunni women Human Rights Watch interviewed had fled areas under Daesh control since June 2014 in western Kirkuk governorate and had arrived in areas controlled by forces of the Kurdish Regional Government (KRG). All of the Sunni women and girls reported severe restrictions on their clothing and freedom of movement in Daesh-controlled areas. They said they were only allowed to leave their houses dressed in full face veil (niqab) and accompanied by a close male relative. These rules, enforced by beating or fines on male family members or both, isolated women from family, friends, and public life.

Families living under Daesh also face intensified suffering from escalating food prices and cash shortages, especially since Iraq’s government stopped sending civil service salaries to Daesh-controlled areas in mid-2015. They also live in fear of airstrikes by United States-led coalition and Iraqi government forces. Those interviewed said the combination of food shortages, fear of airstrikes, and abuse by Daesh led them to flee.

Eleven of those interviewed reported restricted access to health care or education because of discriminatory Daesh policies, including rules limiting male doctors from touching, seeing, or being alone with female patients. In more rural areas, Daesh has banned girls from attending school. Daesh fighters and female Daesh “morality police” hit, bit, or poked women with metal prongs to keep them in line, making them afraid to try to get services they needed.

Airstrikes on health and education facilities where Daesh fighters were present also made women afraid to use these facilities. Women cited the September 2014 bombing of Hawija hospital, by Iraqi government forces according to news sources, and the June 2015 bombing of a market in Hawija by coalition forces, both of which allegedly killed large numbers of civilians, as well as smaller attacks.

Some women said they felt deeply humiliated by their treatment by Daesh, and two said they felt so depressed they had wanted to kill themselves.

KRG officials say that Daesh fighters in Iraq and Syria continue to hold about 1,800 abducted Yezidi women and girls. Human Rights Watch has not been able to confirm these figures, but the United Nations has cited allegations, based on Yezidi officials’ estimates, that as many as 3,500 people remained in Daesh captivity as of October 2015. Many of the abuses, including torture, sexual slavery, and arbitrary detention, would be war crimes if committed in the context of the armed conflict, or crimes against humanity if they were part of Daesh policy during a systematic or widespread attack on the civilian population.

The UN Office for the High Commissioner for Human Rights said in March 2015 that Daesh may have committed genocide against the Yezidi. Although Iraq is not a party to the 1948 Genocide Convention, its provisions are widely recognized as reflecting customary international law. The Genocide Convention prohibits killings and other acts “committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group.”

The abuses against Yezidi women and girls documented by Human Rights Watch, including the practice of abducting women and girls and forcibly converting them to Islam and/or forcibly marrying them to Daesh members, may be part of a genocide against Yezidis. Women also reported Daesh members taking their children from them, physically abusing their children, and forcing them to pray or take Islamic names.

Iraq has not joined the International Criminal Court (ICC) but should do so to allow the court’s prosecutor to investigate and prosecute crimes against humanity, war crimes, and genocide committed in Iraq by individuals belonging to any of the parties to the conflict. The authorities could give the court jurisdiction over serious crimes committed in Iraq since the day the ICC treaty entered into force, on July 1, 2002. The ICC has jurisdiction over serious crimes committed by the nationals of, or in the territory of, countries that are members of the court.

Small numbers of Yezidi women and girls continue to escape Daesh, according to KRG officials and nongovernmental organizations working with this population. Human Rights Watch interviewed 15 Yezidi women and girls, including seven who Daesh had kept in captivity for more than a year and four who had escaped in December 2015 or January 2016. The women and girls said Daesh bought and sold them repeatedly, often raped them, sometimes confined them in rooms for days, humiliated them, and beat their children or took away their children.

The Iraqi and Iraqi Kurdish governments and international donors should ensure adequate support services, including comprehensive, long-term psychosocial support for those who have escaped. Some services also have been provided for women who became pregnant during their captivity, but safe and legal abortion services are not available. The Iraqi national parliament and Kurdistan’s regional parliament should amend laws at least to allow safe and legal abortions for women and girls who have experienced sexual violence and who wish to terminate their pregnancies.

A range of mental health and psychosocial services have been provided by the KRG, UN agencies, and nongovernmental organizations. But because there are not enough services or expenses are too great for some Yezidi families, or distance, lack of understanding about psychosocial support, or ambiguous feelings about getting support and stigma over rape and mental health, only one of the Yezidi women and girls Human Rights Watch spoke to was receiving any sustained psychosocial support or mental health care.

“Daesh attacks on women and girls, especially Yezidis, have created a new and terrifying crisis for women and girls in the region,” Wheeler said. “One way Iraq’s government can help these women is to change its laws and policies to better protect all women who have been subjected to rape.”

All Sunni women and girls interviewed by Human Rights Watch who fled the Daesh-controlled Hawija area to nearby areas under the control of KRG forces said they have subsequently faced further restrictions on their freedom of movement. After screening the women close to the frontlines, they said that KRG forces forcibly moved families, and some women and children traveling without a male companion, to the Nazrawa internally displaced persons camp, east of Kirkuk city. In at least five cases, families said they wanted to live elsewhere but were refused and five other women interviewed said that they had no choice but to go to the camp. Human Rights Watch found no indication that any of the women interviewed were under suspicion for any crime or security threat. The women said that KRG forces guarding the camp have also held identity documents, restricting residents’ freedom of movement through checkpoints outside the camp that require identity documents, and requiring them to return if they leave the camp. In at least three cases women said this has obstructed them from getting adequate health care.

Human Rights Watch appreciates that the KRG has welcomed hundreds of thousands of displaced Iraqis from elsewhere to reside for their protection in the Kurdistan region. However, practices that amount to forcing displaced people to stay in a camp would contravene the UN Guiding Principles on Internal Displacement, which state that citizens of a country have freedom of movement and the right to live where they wish and are protected from being “interned in or confined to a camp.” The UN refugee agency, UNHCR, which operates the Nazrawa camp, has asked Kurdistan authorities to remove restrictions. UNHCR has said the restrictions “are imposed in a manner disproportionate to any legitimate concern, including those related to security.”

Human Rights Watch wrote to the KRG on March 7, 2016, regarding these and other allegations. The government’s initial response of March 26, 2016, stated with respect to Kirkuk frontlines that for security reasons, “some segments of the local Arab citizenry whose homes and villages were located on the frontlines [a conflict zone] have been temporarily relocated to camps which are protected by Peshmerga forces. This precaution has been taken in the interests of these citizens as it ensures no harm can befall them by the Daesh terrorist group.”

The response further stated: “After the liberation of the village of Kharaba Rotah [Kharabaroot a short distance east of Malha] in Hawija district, 520 Arab families moved to secure areas under the control of Peshmerga forces.”

The KRG also said that they had removed families from Malha in order to protect them, but did not say why KRG forces had confined families in Malha for several weeks before moving them. Families forcibly moved from the Malha area to Nazrawa camp did not indicate to Human Rights Watch that they had felt themselves to be under threat from Daesh attacks in Malha.

The Kurdish Regional Government also informed Human Rights Watch that KRG President Massoud Barzani issued Order No. 3 in March 2016, which stipulates, among other provisions:

4. No civilian should be transferred from his original place of residence in areas liberated by Peshmerga forces without sufficient legal or military rationale/justification.
5. The free movement of civilians in liberated areas is non-restricted within the framework of security and military regulations held in the Kurdistan Region. The exception to this is areas which are located immediately on the frontlines between Peshmerga forces and Daesh fighters.
6. International principles of human rights and humanitarian law must be observed with regards to civilians in areas located on the frontlines.

Human Rights Watch welcomes the response of the KRG and President Barzani’s order to comply with international human rights and humanitarian law issued to Peshmerga forces. Residents of Nazrawa camp, a long distance from the frontline in Kirkuk governorate, which is outside the Kurdistan Region of Iraq formally under the KRG, should have freedom of movement and residence. No restrictions other than those necessary to protect civilians in conflict should be placed on their freedom of movement and residence, Human Rights Watch said.

“Women fleeing abuses should not then face further restrictions on their mobility and their right to live where they want in their own country,” Wheeler said. “KRG security forces should abide by the presidential order government and stop placing restrictions on civilians who have escaped from Daesh control.”

Support for Yezidi Rape Survivors
The UN has estimated that in August 2014, Daesh fighters killed or abducted thousands of Yezidi men, women, and children when the group took control of the town of Sinjar (Shingal) and Yezidi villages around Mount Sinjar, 120 kilometers west of Mosul. In interviews with Human Rights Watch, women and girls described how Daesh separated women and girls from men and then divided them by age group or by their marital status, moved them to Syria or multiple times between locations in Iraq and Syria, such as prisons or schools used as detention centers, and kept the women or sold them in a Raqqa slave market. Some women were then resold as sex and/or domestic “slaves” between Daesh members.

Slavery is prohibited under the International Covenant on Civil and Political Rights, the Slavery Convention of 1926, and other international human rights law. Hussein Alqadi, who heads the office of kidnap affairs under the KRG prime minister’s office, said that about 1,000 women and girls have escaped Daesh, but he estimates that 1,800 may remain with the armed group.

Daesh has issued statements acknowledging that Daesh captured Yezidi women and girls as “spoils of war,” and sought to justify the sexual violence. These statements are further evidence of a widespread practice and a systematic Daesh policy. These acts constitute war crimes, and may be crimes against humanity. Removing children from the community and forcibly converting large groups of children and women may be evidence of genocide against the Yezidi people.

In January, Human Rights Watch interviewed 15 Yezidi women and girls who had escaped Daesh, seven in the last six months, all of whom lived in, or close to, camps for displaced people in Iraqi Kurdistan’s northwestern Dohuk governorate.

Those who had been held for more than a year described being held as slaves, forced to do domestic work and repeatedly raped. All were forcibly moved multiple times, beaten and verbally abused, held in poor conditions, including, in three cases, being locked with other women in rooms for days or weeks, and given little food. Some said they were bought and sold multiple times. Three of the women had four different “owners” and were raped by most of them. Women told Human Rights Watch that they had no idea that they had been sold until just before they were moved.

One 39-year-old woman was first sold in a slave market in Raqqa [Syria] to a man called Abu Yassir, then to a man she knew as Akash, then to Abu Yahya, and finally to Abu Mahajar. She said that Akash beat her for crying. Two of the men beat her children. One hit her 8-year-old daughter in the eye when she would not respond to a new name he had given her. The woman escaped in December 2015 with the two children who had been with her. Four of her other children were separated from her when she and her family were abducted in August 2014 and remain missing.

A 30-year-old woman who escaped with three of her children in January 2016 said Daesh members took her to a farm in an unknown location in Syria after they abducted her and her family in August 2014. She and her children were sold to a man she knew as Abu Aris al-Tusi, who said she was his wife but then sold her to a man called Abu Malik, who sold her in turn to a man called Abu Asamam, who then sold her once again to a man called Abu Saad al-Sa’udi. All the men raped her and two of the men also beat her children, she said. Daesh members separated her from two of her children, a 10-year-old son and a 12-year-old daughter, after the family was abducted. They are still missing.

A 14-year-old girl who escaped in August, a year after Daesh fighters abducted her from her village and took her to Mosul, said she was held initially by a senior Daesh member named Abu Harid. But he was killed, and she was transferred to a man named Abu Saad, who then sold her to a man named Abu Umar al-Shishani, who later sold her to a man named Abu Abdallah. All four men raped her, she said. Abu Harid beat her with a piece of wood, and when she asked where her parents were, told her that he had cut them to pieces and fed their bodies to dogs. Abu Saad told her and another captive girl that they were his wives. She described being kept in a locked room for months and “never seeing the sun.”

The World Health Organization has stated that interventions should be implemented in participation with people with mental health conditions and communities, strengthen existing resources, and should be available in a nondiscriminatory fashion to all.

Providing adequate psychosocial care for Yezidi survivors is a pressing and enormous challenge for the KRG government, UN agencies, and humanitarian agencies. The World Health Organization (WHO) has said that mental health and psychosocial support are essential components of comprehensive care for survivors of sexual violence.

While Germany has accepted hundreds of the most traumatized Yezidi women and girls under an agreement between the German state of Baden-Wurttemberg and the Iraqi Kurdish government, hundreds of survivors remain in Iraqi Kurdistan and many suffer from severe trauma. The German program, which costs €95 million and provides the women and girls with residency for two years that they can then extend, has closed its intake so this option is no longer available to more recent escapees. According to officials working on the program, some women and girls who escaped earlier also could not participate because they had to stay in Dohuk for family reasons or were unable to get passports because they had lost their national identification papers during the Daesh attacks.

Eleven staff of governmental and nongovernmental providers of mental health care and psychosocial support emphasized to Human Rights Watch that post-traumatic stress disorder (PTSD) and other mental health conditions are widespread among Yezidi women escapees and that there is a significant need for comprehensive, long-term medical care and psychosocial support for abduction and rape survivors. Dr. Nezar Ismet Taib, director general for health in Dohuk, and Dr. Adnan Assad Taha, head of the psychiatry department of Azadi General Hospital, said that the need for psychological support in Dohuk is likely to increase as the immediate needs for food and shelter for women and girls who have escaped Daesh are met. Moreover, it is expected that Yezidi women and girls will continue to arrive, even if in smaller numbers than in 2015.

In February 2015, Human Rights Watch had found that medical care, psychosocial services, and other services for Yezidi survivors were largely lacking. By January 2016, we observed improvements. The Iraqi Kurdish government has set up a survivors’ center, staffed by two psychologists and other healthcare staff, and is overseeing the growth in psychosocial services, especially in Yezidi displaced people camps. Most camps where women and girls were living now have a visiting psychologist or, more commonly, social workers and volunteer outreach workers. Nongovernmental organizations were providing some psychosocial services and employed psychologists at some displaced people’s camps. The government and aid agencies have begun establishing referral systems to ensure that women and girls in crisis in the camps can access care in emergencies. This facilitated, for example, the referral of about 20 women in the Kapartu camps to Azadi General Hospital between June and August, after they threatened or attempted suicide.

But a range of barriers continue to prevent women and girls from accessing the services or receiving the ongoing treatment they require. According to Dr. Taib, the survivors’ center has registered 668 women and girls who escaped Daesh, but only a small proportion are regularly accessing therapy at the center, one of the few locations women and girls can access free long-term individual counseling with trained psychologists. Several providers interviewed said there were too-few psychologists in Dohuk, especially female specialists in sexual abuse. Only one of the women and girls Human Rights Watch spoke to was receiving ongoing care although they all reported struggling with problems such as insomnia, flashbacks, anxiety, and depression.

Experts said that the quality of care, especially access to good long-term psychosocial support or group/individual therapy, differs from camp to camp. Women and girls in camps further from Dohuk or in non-camp settings appear to have fewer opportunities for care. Many of the women and girls Human Rights Watch interviewed identified a lack of money or transport or childcare or other family commitments, as reasons why they were not accessing assistance. Women and providers also identified a lack of outreach by providers; stigma surrounding mental health problems and rape; and a lack of knowledge about and understanding of services as barriers to care.

A budgetary crisis in Iraqi Kurdistan is complicating the response. Dr. Taha of Azadi General Hospital said that budget cuts had limited availability of key medications required for the care of these women and girls. Some nongovernmental organizations, including the Iraqi-German group WADI e.V. and the local Jihan Center for Human Rights, which also take international donor money, said they too face funding shortages that impede their ability to offer psychological or psychosocial services, or both.

Health officials in Dohuk said they have been overwhelmed by the needs of the women and girls who escaped Daesh and have suffered horrendous human rights abuses. Providing adequate mental health care and psychosocial support is a complex and long-term challenge. To date, the response has been ad hoc and at times lacking in coordination. To adequately tackle the challenge, it is essential that the KRG government, UN agencies, and other stakeholders put in place a coordinated response, based on an assessment of the needs and the most pressing priorities, the identification of key barriers to making care and treatment accessible and available, and the cost implications. Such coordination efforts should include the WHO and representatives from the survivors.

Women and girls who have become pregnant as a result of rape during captivity have not been able to access safe and legal abortions. Some provisions, including shelters and adoption, have been created for pregnant women and children born of rape. The Iraqi government should amend the penal code, at least to allow safe and legal abortions for women and girls who have experienced sexual violence and who wish to terminate their pregnancies.

Daesh Restrictions on Dress, Freedom of Movement
All 21 of the Sunni Arab women and girls Human Rights Watch interviewed reported being forced to wear the niqab, which covers body, face, and head, with veils over their eyes, gloves, and socks whenever they left their houses. All clothing had to be black and without decoration. Many said that with their eyes veiled, they could not see where they were going and sometimes stumbled and fell. Before Daesh took over their areas, they said, they wore headscarves with their faces showing, and colored clothing.

The women said they feared being beaten if they did not comply. More frequently, male relatives were punished for infringements of the dress code with 30 lashes or fines of 50,000-100,000 Iraqi dinars (US$45 to $90), or both.

“My neighbors had to pay money just because they cleaned right outside their house without full niqab,” said a 44-year-old woman from the town of Riyadh. In some areas, including Hawija, foreign female Daesh fighters participating in a hisbah (“accountability”) – which acts as a morality police force – policed women’s dress armed with metal prongs, sometimes poking, slapping, or even biting women for dress code breaches. One woman said female officers threw water from a drain in her neighbors’ face because they were sitting outside their homes without their faces covered.

The women said they were not allowed to move outside their houses unless accompanied by a male guardian – a close male relative – even to visit relatives nearby.

These restrictions have sharply reduced women’s ability to participate in their community. Many said that before Daesh took control, they had left their houses every day, to visit family or shop, but after Daesh arrived they only left once a month, or in some cases even less frequently. Human Rights Watch spoke with two women who had left Mosul and two who had left Ramadi, both at the time under Daesh control, who described similar dress codes and punishments. The women who had left Mosul said that hisbah enforcers cut women’s fingers with a metal instrument similar to nail clippers for minor infractions.

These restrictions on dress and movement violate the rights to freedom of expression and freedom of movement and unlawfully discriminate against women and girls.

Restrictions on Access to Health Care, Education
Because many healthcare personnel fled ahead of the Daesh takeover of the Hawija area, access to health care diminished for the entire civilian population, most of those interviewed said. Women and girls faced further barriers because of restrictions imposed by Daesh. Fearful of punishment, the women said, most male doctors would not examine female patients.

One woman from the village of Kubaiba said a doctor would not examine her daughter, who she feared had typhoid, leaving it to the girl to describe her symptoms. Another said her doctor asked her to open her mouth and then peered at her sore throat from across the room.

In some cases, including in Hawija hospital, foreign male doctors who the women said were Daesh members, were allowed to touch women patients, particularly during emergencies. However, the restrictions have aggravated shortages in quality medical services for women and girls, interviewees said. The few available female doctors cannot provide adequate care to all women and girls who require it. Women from Hawija said they had to wait for up to three days to see a female doctor, longer than men had to wait. Others said they gave up, sending male relatives to pharmacies to get medicine or visiting pharmacies themselves, sometimes in secret.

One woman said that her pharmacist would have been beaten if Daesh fighters had known he was touching her arm to check her blood pressure. Two women said that when they or female relatives became pregnant, they went to local midwives rather than doctors because of the restrictions. One of the women said she suffered complications as a result of poor postpartum care.

Harassment by Daesh fighters at checkpoints has also made it harder for women to travel to get medical care. Several women said that female hisbah officers monitored women’s clothing and behavior in clinics and hospitals. “They hit my relative for breast-feeding in Hawija hospital,” a 50-year-old woman from Shirqat said. “People are too afraid to go.” Another woman said a hisbah member squeezed her arm painfully for not covering her eyes in a clinic.

Families have sometimes stopped their children from going to school because of a lack of qualified teachers, some of whom fled ahead of the Daesh attack, or because Daesh has changed the curriculum to study of the Quran, fighting techniques, and instructions on how to make improvised explosive devices, mothers and girls said.

One 16-year-old girl from Hawija described the education available as “brainwashing.” Women interviewed said that schools have closed because of a lack of teachers or because parents are afraid of airstrikes. Daesh gender-based restrictions have imposed particular barriers for girls. In the villages of Kubaiba, Madhuriyya, and Hababza, Daesh forced girls out of school, while allowing boys to attend, family members said. In Atshana, Daesh allowed girls to attend, but those over 12 were required to wear the niqab. In Mahhuriya, boys – but not girls – were allowed to travel out of the village to secondary school.

Some families have stopped sending children to school, fearing that schools will be bombing targets because Daesh fighters have used schools as bases, including a kindergarten in Riyadh and a school in the Shirqat area. The UN Security Council has called on all parties to armed conflict to refrain from actions that impede children’s access to education.

Impact of Airstrikes, Civilian Casualties
Many of the women said that fear of airstrikes, especially fear that the main Hawija hospital will be targeted because of the presence of Daesh fighters, have kept people from seeking care. Bombs fell on Hawija hospital, including the maternity ward, on September 6, 2014, allegedly killing more than a dozen people. News reports at the time suggested that the Iraqi air force was responsible. One woman said that a friend of hers, the friend’s baby, and another woman she knew were killed.

Women from the area said that a strike on Hawija market on June 2, 2015, by US-led coalition forces, reportedly killed dozens of civilians and left them fearful of moving around town.

Three women said that family members or neighbors were killed in airstrikes in the Hawija area, which they said have increased since around September.

High food prices have been especially hard on civilians since the Iraqi government stopped sending salaries to government workers in Daesh-controlled areas in mid-2015. A few women said that before they left Hawija, they had been hungry or had less to eat than normal, and one women from Shirqat village said that her daughter, still in Hawija, did not have enough food to feed her children.

A Dangerous Escape, Further Restrictions by KRG Forces
Women, girls, and their families faced multiple dangers escaping Daesh-controlled areas. Women described hiring expensive guides to avoid Daesh improvised explosive devices as they and their families walked through fields. One woman said that her male cousin had been killed when he stepped on one. Daesh has beaten, fined, and in some cases killed civilians caught leaving Daesh areas, the women said, although no one they knew had been killed for this reason.

Women and their families sometimes faced further abuse after crossing front lines into Kurdish-controlled areas from security forces of the Kurdish Regional Government, including restrictions on their freedom of movement and right to live where they wished, the women said.

Ten women said Peshmerga forces made their families stay under their control for a period after leaving Daesh areas. Some were forced to stay in unfinished buildings at a checkpoint in the village of Malha, four kilometers south of Bay Hasan in Kirkuk governorate. “We were guarded by KRG forces in Malha [between October and December 2015] and they kept our IDs too,” one 22-year-old-woman said. The women were screened while in Malha but were uncertain as to why they were being held. Another woman described being kept in detention. “They put us in a tiny room for 15 days, we were very crowded, there were 18 people in the room,” she said. Peshmerga also interrogated male relatives.

Twenty of the women said Peshmerga forces on the front lines took their families, along with other families, to the Nazrawa camp in the eastern part of Kirkuk governorate. Ten of the women interviewed said they were not given a choice. Five women said they had expressed a wish to go to nearby Kirkuk to live with relatives or to other locations but the Peshmerga had refused.

KRG forces imposed restrictions on families in Nazrawa camp. All of the women said that they could only leave the camp if they left their national identity document at the gate, guarded by the Asayish [the Kurdish security agency]. The women said that without their identity documents they were unable to move through checkpoints easily, rent housing, or enroll their children in schools. In three cases, women whose identity documents had been retained by the Peshmerga said that they could not leave the camp at all.

Others said they were able to leave the camp but were not allowed to go out late in the day or spend a night outside of the camp and were sometimes turned back if they tried to cross the checkpoint to Kirkuk. In two cases, people seeking health care in Kirkuk were turned back, even though they had letters from health officials in the camp, because they had to leave their identity cards at the camp.

These restrictions have also caused them problems accessing specialist health care not provided by the camp’s clinic. One pregnant woman who wanted to go to Kirkuk for an ultrasound exam said she was turned back at a checkpoint manned by Kirkuk governorate police because she did not have her identity documents. Asayish took a woman who was severely ill to the nearby Leylan clinic and only then to Kirkuk hospital rather than directly to the hospital. She died 10 minutes before reaching the hospital, her husband said. Human Rights Watch was unable to establish whether she could have been saved if she had been taken directly to the hospital.

​