Despite limited improvements in security in some areas, armed violence is still having a disastrous impact. Civilians continue to be killed in the hostilities. The injured often do not receive adequate medical care. Millions of people have been forced to rely on insufficient supplies of poor-quality water as water and sewage systems suffer from a lack of maintenance and a shortage of engineers.

Many families include people who have been forced by the conflict to flee their homes, leaving those left behind with the daily struggle of trying to make ends meet. A sustained economic crisis marked by high unemployment further aggravates their plight.

To avert an even worse crisis, a renewed effort is required to address the everyday needs of Iraqis. As a matter of priority, every Iraqi man, woman and child should have regular access to health care, electricity, clean water and sanitation. Moreover, all those involved in the conflict and those who can influence them must do everything possible to ensure that civilians, medical staff and medical facilities are not harmed. This is an obligation under international humanitarian law that applies to all parties to an armed conflict – both States and non-State actors.

Despite the difficult security situation, the ICRC has been able to help hundreds of thousands of the neediest Iraqis. It has been working closely with local organizations to ensure that people all over the country receive the aid they most require.

It is extremely difficult to obtain reliable and comprehensive statistics on the state of public services in Iraq. This report is based on the findings and observations made by ICRC personnel during their regular contacts with staff in hospitals, health-care centres and water and sanitation facilities, with public authorities and with other organizations.