More than a decade after a genocidal campaign killed thousands of Yazidi people, primarily men and older women, an estimated 200,000 Yazidis are still unable to return home, living in displacement camps in the semi-autonomous area of Iraqi Kurdistan.

“The Yazidis have been forgotten by the world,” said Gier Fjeld, head of international operations at the Medical Initiative Norway, speaking from his office in Iraqi Kurdistan in late 2024.

Public support programs for displaced Yazidis, refugees, and other vulnerable people in the region were canceled or discontinued beginning in 2023. People living in camps for safety have been told to return to their homes in hostile areas, where their safety will be at severe risk. Yazidi women, many of them victims of sexual violence, were widowed by the genocide, and now struggle to pay for food, water, and medicine for their families. Fjeld said many have been forced into prostitution to feed their children.

“When you remove all the services — food, water, safety, and medical care — you force the Yazidis out of the camps. They’ll create temporary settlements in abandoned buildings, without any access to safety,” he explained.

The loss of public funding has caused suspended services, closed camps, and severely limited the regional healthcare system, which is responsible for more than a million refugees and internally displaced people. The Duhok Directorate of Health, a public health authority in Iraqi Kurdistan, cares for people, including Yazidis, in camps and other temporary settlements. While medical providers are available to care for patients, even going without pay for long periods in some cases, medicine shortages are a serious issue for people with cancer and other chronic diseases.

“Getting diagnosed is not a problem. The problem is the treatment. Most people are referred to private treatment,” which they can’t afford, explained an aid worker stationed in Iraqi Kurdistan, who asked to speak anonymously to preserve their safety while working in the field, during a 2024 Direct Relief interview. They have been working in the region since 2014.

“If you have a chronic disease, and you are without medication, there’s no stability. You might receive some…medication this month, but you might not for the next two months,” Fjeld said.

Partnering closely with the Duhok DOH, Direct Relief has mobilized over $144 million in cancer drugs alone to Iraqi Kurdistan since 2020. The organization has also provided partners in the region with emergency preparedness and response items, such as field medic packs, insulin and other medications for non-communicable diseases, and other requested items – totaling more than $156 million and 1,300 tons since 2016.

“Direct Relief is the largest contributor of aid to the Directorate of Health in Duhok, securing life-saving medications for thousands of patients throughout the Kurdish region of Iraq,” wrote Dr. Lazgin Jamil, a pediatric oncologist with the DOH, in an email. “As the DOH continues to suffer from lack of medication…in addition to lack of funds to purchase medicines and medical consumables, we are grateful beyond words for the incredible support from Direct Relief.”

Fjeld explained that a patient with symptoms of cancer might be referred to a public health facility for diagnosis: “They’ll have a bed, doctors, and nurses,” but without outside support, there would be “no cancer medications.”

“Because of Direct Relief’s support the cancer medicine is there and freely available,” he said. The partnership is “saving thousands of children suffering from cancer.”

Iraqi Kurdistan is largely out of the media spotlight right now, said the on-the-ground aid worker, which means that it’s often overlooked as a potential location for donor support. However, they emphasized, the dedicated public health providers, strong logistical network, and close partnerships make it an especially effective place to establish and deliver a system of longer-term medical support.

Direct Relief’s shipments of oncology supplies and other medications have also freed up room in healthcare budgets, allowing organizations working in the region to offer more services. Fjeld explained that providing medications alone might be half the monthly cost of running a camp, but “Direct Relief is giving medicines for free.”

“It’s been a very successful program, beyond what I ever imagined,” the aid worker noted. “It’s really been amazing what we’ve been able to pull off.”