The day that the Islamic State (IS) attacked Mosul, Wassan, an affable young doctor with a cherubic face, ran from the maternity ward to the emergency room at Jimhoriya hospital. Injured civilians had begun pouring in. Wassan had just graduated from medical school, and had no experience in treating trauma casualties. As the wounded continued to arrive, what she lacked in knowledge she tried to make up for with enthusiasm.
By the evening, the wards were overflowing, patients spilling into the corridors. Wassan slept overnight in the hospital, ignoring her father’s incessant cellphone calls to come home.
The next morning, when mortar shells started falling near the hospital, doctors and patients alike piled into ambulances and fled across the bridge to the east side of the city.
There, they heard the news. The governor and senior generals had fled.
Western Mosul had fallen.
Her father called again. He was taking the family to safety in Erbil, in the autonomous Kurdish region.
“Just leave my passport at home and go,” she replied. “I have sworn an oath to help the patients.”
She hung up. Soon she was back at the hospital.
Three days after the first clashes, men carrying machine guns, their faces wrapped in scarves, entered the wards. Wassan and the few other young doctors who had stayed behind had begun a new life.
Like many other diwans (“ministries”) that IS established in Mosul, as part of their broader effort to turn an insurgency into a fully functioning administrative state, the Diwan al-Siha (“Ministry of Health”) operated on a two-tier system.
There was one set of rules for “brothers” — those who gave allegiance to IS — and another for the awam, or “commoners.”
“We had two systems in the hospitals,” Wassan said. “IS members and their families were given the best treatment and complete access to medicine, while the normal people, the awam, were forced to buy their own medicine from the black market.”
“We started hating our work. As a doctor, I am supposed to treat all people equally, but they would force us to treat their own patients only,” Wassan said. “I felt disgusted with myself.”
For all their posturing, the IS version of a city-state was neither properly efficient nor concerned with justice. Notwithstanding the archaic names and terminologies, or the new stationery printed with departmental logos, Mosul was operated on a mix of systems, ranging from capitalist free-market to a totalitarian command economy.
Underneath it all, the same century-old rotten Iraqi bureaucracy prevailed.
State functionaries continued to file memos, write inventories in big ledgers and demand written orders from superiors before taking any action. People like Wassan lived in a surreal universe in which they remained employees of the Iraqi state, which continued to pay their salaries, while answering directly to IS bosses who took a cut.
“The brilliance of IS lay in its ability to bring together a world of contradictions, all for achieving the main goal,” one former administrator said. “The side issues were not important.”
Like their administrative system, he said, the new ruling elite were also a motley mix.
“They were an incoherent mix, a cocktail of different components with no common thread. There were two kinds: those who came to benefit, and those who came out of belief. But there were tribesmen from the countryside, and members of old families from the heart of the city; there were religious clerics and street thugs; foreign jihadis and former army officers,” he said.
“IS fulfilled the desires of each one of these groups,” he added. “Those who came from the countryside were given houses in the rich neighborhoods of Mosul — something unheard-of before — the foreigners were given women and power, and the officers were given back authority they had lost after 2003.”
When Wassan began to understand how different the IS regime really was from everything that had come before, she tried to leave, but by then it was too late.
A smuggler she had exchanged messages with was caught, and female members of the hisbah (“religious police”) raided Wassan’s house, confiscated her phone and informed her that she was under surveillance.
She could not leave her job: Three days’ absence from work would get you arrested for desertion. She decided to rebel from within.
“You can acclimatize to any condition in life, and this is how we survived the rule of IS,” she said. “We had parties for female friends who got married. We had birthdays and engagement parties. We had DJs, but with very low sound. We tried to live our same old life without much change. At the hospital, we would shade the cameras monitoring us and throw parties for the children in the cancer ward.”
One day she found one of the few cake shops still open in the city and asked for a cake in the shape of Sponge Bob, a favorite character of a young patient with terminal cancer. The owner apologized: He was banned from baking any cakes with figures drawn on them.
However, as a compromise, he gave her a square-shaped yellow cake.
As she told me these stories, she pulled out her cellphone and flipped through the pictures of these parties.
Half of the children were now dead for lack of medicine, she said.
Eventually, she realized that she had to move from passive rebellion to active resistance.
“Before the start of military operations, medicines began to run out,” she said. “So I started collecting whatever I could get my hands on at home. I built a network of pharmacists who I could trust. I started collecting equipment from doctors and medics, until I had a full surgery kit at home. I could even perform operations with full anesthesia.”
Word of mouth spread about her secret hospital.
“Some people started coming from the other side of Mosul, and whatever medicine I had was running out,” she said. “I knew there was plenty of medicine in our hospital, but the storage rooms were controlled by IS.”
“Eventually, I began to use the pretext of treating one of their patients to siphon medicine from their own storage,” she said. “If their patient needed one dose, I would take five. After a while they must have realized, because they stopped allowing doctors to go into the storage rooms.”
The punishment for theft was losing a hand. Running a free hospital from her home would have been sedition, punishable by death.
If IS was a kind of Ponzi scheme, dependent on constant expansion to reward its followers, that scheme began to crumble when the Iraqi state stopped paying the salaries of government employees in Mosul.
Most stopped going to work.
Teachers had all but abandoned their schools already, after most of the students began staying home following changes to the curriculum by the new Egyptian head of the education ministry.
Those IS deemed as essential, such as doctors like Wassan and engineers working in service departments, were ordered to show up anyway, and paid one-10th of their former salary.
To keep the city running, the state became more ingenious in attempting to fill its coffers. Taxation increased. Fines were added to floggings.
Carrying prayer beads, which IS teachings considered a sin, was fined according to the number of beads. Those caught with cigarettes were sent to jail and fined the black market price of their confiscated cigarettes.
The energy ministry began diverting electricity away from residential houses and into three cement factories, which generated a reliable income. All government cars were confiscated.
Meanwhile, the US and its allies had started targeting fuel trucks traveling between oil fields in Iraq and Syria. The air raids on the city itself intensified — the elegant medical school building was bombed.
When Wassan’s hospital was appropriated by IS fighters, her secret house-hospital proved essential. More than a dozen births were performed on her dining room table. She kicked both of her brothers out of their bedrooms to convert them into operating rooms. Her mother, an elderly nurse, became her assistant.
The fall of Mosul unfolded over many months. Every few weeks, Iraqi government forces would liberate a new neighborhood. Meanwhile, the bureaucracy of IS continued to function. They collected fees, distributed basic food supplies and enforced their strict religious codes, including regarding beards. IS platoons searched for illicit satellite dishes mere blocks away from advancing Iraqi army troops.
The first thing that Wassan did when Iraqi soldiers entered her neighborhood was to go to the house of one of her cancer patients, an eight-year-old boy suffering from leukemia, put him in a car and drive him north to Erbil to try and save his life: He had not taken any medication for three weeks. A week later, the child died.
She returned to the hospital. The walls were burned and gutted. There was almost no medicine, and most of the equipment was broken.
However, the bureaucracy survived. Today, medics write names in big ledger books, just as they did during IS rule and before.
“The terror that they imposed is what gave them power, not their numbers,” said Azzam, an electrical engineer who saw IS come and go.
“In the end, we realized that there were very few of them — in our street, no more than a dozen,” Azzam added. “People say, ‘Why didn’t we do anything?’ I answer: ‘Because terror paralyzes.’”
For Wassan, the ending of IS rule in Mosul is bittersweet. After many attempts to reach Baghdad to write her board exams for medical school, she was told that her work in the hospital for the past three years did not count as “active service,” and she was disqualified.
“The ministry said they won’t give me a security clearance because I worked under the IS administration,” she said. “I am back to square one. And you ask me why Mosul is angry? Of course we are angry, if you continue to treat us as if we are all IS.”
“Now there is a different kind of civil war in the city — between those who stayed and went through all the suffering of three years, and those who left,” she said. “They say we were collaborators, and we say you didn’t suffer. Everyone wants to go back to 2014 and restart their lives from there. They can’t accept that the past three years have been for nothing.”
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