Laylan (Iraq) (AFP) - No documents? No doctor. Without state-issued IDs, Iraqi mothers struggle to have children born under the now-defeated Islamic State group treated for conditions ranging from asthma to epilepsy.
"It's unjust," said Salima, a 36-year-old mother of four living in the Laylan 2 displacement camp in northern Iraq.
Three of her children were born under IS rule and cannot go to school or leave the camp because they lack state-issued identity papers -- including Abdulkarim, who was struggling to nap in her lap on a muggy afternoon.
The toddler's breathing was strained, his tiny chest heaving. The asthma, Salima said, was getting worse.
"There's a clinic in the camp but it's no good. They refer us to hospitals but the camp security won't let us go," she said, stroking his head.
To leave Laylan 2 even briefly, displaced families need to present IDs to the federal police at the entrance and sometimes even get a sponsor to vouch for them.
Salima said she tried numerous times to take Abdulkarim to a specialist in nearby Kirkuk, but was not allowed to leave.
And trying to have IDs issued for her three stateless children has proved almost impossible, as both parents' papers need to be submitted.
Her husband was an IS member killed in fighting, which means Salima's own papers have been confiscated by camp security.
"I've been trying to get our papers issued for seven months and haven't been able to, because we're 'Daesh' families," she told AFP, using the Arabic acronym for IS.
"This affects my children in every way -- from a security perspective, economically, health-wise, education."
- 'Life on margins' -
Iraq declared victory over IS in late 2017, but the jihadists' three-year reign over swathes of the country planted a destructive and long-lasting legacy.
Much of Iraq remains in ruins, with 1.6 million people still displaced.
Among them are 45,000 children living in camps who were born under IS and are therefore lacking state-issued legal documents, the Norwegian Refugee Council (NRC) recently found.
These children cannot register for school or access steady health care, and may not be able to marry or own property, the NRC said.
The effects on health care are not uniform nationwide, and appeared to vary depending on the checkpoint or facility.
Laylan 2 seemed to have the toughest restrictions, according to camp representative Hussein Habd, 53.
"Three-fourths of the families in the camp don't have IDs and cannot exit. Even if they're sick, if they have cancer or skin diseases, they're barred from leaving," he told AFP.
At a checkpoint a few kilometres (miles) away, a member of the security forces said orders allowed them to let medical cases through, even without paperwork.
Around Hawija, 80 kilometres (50 miles) to the west, the NRC found infants without papers were denied vaccinations, reportedly causing an emergence of scabies, measles and other diseases.
And further north in Mosul, IS's onetime Iraqi capital, women without paperwork were not allowed to give birth in hospitals, according to the NRC, which in turn impacted newborns' access to state-issued birth certificates.
The NRC warned that could condemn children to "life on the margins".
"If this issue is not addressed immediately, it could spiral. This issue did not end with the conflict against IS," said NRC spokeswoman Alexandra Saieh.
- A future at risk -
The lack of documentation has also impeded families' ability to register for state welfare programmes.
That restriction has been devastating for five-year-old Methaq.
"My son has epilepsy, autism, and no ID," his mother Alaa Hamza told AFP in a shabby home they rent in Hawija.
Born less than a week after IS overran their hometown in 2014, Methaq was never issued a birth certificate.
He now suffers from seizures and mood swings. But sustained care seems a long way off.
Hamza splayed out the contents of a plastic bag on the torn carpet in their living room -- medical prescriptions, brain scans, and other tests dating back to 2017.
"We went to four different doctors, every time they take money: $250 in Kirkuk for an EEG, then another $150 for more tests," she said, which she paid for through donations.
"Our financial situation is dire, and we need to get him an ID so he can benefit from state healthcare," she said.
But she can't even afford that.
"If I want to get him one, it will cost me between 25,000 and 30,000 IQD (around $25). We don't have it," she said.
Methaq currently takes a nightly pill to ease his seizures, donated by Doctors Without Borders. His mother said he needs more intensive help.
"He's five and doesn't speak yet. I'm worried for his future," she said.