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Background Numerous reports have demonstrated the disproportionate impact that COVID-19 has had on vulnerable populations. Our purpose is to describe our health care system’s response to this impact. Methods We convened a Workgroup with the goal to mitigate the impact of COVID-19 on the most medically vulnerable people in Springfield, Massachusetts, USA, particularly those with significant social needs. We did this through (1) identifying vulnerable patients in high-need geographic areas, (2) developing and implementing a needs assessment/outreach tool tailored to meet cultural, linguistic and religious backgrounds, (3) surveying pharmacies for access to medication delivery, (4) gathering information about sources of food delivery, groceries and/or prepared food, (5) gathering information about means of travel, and (6) assessing need for testing. We then combined these six elements into a patient-oriented branch and a community outreach/engagement branch. Conclusions Our highly intentional and methodical approach to patient and community outreach with a strong geographic component has led to fruitful efforts in COVID-19 mitigation. Our patient-level outreach engages our health centers’ clinical teams, particularly community health workers, and is providing the direct benefit of material and service resources for our at-risk patients and their families. Our community efforts leveraged existing relationships and created new partnerships that continue to inform us—healthcare entities, healthcare employees, and clinical teams—so that we can grow and learn in order to authentically build trust and engagement.

‘The National Bank of Turkey was founded in 1909 with British Government encouragement and support to further British economic enterprise in the Ottoman Empire’ so we are told in all die standard and respectable works on the subject. This is correct in form but incorrect in substance, for one cannot accept the implications it carries with it, in some cases explicitly stated. These are that, in the first place, the Foreign Office was instrumental in actually starting the Bank, in the second place, that the Bank succeeded very far in its objects, and in the third place, that it ever received much Foreign Office support in what it sought to do.

Though the Foreign Office Agreement of 19 March 1914 had provided for amalgamation of the major competing interests seeking the Mesopotamian oil concession, the details of this merger had yet to be settled. Indeed, the grant of the concession, the raison d’etre of the whole operation, had still to be secured. Bringing both matters to a successful conclusion continued to require the British Government’s close attention, both in defining points of principle and in supervising their material outcome. Breaking in on these arrangements came war, first with Germany, and later also with Turkey. It disrupted negotiations but provided, in consequence, the germ of an alternative settlement.

After two years in which American competition and Turkish dilatoriness had prevented the D’Arcy group’s claims for the Mesopotamian concession from making any progress, matters started to move again. The next phase from the latter part of 1912 until mid-1913, saw the development of a much fiercer competition between British and German interests and the emergence of a number of complex problems associated with this competition. The rivalry hardened partly because of the respective governments’ increased support for their nationals, and partly because of the allied problem of general commercial competition. The Anglo-Persian Oil Company was faced with strong pressure from its rival, Shell, to take over its interests. This affected the future of both the Persian and the Mesopotamian oilfields, involving imperial and naval arguments. The only alternative, the Anglo-Persian decided, was to obtain from the British Government far more substantial backing than it had had previously, and during this six-month period it argued its case and presented various means for solving it. It was eventually successful, but meanwhile it had found that the Mesopotamian concession, the obtaining of which was one of the company’s chief reasons for resisting the Shell pressure to amalgamate, could not be gained without the two companies coming to terms.

Though the outbreak of war meant that the quest for the Mesopotamian oil concession had temporarily to be abandoned, Middle East oil concessions still remained an important British Government preoccupation. War brought home forcibly to the Government its almost complete dependence on foreign oil supplies and obliged it to develop a policy and an organisation for ensuring that oil supplies were adequate, both for its wartime activities and for afterwards. Further, Middle East oil also became involved in questions of military strategy and post-war territorial ambitions. The wartime interdependence of strategy and supply thus meant that Middle East oil concessions played an important part in the evolution of British Government oil policy.

Against such a background of uncertainty, the amalgamation negotiations between the two main contenders for the Mesopotamian concession should have been speedy and determined. Instead, the conference of 5 June did no more than initiate ten months of bargaining over the terms of amalgamation. Broadly, the issues involved concerned the proportion of share capital each group was to have and, accordingly, its representation on the board of the new company. The size of the groups’ individual shareholdings was closely connected with the question of national allegiance, particularly the question of British predominance which was sought also through control of commercial policy and the marketing of the company’s products. Stipulations concerning the latter varied from territorial division of the concession to allocation by type of product, while the percentage of the total quantity of oil produced to be reserved to the respective governments was regarded as a national consideration.

The last sixteen months in the twenty-year period covered by this study of the British Government’s interest in the Mesopotamian oil concession demonstrate the way in which the threads of the preceding years had by now drawn together. The oil question was greatly affected by the conclusion of the armistice with Turkey on 30 October and with Germany on 11 November 1918. Not only was Britain a victorious power, whose friendship was therefore additionally valuable to an international oil combine, but in addition there were now material quid pro quos, such as Mesopotamian oil, to include in the bargaining.

Since the Mesopotamia oil negotiations could be isolated neither from Britain’s general oil policy nor from her international dealings with other great powers, it is worth inquiring how they fitted into Britain’s general Mesopotamian aims and preoccupations during these years. General international interest in the Ottoman Empire has already been indicated. But how were more specifically Mesopotamian interests occupying Britain during these years?

In Mesopotamia, as in Persia, certain areas had for thousands of years been known to contain oil springs and seepages, but, apart from primitive local uses, there was no developed industry.1 European interest in the possibility of exploiting Mesopotamian oil commercially had been manifested since the last quarter of the nineteenth century. Individuals and expeditions visited the area, and even before the turn of the century numerous reports had been made on its oil potential. As early as 1871 a German expedition reported favourably on the prospects,2 while in the 1890s several reports were made,3 either to the home governments or to learned societies, or, as in the case of C. S. Gulbenkian,4 to the Turkish Government. The Ottoman administration was thus forced to become aware of this possible rich source of of revenue,5 and at the suggestion of Agop Pasha, Director of the Privy Purse, Sultan Abdul Hamid issued firmans in 1888 and 1898 (renewed in 1902) that placed the revenue of the oil properties of the Mosul and Baghdad vilayets (provinces) under the control of the Sultan ’s Civil List. Thenceforth any negotiations for oil concessions in these areas had to be conducted directly with the Civil List authorities. Legal rights to any concession could be obtained by a concession seeker only through an official contract, an imperial firman, or by a permis de recherche.