On 20 August 1918, for fear of persecution from the Ottoman Turks during their campaign of genocide against Armenians, Assyrians, and other Christians of the Ottoman Empire, the newly elected Catholicos-Patriarch fled with about 60,000 of his people from Urmia in Iran seeking the protection of the British in Iraq. 15,000 of his followers died on the way. The survivors were in a camp in Baquba, about 50 kilometers north of Baghdad. Becoming very sick, Shimun XX spent his short patriarchal days at Mor Mottai monastery belonging to the Syriac Orthodox Church of Antioch. He died on 27 April 1920 and buried on 9 May 1920 in the Armenian cemetery in Baghdad.
The episcopacy of the Autocephalous Assyrian Church of the East at this time consisted only of four bishops: Mar Yosip Khnanisho, Mar Zaya Sargis of Jilu, Mar Yalda Yahballaha of Barwari and Mar Abimalek Timothy (South India).
David Wilmshurst:The Ecclesiastical Organization of the Church of the East, 1318-1913. (Corpus Scriptorum Christianorum Orientalium 582 / Subs. 104). Peeters, Leuven 2000, 367th ISBN90-429-0876-9.