An Essay About Health And Medicine In Libya Trying

Copyright: Ivor Prickett / Panos

[CAIRO] A couple of years ago, Libyan youth expressed anger over the acceptance of a planeload of medical supplies from the United Arab Emirates as post-revolution conditions deteriorated in Libya.

The Libya Liberal Youth angrily lamented on its Facebook page: “After being the ones who used to send medical aid to countries across the world, this is the situation Libyans now find themselves in.”

Today, Libyan citizens can only hope to receive the aid previously criticised by the youth. During the second Libyan tribal leaders' forum, which was held in Cairo on 25-28 May with the aim of finding solutions to the Libyan crisis, the tribal heads called for medical assistance from Egyptian authorities.

Mohammed al-Shahoumi al-Idrissi, the leader of the Sheikh Zileeten Sons Tribe in Libya, tells SciDev.Net that they “made an agreement with the Egypt’s minister of health to facilitate the entry of a medical convoy to Libya in July”. He says the minister promised to secure this in cooperation with the Libyan army until it reaches Benghazi and the eastern province by land.

“Due to the targeting of airports in the internal conflict raging between the two governments in Libya, it has become difficult to secure medical supplies sent by air,” says al-Idrissi. “This has caused the health situation to deteriorate and led to complete reliance on neighbouring countries such as Egypt and Tunisia.”

As with other Arab Spring countries, following the 17 February 2011 revolution, Libya experienced sharp division that reached its peak with the existence of two governments and two parliaments. The situation between the two sides escalated to armed conflict, with each side claiming to be the legitimate people’s representative.

"Where will the financial authorisations come from if there is no state,” asks Mohammed Abul Qasim, a physician at one of the hospitals in the eastern province.

To make matters even more complicated, armed groups such as ISIS appeared on the scene.

Abul Qasim says that the shortage of key medical staff is another offshoot of the crisis. “Before the revolution, Libya was suffering from a shortage of medical professionals and it tried to solve the problem by bringing in doctors from Arab countries,” he tells SciDev.Net.

He adds that the current conflict led to the departure of many doctors, especially after an Egyptian doctor and his wife were killed and their two daughters were kidnapped last December.

According to Abul Qasim, replacing these medical teams with local ones is impossible under the deteriorating security situation and after the complete destruction of the Al-Arab Medical University in Benghazi, which was specialising in preparing medical professionals.

Abul Qasim explains the problem is aggravated by a shortage of nursing teams after the Philippines decided last August to withdraw 13,000 Filipino citizens, including some 3,000 workers in the medical sector.

The decision came after unidentified gunmen beheaded a Filipino working in Benghazi and a Filipino nurse was kidnapped and raped by an armed group in Tripoli.

“Filipinos working in the health sector make up around 60 per cent of the medical and paramedical workforce in Libya,” says Abul Qasim.

To cope with the deteriorating situation, hospitals have been forced to apply strict rules in accepting patients who are now limited to critical cases. The children's department in Benghazi Medical Center was hit especially hard. According to gastroenterologist consultant Adel al-Tawati, his department no longer accommodates children and only treat emergency cases.

This has resulted in a growing desire to travel to neighbouring countries for treatment, creating a phenomenon known as the visa trade, where the cost of a travel visa has reached 10,000 Libyan dinars (US$7,300).

Faced with this dilemma, the Libyan Ministry of Health has had to resort to foreign support. Earlier this month, the health minister of the Interim Government of Libya, Rida al-Oakley, signed a cooperation agreement with the head of the Doctors Without Borders mission in Libya.

In a press statement, the ministry’s official spokesman Ahmed al-Ulaiqi said that “the organisation will commence its work in the near future by providing medical personnel, as well as medical equipment and supplies.”

This article was originally produced in Arabic by SciDev.Net's Middle East & North Africa desk and translated by the South-East Asia & Pacific desk.

 

The Benghazi Medical Center. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

 

Every day, the emergency room at the Benghazi Medical Center receives dozens of patients wounded by clashes in

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Benghazi. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

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An elderly man is given treatment at the Benghazi Medical Center. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

 

Workers at the Benghazi Medical Center build a barricade out of sandbags to protect the building from random

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bullets and shells. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

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A hospital room that was exposed to mortar shelling at the Benghazi Medical Center. Photo by Abdul Hakeam

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al-Yamany, May 13, 2015.

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An entire wing at the Benghazi Medical Center caught fire as a result of shelling. Photo by Abdul Hakeam

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al-Yamany, May 25, 2015.

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A corridor at the Benghazi Medical Center suffered damages after mortar shellings. Photo by Abdul Hakeam

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al-Yamany, May 13, 2015.

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The Benghazi Medical Center wall shows damage from several gunshots and shrapnel. Photo by Abdul Hakeam

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al-Yamany, October 25, 2015.

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Damage from a rocket launched from a nearby battle line. Photo by Abdul Hakeam al-Yamany, October 25, 2015.

 

Benghazi Medical Center staff. Most of the foreign doctors on the crew have since left the country. Photo by Abdul

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Hakeam al-Yamany, May 25, 2015.

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A student at University of Benghazi’s School of Medicine receives training at the Benghazi Medical Center. Photo by

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Abdul Hakeam al-Yamany, May 25, 2015.

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Volunteers receive practical training at the Benghazi Medical Center. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

 

Training for volunteers from Benghazi’s medical schools. Photo by Abdul Hakeam al-Yamany, May 25, 2015.

 

The October 7 Hospital, located in an area of clashes in downtown Benghazi, suffered structural damage and is now

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closed. Photo by Abdul Hakeam al-Yamany, February 12, 2015.

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Benghazi Eye Hospital was damaged during clashes in the neighborhood. Photo by Abdul Hakeam al-Yamany, April 14, 2015.

 

Soldiers from the Libyan Army are stationed in one of the rooms at the Benghazi Eye Hospital. Photo by Abdul Hakeam

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al-Yamany, April 14, 2015.

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A damaged operating room at the Benghazi Eye Hospital. Photo by Abdul Hakeam al-Yamany, April 14, 2015.

 

The doctor’s office at the Benghazi Eye Hospital. Photo by Abdul Hakeam al-Yamany, April 4, 2015.

    Since fighting broke out in Benghazi in May 2014, health services in the city have been significantly affected. Most of the city’s hospitals are located in areas where there have been clashes, and the remaining hospitals have been drained of medical resources and equipment. According to the Minister of Health, Rida El Oakley, about sixty percent of the city’s hospitals have been forced to close since the start of clashes, and the rest are unable to respond to the needs of the city’s population. 

    “Missiles and rockets have become part of our daily work in the hospital,” said Dr. Salem Lanqi, as he inspected a barrier of sandbags erected by workers at Benghazi Medical Center in order to avoid the barrage of bullets coming from a nearby battle line. Benghazi Medical Center is the largest health facility in eastern Libya and has become the main hospital in the city after most of Benghazi’s other hospitals. Lanqi added that the center is not equipped to operate in a war zone, as it has only 260 beds. This number is insufficient to accommodate the dozens of people injured in clashes every day, not to mention the usual patients undergoing regular treatment at the hospital. 

    The situation is further exacerbated by the departure of most foreign medical personnel, who made up the backbone of workers in the hospitals. For more than a year, foreign embassies have called on their nationals to leave the country due to the worsening security situation. A catastrophe for the center, as foreign workers used to make up 90 percent of its staff. Lanqi notes that many local doctors and nurses are also unable to work. According to him, they have either left the city or are afraid to go to the hospital due to the security situation—especially after a number of workers were injured in the center on May 9, when the building was targeted by shelling and bullets. 

    “The security situation is now even worse than what we saw during the Libyan Revolution four years ago,” said Leon Tombo, a Philippine national and a nurse in the emergency room of the Benghazi Medical Center, in May 2015. He added, “I will resign at the end of this month, and many of my colleagues have already left. We are no longer safe inside the hospital; bombs and bullets are hitting the building, and a number of my colleagues have been injured in these attacks.” The conflict has also placed financial strains on foreign workers, Tombo explains, “Our families are also very angry because we have not been able to send them money from our salaries for more than a year, due to restrictions banks have put on money transfers. They are in dire need of this money, and it’s what pushed us to work [here] in the first place.… The value of the Libyan dinar against the U.S. dollar has collapsed. This means our salaries are not as good as they used to be, especially since we transfer money in U.S. dollars, and we’ve had no salary increase in five years.”

    Because of the departure of foreign medical staff, doctors in Benghazi are trying to avert a health disaster by training medical students to replace the foreign nurses in the city’s hospitals. Essa al-Dinaa, a doctor at the Benghazi Medical Center, said, “We appealed to medical students in Benghazi to volunteer and work as nurses in the hospitals. We were surprised by the number of local students who responded to our call—we now have more than 600 volunteers.” He added, “We formed an academic committee of doctors to train large groups of 40 volunteers each. We will distribute them among the remaining hospitals in the city and they will form the backbone of workers in the hospitals in the event that all foreign nurses leave [the country].” Dinaa continued, “This is a new experiment and there are many warnings and red lines we have set for volunteers in nursing. We realize that volunteers will not have the same proficiency as those who have graduated from nursing schools, but we are training them on nursing skills, and their job will be to help nurses employed at the hospital.” But the volunteers are unpaid, and though many say they will continue to work in the hospitals until the conflict is over and foreign medical staff return, doctors are uncertain how long this approach can last.

    Yet most hospitals still struggle to provide adequate medical services required for a war zone. Making matters worse, though the World Health Organization warned of a health crisis in Benghazi, international relief organizations with war zone experience—such as the International Committee of the Red Cross and the International Medical Corps—have left Libya because of the security situation. 


    This article was translated from Arabic.

    Abdul Hakeam al-Yamany is a Libya-based journalist.

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