Boosting humanitarian health support inside Libya
Fighting has subsided in Misratah, but the medical situation remains critical. An inter-agency assessment was conducted by ACTED, IOM, IMC, InterNews, Mercy Corps and WHO on 21-22 May to help plan the response to immediate and mid-term needs of the population. It reports an acute lack of nursing staff, either due to departure or to difficulties in reaching health facilities, and critical shortage of antibiotics, chemotherapy medicines, anti-tetanus toxoid and vaccines.
The community has begun rebuilding the polyclinic and local cancer institute, both hit during the conflict. Much of the hospitals' equipment was destroyed either through shelling or during the transfer between hospitals and will need to be replaced urgently.
The provision of psychosocial and physiotherapeutic support is vital (about 50 persons will need prosthetic and rehabilitation care following amputations). Patients needing cancer treatment, dialysis and other specialized intensive care continue to require particular attention to ensure that their therapy is not interrupted.
Several hundred people have been evacuated from Misratah during the past month. Although medical records were very much affected during the conflict, figures collected suggest that an average of 70 people were injured and 12 killed everyday.
Meanwhile, fighting has intensified in several towns in the western Nafusa Mountains. The hospital in Zintan has reported 100 wounded since early May. WHO has not been able to access the area so far but information received from various sources report that medicines, medical supplies and health personnel are urgently needed. About 250 000 people (half of the population) are reportedly affected.
The fighting has triggered massive population movements. After the first wave of foreign migrant workers, the number of Libyan nationals fleeing the violence has risen dramatically. As many as 100 000 have crossed into Tunisia and several thousands have made their way to Egypt. The registration process conducted by local authorities in Benghazi reports more than 110 000 internally displaced people (IDPs) in that city alone. The revised Flash Appeal estimates that up to 1.6 million people require humanitarian aid within Libya, including more than 460 000 displaced people.
In Tunisia, the vast majority are hosted by communities adding a further burden on the local health resources. As this new population includes not only young healthy men but also older people, women, some pregnant, and children, it also requires a different and more complex kind of health care.
WHO is currently leading the Health and Nutrition Cluster in Cairo, with a sub-cluster located in Benghazi and a coordination cell in Tunisia covering Zarzis, Tataouine and Ras Ajdir.
WHO is coordinating the organization of medical evacuations from Misratah with international and local partners. Critically-injured patients and patients suffering from chronic diseases are evacuated to Benghazi, Tobruck and Messaid, where WHO has set up logistics support systems to ensure the provision of medical supplies to all health facilities receiving evacuees.
All agencies are requested to provide details of donations of medical supplies to the medical supply department. WHO continues to coordinate international and local partners to identify critical gaps and needs in terms of supplies and staff.
Since the beginning of the crisis, WHO has delivered 15 trauma kits and five international emergency health kits in Benghazi and Misratah, providing essential medicines and supplies for 50 000 people and specialized drugs and consumables for 1500 surgical interventions. An additional five trauma kits and five IEHK kits will be delivered to the Nafusa Mountains area.
WHO urgently requires US$ 2 million to purchase vaccines against diphtheria, hepatitis B, influenza, measles, mumps, pertussis, polio, rubella and tetanus for 204 000 children under one year old.
WHO is training medical staff in eastern Libya on mass casualty management, basic and advanced life support and first aid. WHO is also working closely with the department of hemo-oncology of the Benghazi medical centre on capacity building.
Tunisia and Egypt
Triage and referral services are functioning well on both Egyptian and Tunisian borders. Children crossing both borders are vaccinated against major childhood illnesses. Systems for communicable disease surveillance were established on both borders and the MoH in each country is issuing regular epidemiological bulletins, with support from WHO. No outbreaks have been reported to date.
A network of mobile clinics supported by a polyclinic provide health care to people crossing the border into Egypt. Services include breastfeeding counselling and obstetric care to respond to the needs of the increasing number of pregnant women and mothers.
In Tunisia, 24 basic health kits have been delivered to the 24 health posts along the Libyan-Tunisian border. Each kit contains supplies for 1000 people for three months. Six interagency health kits and five trauma kits have also been delivered and surgical supplies are expected to arrive before the end of the week.
In Egypt, WHO delivered 15 kits of surgical supplies.
In the revised Flash Appeal launched on 18 May, the Health and Nutrition Cluster is appealing for US$ 25 million, of which US$ 12.1 is requested by WHO. The CERF, Italy, Norway and the United States of America are supporting WHO’s operations.
1Permanent Mission of Libya to the United Nations Office at Geneva, Switzerland
2Department of Respiratory Medicine, Salford Royal, Manchester, United Kingdom
3The Libyan National Programme of Organ Transplant at Tripoli, Libya
4Department of Orthopeadics, Tripoli Medical Centre, Tripoli, Libya
5Department of Family and Community Medicine, University of Toronto, Toronto, Canada
6Department of Surgery, South London healthcare NHS Trust, London, United Kingdom
7Faculty of Pharmacy, University of Zawia, Libya
8Department of Infectious Disease, Central Hospital, Tripoli, Libya
9Heart of England Foundation Trust, Birmingham, United Kingdom
10Department of Paediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
11Consultant Pediatrician, Benghazi Medical Centre, Benghazi, Libya
12Department of Neurology, New Cross Hospital, Wolverhampton, United Kingdom
*Reida M. El Oakley, Libya’s Representative at the World Health Organisation, Permanent Mission of Libya to the United Nations Office at Geneva, Switzerland. Tel: Libya (+) 218 918677614; Geneva (+) 41791247313. Email: moc.liamg@yelkaole
Author information ►Article notes ►Copyright and License information ►
Received 2012 Dec 15; Accepted 2012 Dec 21.
Copyright © 2013 Reida M. El Oakley et al.
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.