Médecins Sans Frontières expands its support to war-torn Libya

Hospital Abbad in Misrata, Libya. © MSF

Heavy fighting continues in Libya, with the eastern part being under control of the insurgency and pro-Gaddafi forces holding the West. Fighting is ongoing around Misrata in Western Libya, and the situation of civilians caught up in the conflict is becoming increasingly difficult. The situation of migrant workers in Libya is another particular concern. Many leave by boats to Europe in very insecure conditions or have fled to refugee camps in Tunisia where they face further violence and insecurity.

Médecins Sans Frontières has been present in Libya since February 25th. As the conflict continues, Médecins Sans Frontières is expanding its assistance in the cities of Misrata, Benghazi, Zintan, in camps along the Libyan-Tunisian border, and on the Italian islands of Lampedusa and Sicily. Offers by Médecins Sans Frontières to set up activities in pro-Gaddafi areas have so far been declined by the government.

Difficult conditions persist in Misrata

As fighting continues around Misrata, Médecins Sans Frontières is performing war and post-conflict surgery such as skin grafts and plastic surgery in the Abbad hospital. Médecins Sans Frontières has set up two operating theatres in Kasr Ahmed hospital to respond to other surgical and medical needs of the population. Each day, Médecins Sans Frontières staff working alongside Libyan medical staff also assist around 15 deliveries in the Ras Tubah hospital.

Médecins Sans Frontières has trained a team of 20 psychologists, who are now delivering psychological care to medical staff and patients in four hospitals in the city. “Although the frontline has moved outside of the city centre, people here are still having to cope with very difficult conditions. They suffer the psychological trauma of having experienced heavy fighting on their doorstep, and are living under siege. It’s inhumane to be forced to endure such conditions.” said Renzo Fricke, Médecins Sans Frontières’ Emergency Coordinator in Misrata.

Libyan medical staff lacking experience of trauma surgery has been given training by Médecins Sans Frontières surgeons. Basic training has also been provided to medical students who have volunteered to work as nurses, as most nurses in the city were foreigners who have now fled the country.

Outside of Misrata, Médecins Sans Frontières is providing support to advanced medical posts by the frontline that are delivering first aid to the wounded before referring them to Misrata hospitals by ambulances. This support includes training of the medical staff to stabilize the wounded, and providing donations of medical and communication equipment.

Ongoing shelling in Zintan forces Médecins Sans Frontières to evacuate

In the western Libyan city of Zintan, a Médecins Sans Frontières team has been supporting the hospital, managing the influx of wounded – over 120 were admitted in the last month - following fighting in the Nafusa Mountain region. Médecins Sans Frontières has also been providing training, medical equipment and medicines to the hospital. 

On 27 May, the Médecins Sans Frontières team was forced to evacuate following repeated shelling, with several rockets landing only metres away from the hospital. A reduced team of two returned to Zintan on 4 June to assess the situation and resume medical activities. The security situation remains highly precarious, with ongoing shelling over the city and surrounding areas. Patients admitted to the hospital are currently being referred to medical facilities in Tunisia or the nearby Libyan city of Jadu.

Providing psychological-, maternal- and paediatric care in Benghazi

In the former battleground of Benghazi, Médecins Sans Frontières focuses on mental health care for women and children as well as medical staff which have been working when fighting was taking place in the city. A Médecins Sans Frontières psychologist is training Libyan psychologists to help screen patients with trauma or trauma-related syndromes, especially depression.

Médecins Sans Frontières is also providing support to the central pharmacy in the procurement of drugs, although less support is needed now as more international organisations are present in the city.

Outside Benghazi, Médecins Sans Frontières supports gynaecology care and antenatal care in three sites located between Benghazi and the town of Ajdabiya.

Refugees fleeing to Tunisia and Italy

Thousands of Libyan families have fled the Nafusa Mountain region and have made their way over the Tunisian border. From early April to the beginning of June, more than 60,000 Libyans have fled the conflict to find refuge along the Tunisia-Libya border.

Médecins Sans Frontières is supporting local health infrastructures to cope with growing medical needs. Médecins Sans Frontières has also set up mobile clinics in refugee camps in the areas of Remada and Dehibat, providing medical care and mental healthcare to the refugee population. The situation in Dehibat is tense, with fighting and shelling crossing over the Tunisian border.

In the Ras Adjir transit camps, located at the northern Tunisia-Libya border, nearly 4,000 people – mainly sub-Saharan Africans – cannot be repatriated due to the situation in their country of origin and face an uncertain future. Since early March, Médecins Sans Frontières has been running a mental health programme in the camps, as many people have either witnessed or directly experienced violence in the course of their escape from Libya.

In Shousha, the largest camp, the protracted situation has lead to increasing tensions. At the end of May, four refugees died when a fire spread through the camp. This event was followed by violent demonstrations against the poor living conditions in the camp. At least two people were killed, while many more were injured and two-thirds of the camp was burnt down. The day after the incidents, Médecins Sans Frontières distributed food, water and non food items to approximately 4,000 people, in addition to providing medical care and mental health care. While the situation in the camp has returned to normal, a climate of fear and mistrust reigns and many have reportedly crossed the border back to Libya, ready to risk their lives again in search for a future. Since the end May, Médecins Sans Frontières is also providing primary health care to the Shousha camp’s population, as a number of refugees present injuries linked to the recent violent events, while other complaints are linked to the poor living conditions and over-crowding inside the camp.

On the island of Lampedusa, Médecins Sans Frontières looks after the triage of patients at the port and their medical follow-up in the island’s detention and reception centres. During the period February-May, Médecins Sans Frontières assisted almost 12,000 people in Lampedusa who have fled the conflict in Libya. Médecins Sans Frontières is also providing mental health support project in a reception centre in Mineo in Sicily, where about 3500 migrants of various nationalities have been transferred since March. In addition, Médecins Sans Frontières has taken on the role of evaluating the migrants’ living conditions and access to care in detention centres in mainland Italy.