Critical shortages of essential supplies in Libya
Concerns are high regarding the health and welfare of populations in conflict-affected areas. Heavy fighting was reported throughout July in the Nafusa Mountains, and sporadic heavy fighting and shelling continues near Misratah and around Zlitan.
However, insecurity limits both the availability of information on the health consequences of the fighting and the provision of humanitarian assistance.
Lack of essential medical supplies
From 16 to 23 July, WHO participated in the fourth United Nations interagency mission to Tripoli, Al-Gharyan (in the Western Mountains), Zlitan and Al-Khoms (East of Tripoli).
Interviews with health staff show that injuries remain the health priority everywhere. This is a key concern as there are shortages of medical supplies and medicines. Life-saving products including insulin, antiretroviral drugs, chemotherapy regimens, immunosuppressive drugs, hypnotic and psychiatric drugs as well as vaccines, blood products, dialysis supplies and laboratory reagents and consumables are needed. In many places, antiretroviral drugs and laboratory consumables are already out of stock. All other special supplies are expected to be out of stock by September.
An earlier interagency mission to Misratah has shown a similar lack of vaccines for childhood diseases, particularly measles vaccines.
Shortages of essential supplies, especially vaccines, may result in an increase in morbidity and mortality and in outbreaks of communicable diseases. Laboratory supplies are indispensable to maintain the already weakened disease surveillance and outbreak response system.
Lack of maintenance and spare parts as well as the departure of professional medical workers due to the violence adds additional strain on the health sector. Fuel shortages limit patient access, including pregnant women, to essential medical services. It also has an impact on the access of medical personnel to their work place. Finally, as Libyans are unable to travel by air due to the no-fly zone, it has become impossible for the chronically ill to seek treatment abroad.
The mission also received reports of rising psychosocial trauma especially among women and children. Additional support is required to strengthen the response.
The Ministry of Health recently reported 5000 casualties – killed and wounded – since last May.
In many cities, municipal services have collapsed or are extremely weak because of unpaid salaries, fuel shortages and departure of foreign workers. Garbage is piling up in some streets, increasing the risk of communicable disease outbreaks at a time when the country’s disease surveillance and response system is weak.
Health Cluster partners’ activities
Health Cluster partners continue to support key primary health care facilities and to provide specialized health personnel to hospitals in priority areas. The International Medical Corps are supporting Al Hilal Hospital in Misratah to increase the surgical ward’s capacities and Save the Children has begun supporting health authorities in Benghazi. The MoH, WHO, UNICEF, the International Medical Corps and Save the Children reviewed existing primary health care needs in Libya. A tool was developed to map and assess key priorities in school health, occupational health, mental health care, communicable diseases and vaccination in Eastern Libya. Health Cluster partners are also providing medicines and medical supplies.
Health Cluster partners have elaborated a contingency plan for Libya to:
- coordinate and monitor health and nutritional needs and health care delivery;
- ensure life-saving treatment for trauma and injury patients and access to essential health care including for chronic disease;
- restore the medical supply chain for essential medicines, vaccines and other medical equipment;
- strengthen the health system to deliver essential health services.
A collective effort is needed to ensure the uninterrupted flow of medical supplies and provision of spare parts to the health care system. More advocacy and technical assistance is needed.
Libyan authorities have requested WHO’s support in procuring essential medicines, vaccines and supplies to manage the health system of Libya – including Tripoli-controlled areas, Benghazi-controlled areas, Misratah and the Jebel Nafusa mountains.
The central bank of Libya has transferred 100 million Euros to a bank in the Netherlands. The Netherlands have requested approval from the United Nations Sanction Committee for the release of the funds to WHO. As soon as the authorization to unfreeze the funds is received, WHO will begin to implement the procurement plan agreed upon. WHO will deliver and oversee the distribution of the supplies.
In Tunisia, the refugee populations in camps is stable at approximately 5700 persons. There is no evidence of excess mortality or morbidity among vulnerable populations at present, but the additional population in need of health care services is an additional burden for the Tunisian health system. Many hospitals have exhausted their funds for the procurement of medicines and medical supplies for chronic diseases and funds are needed for replenishment.
The Health and Nutrition Cluster component of the Flash Appeal was based on the assumption that the MoH would have access to funds to purchase essential medicines and consumables for the health system while humanitarian partners would fill gaps for the most vulnerable populations. So far, only 39% of the appeal has been funded.