Libya: strengthening and expanding the provision of health care to people fleeing violence
Increasing needs
The situation inside Libya remains of utmost concern. The ongoing conflict has resulted in untold numbers of deaths and injuries and has prompted over 350 000 people to flee the country.
Since the adoption of United Nations Security Council Resolution 1973 calling for a no-fly zone over Libya, the situation on the ground has changed significantly. Supply lines for food and medicines have been badly disrupted, and critical shortages of medical staff, equipment and supplies are exacerbated by the increasing numbers of patients.
Moreover, in spite of a recent visit to Tripoli by the United Nations Humanitarian Coordinator for Libya, humanitarian aid workers are still unable to enter the country to assess humanitarian needs. The UN is striving to re-establish a presence in the east and west of the country, as soon as arrangements for the security of humanitarian operations are agreed with all parties.
WHO’s response
WHO has established operations on the Egyptian and Tunisian sides of the border with Libya, where hundreds of thousands of people, mostly male migrant workers, have fled.
While most of these people have been Egyptian or Tunisian nationals who have gone back to their homes, many are third-country nationals who remain stranded at the border (around 7300 in Tunisia and 1500 in Egypt, as of 20 March 2011). All health partners are preparing contingency plans for a major influx of refugees from Libya.
Tunisia
In Tunisia, WHO was one of the first humanitarian agencies to set up operations at the border. It has helped the Ministry of Health (MoH) establish a disease early warning system to detect and respond to epidemics, monitor specialized care needs (e.g. for traumatic war injuries), and follow up patients referred for hospitalization to ensure they are reintegrated into the repatriation process on their discharge.
WHO and the MoH are monitoring the use of health care services in the border transit camps (data disaggregated by age and sex) and issuing regular health bulletins. Health services in Choucha, the main camp, comprise seven health care points including a field hospital with an operating theatre, scanner room and laboratory.
The camp demographics are changing, with a steady increase in the numbers of families (many from sub-Saharan Africa) with young children. Health care services have been expanded to include pre- and postnatal consultations, and all children crossing the border are being vaccinated.
WHO and partners have established working groups on water and sanitation, mental health, and maternal and child health. The MoPH and WHO are holding daily coordination meetings with all health partners. With support from WHO, the MoH is now coordinating all aspects of the health response, including epidemiological surveillance, essential medicines, data collection, transfer register, camp population profiling, coordination and contingency planning.
Egypt
In Egypt, WHO logisticians and pharmacists stationed at the border are working with the Egyptian authorities to facilitate the dispatch of medicines and medical supplies to Benghazi for distribution to hospitals in the east of Libya.
Supplies donated by WHO include 4000 doses of tetanus toxoid to prevent potential infections arising from the delayed treatment of injuries, as well as ten trauma kits A and B and five surgical supply kits. WHO public health teams are supporting the public health screening of people crossing the border; WHO has developed a rapid screening checklist to be translated and distributed in at least four languages.
Twenty mobile clinics and four ambulances are stationed at the Salloum border crossing. WHO and the MoH are conducting public health surveillance and issuing regular health bulletins. All children under five who have crossed the border have been vaccinated against all major childhood diseases.
Niger
In Niger, the influx of migrants from Libya to continues. Planning figures are of 2000 migrants per week for the next three months, for a total of 24 000 people. The most important health needs include basic medicines and medical supplies, qualified staff, including nurses, physicians and psychologists, condoms, meningitis vaccines A & C and treatment for chronic diseases.
Funding
In the revised Flash Appeal launched on 1 April, requirements for the health sector were raised from US$ 11.1 million to US$ 12.6 million. As of 4 April, the health sector was funded at 38%. WHO has received 81% of the US$ 4.2 million it requested.
For more information
- Public health risk assessment and interventions - The Libyan Arab Jamahiriya : Civil unrest
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Health partners prepare for possible influx at Libya-Egypt border
pdf, 56kb - Vaccination begins at Tunisia-Libya border camp
- WHO medical supplies arrive in Libya
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Libya crisis: Meeting humanitarian health needs
pdf, 86kb - Regional Office for Eastern Mediterranean web site