Libya’s health system struggles after exodus of foreign medical staff

BMJ 2011; 342 doi: (Published 22 March 2011) Cite this as: BMJ 2011;342:d1879
  1. John Zarocostas
  1. 1Geneva

The World Health Organization and other relief agencies have stepped up the delivery of drugs, surgical supplies, and personnel to treat large numbers of casualties and people affected by the escalation of hostilities in Libya.

Fadela Chaib, a WHO spokeswoman, told reporters on 22 March, “The conflict has led to acute shortages of essential medicines, including anaesthesia drugs. This poses particular problems given the current high rate of patients admitted to hospitals with acute trauma injuries that require urgent surgical intervention.”

The agency said there is also a “huge shortage” of drugs to treat chronic diseases, such as diabetes and cardiovascular diseases, and mental health disorders.

Sliman Bouchuiguir, secretary general of the Libyan League for Human Rights, told the BMJ that there had been between 5000 and 6000 casualties since 17 February, when Muammar Gaddafi’s regime began its crackdown against opposition groups. Most casualties were civilians, he said.

On 17 March the United Nations Security Council adopted resolution 1973 authorising member states “to take all necessary measures . . . to protect civilians and civilian populated areas under the threat of attack in Libya.”

The UN’s chief, Ban Ki-moon, said on 19 March that “many of the acts we are witnessing appear to constitute crimes against humanity,” and he called on Libyan authorities to disband their armed forces and heavy weapons around major cities.

Mr Ban also called for humanitarian agencies to be given prompt access to the country.

On 19 March a coalition including the United Kingdom, France, and the United States launched air strikes on Libyan government forces.

The International Committee of the Red Cross has called on all parties—the international forces, the Libyan government forces, and the armed opposition—to abide by international humanitarian laws and emphasised that those involved in hostilities “must distinguish at all times between civilians and fighters.”

It added, “Attacks that directly target the civilian population are strictly prohibited.”

WHO says that reliable information on the numbers of deaths and casualties has yet to be shared with the relevant health authorities.

UN officials say that blocked access into Libya continues to impede the delivery of supplies to the country’s second biggest city, Benghazi, and to most other parts of the country.

Parts of Libya’s healthcare delivery system, particularly the supply of drugs, have been affected, Ms Chaib said. The country also has an “acute shortage of physicians and nursing staff in intensive care units,” she said. “Many of these facilities were staffed by expatriate medical staff that have since left the country.”

WHO’s regional office for the eastern Mediterranean estimates that 400 specialised nurses are urgently needed inside Libya.

WHO said it is also increasing its relief efforts at the Tunisian and Egyptian borders and in accessible areas inside Libya, including two military field hospitals, 20 mobile clinics from the Egyptian health ministry, and 26 ambulances on standby at the border crossing.


Cite this as: BMJ 2011;342:d1879

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