The renewed political impasse in Libya threatens to spread epidemics

The World Health Organization expects that the number of sites “reporting daily notifications and weekly diseases” in Libya will reach 100 by the end of this year, after it was only 23 in early 2016. These sites are monitoring and monitoring points for any emerging or warning cases of diseases. With the possibility of an epidemic. These points report information to the center, which acts accordingly. This may happen daily or weekly, under what is known as the early warning and reporting system.

It is noteworthy that the Prime Minister of the interim government in Libya, Abdullah Al-Thani, recently relieved the Minister of Health, Reda Al-Okali, from his position, and decided to change the members of the Board of Directors of the Medical Supply Authority, move its headquarters to Benghazi, and ban the supply of medicines from land ports and designate air and sea ports, and he is counting on the election of a new president. For the Central Bank of Libya to overcome the problem of providing the necessary credits to confront the deteriorating health conditions in the country. Al-Awkali had stated before his dismissal that more than 80 percent of Libya’s hospitals were closed or unable to provide services to the public. Al-Awkali also said that more than 90 percent of doctors and nurses left the country due to the deteriorating conditions, stressing that the lack of financial liquidity caused a failure to provide necessary treatments such as heart medications and vaccinations. The former Libyan minister held the international community responsible for the deteriorating health and humanitarian situation in Libya, criticizing the linking of arming the Libyan army and providing humanitarian and relief aid to the Libyans to the agreement to form the Government of National Accord.

According to the World Health Organization, the deterioration in the health sector in Libya is largely linked to the political conflict and instability that the country has witnessed since the beginning of 2011. The organization confirmed in a press statement, a copy of which was obtained by Al-Hayat; A significant number of health workers in various parts of Libya, the majority of whom are foreigners, fled the scourge of violence, while health care facilities were damaged or destroyed, and in many areas the entry of medicines and medical supplies was not possible at times. She stated that as a result, many dangers have emerged, such as the possibility of the return of polio and other epidemics, and the cessation of providing long-term and preventive care necessary to confront major non-communicable diseases to large numbers of those suffering from them in conflict areas. The organization believed that the “Arab Spring” and the conflicts that resulted from it “burdened the health system with the burden of providing urgent medical services in several countries,” with Libya coming first.

However, WHO and health cluster partners continue to work with the Libyan Ministry of Health, to provide the required support, strengthen health services and purchase medical supplies with international funding. The organization enumerated models of the response provided by donor countries and the United Nations health group in cooperation with the Libyan health authorities and the activities that are being implemented within the various regions of Libya despite the hot conditions, most notably vaccination services, with follow-up through “remote monitoring” from the control room in Tunisia. In this regard, it is noteworthy that Libya was one of the first countries to declare the elimination of polio since 1991, and with the outbreak of conflict, the challenge was to maintain the level of coverage of vaccinations to eliminate measles, rubella, and mumps. The World Health Organization office in Libya contributed to providing supplies for 20,000 dialysis operations last October, which were purchased from Belgium through the Ministry of Health in the interim government. The World Health Organization had to pay approximately 300,000 euros to cover the cost of shipping these supplies, knowing that they would cover the needs of dialysis centers and patients, in various parts of Libya, for only three months.

Maternal and child health

Maternal, infant and child health care services have been significantly affected since the start of the conflict. Entire regions suffer from a lack of medical personnel and necessary supplies. There are areas where health facilities do not exceed one hospital, which may operate partially. Among these areas is the Ghat region in southwestern Libya, whose residents were forced to seek help after medical services provided to pregnant women, mothers and infants from the only hospital in the region stopped due to the lack of doctors. The families organized a campaign on social media asking for help from officials to save mothers following the death of a pregnant woman who could not find a male or female doctor to supervise her birth. Residents raised the slogan: “Save the mothers in Ghat.” The World Health Organization responded to the distress call by providing medical personnel to the hospital for a period of six months to provide the required care for pregnant women, mothers, infants and children. The organization itself is holding a series of training courses to raise the efficiency of health workers in many fields, with support from the European Union. Trainees are involved in aspects of the medical supply chain and are committed to improving access to medical supplies. According to a statement from the World Health Organization headquarters in Cairo, there is a training course to increase epidemiological surveillance capacity and strengthen the early warning system for diseases and early response, and participants receive training on methods of managing potential disease outbreaks within the framework of priority communicable diseases. Participants will receive tablet computers and will be trained to use the software supported by them and will be trained to immediately report infectious diseases as soon as they occur and to report on a weekly basis.

The Epidemiological Surveillance, Early Alert and Rapid Response Network will receive electronic reports from 13 detention centres, on an immediate and weekly basis, which is unprecedented in Libya. The scope will also be expanded to include other detention centers recognized by the government. Within the framework of the “Strengthening the Health Information System and Medical Supply Chain Management” project, funded by the European Union, the newly established Libyan Health Waste Management Committee received extensive training in many aspects of medical waste management.

Measles elimination programme

After the collapse of the measles elimination program due to the conflict, the measles surveillance program was also severely affected, resulting in a decline in the rate of case reporting and prompt notification in the event of an epidemic. Libya faced difficult situations, and there was an urgent need for urgent and cooperative efforts to restore the program and move the country forward towards eliminating the disease. Therefore, WHO Libya supported efforts to restore the measles elimination program and integrate it with the acute flaccid paralysis surveillance programme. This is done by: developing a roadmap for recovery of the measles elimination program in Libya by the end of 2017. This includes building the capacity of Libyan surveillance staff in surveillance programmes, acute flaccid paralysis and measles, and discussing the best possible ways in which surveillance of the two diseases can be integrated. Indeed, the rate of reporting and sampling has improved significantly. WHO will continue to support the Libyan government, the Ministry of Health, the National Center for Disease Control and the Libyan people to provide optimal health care services. The European Union-funded WHO project Strengthening the Health Information System and Medical Supply Chain Management (SHAMS) is currently conducting an analysis of the situation in the pharmaceutical sector in Libya.

Conditions of displaced persons and migrants

The World Health Organization noted that the conflict in Libya resulted in the phenomenon of internal displacement of groups of residents who were forced to leave their homes, neighborhoods or cities to less dangerous areas. This situation has resulted in difficulties related to access to health services and care for displaced people, difficulties for host communities and a burden on health care providers in areas of displacement. The World Health Organization and its partners are seeking to support the Ministry of Health to cover these and other areas that lack health services by providing mobile medical clinics and supplying hospitals and health clinics with the necessary medical supplies. In addition to displacement, Libyan society is facing the phenomenon of migrants, especially from African countries. These migrants are concentrated in areas where health and other services are not available, in addition to not being officially included in records, which deprives many of them of the opportunity to obtain health services, especially vaccinations, and thus exposes them to outbreaks of diseases. While the concerned parties in the health group continue to work to remedy the deteriorating conditions and provide care for the groups most affected and those least benefiting from services, this group faces a challenge of another kind, which is the attacks on health facilities and health workers in some areas, the most recent of which was Sabha, southern Libya, where it received… The World Health Organization reports from the Sabha Medical Center about the recent kidnapping of one of its doctors. These attacks have a negative impact on the delivery of health care, and in addition to being unethical and in violation of international humanitarian law, they impede the provision of health services to those who deserve them.

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