Havnen og lufthavnen i den libyske storby Banghazi er lukket, så hospitalerne kan ikke få forsyninger ind. Samtidig har flere hjælpeorganisationer trukket folk ud af byen på grund af kampene mellem regering og væbnede grupper.
DUBAI, 5 November 2014 (IRIN): Medical conditions are under severe strain in the east Libyan city of Benghazi, where government forces are grappling to regain territory from Islamist rebels, and residential streets have become battle zones patrolled by self-appointed local committees.
Hospitals are struggling to secure drug supplies to treat chronic conditions, while a shortage of skilled staff is limiting capacity to respond to the growing caseload of trauma injuries.
This week the 7th Of October Hospital and a maternity unit in the Sabri District of the city, close to the port, were evacuated ahead of a planned government offensive to reclaim territory from militant groups who had seized key infrastructure there in July.
The Libyan Red Crescent, whose volunteers led the evacuation in the early hours of 3 November, told IRIN that close to 100 healthcare workers and patients – including some from an intensive care ward – were taken to safety by ambulance with the Libyan Army clearing a safe corridor for their passage.
Meanwhile, elsewhere in the city fighting raged with witnesses telling of tanks on the streets and warplanes overhead.
According to local media reports, more than 230 people have been killed and many more injured since government forces launched a counter-attack on rebel positions last month, and the city’s hospitals are coming under increasing strain.
The August bombing and looting of Benghazi’s main pharmaceutical warehouses has affected the medical supply chain and there are urgent calls for more drugs to be sent into the city.
“We don’t have any new supplies coming in because the port and airport are closed,” said a surgeon at Benghazi Medical Centre (BMC) who did not want to give his name for security reasons.
“We had a medical store but it was destroyed by a bomb and we lost a lot of medicine and medical materials,” he added, explaining that services had also been affected by a lack of qualified staff, with many workers either fleeing the city altogether or choosing not to risk the crossfire to get to the hospital.
“There is shooting in the streets and fighting, and reaching the hospital is very difficult,” the surgeon said. “One or two kilometres can take you one or two hours.”
Armed vigilantes
Benghazi resident Siham El Amami described to IRIN how armed volunteer groups known locally as sahawa (a common Arabic term for local tribal groups, literally meaning “the awakening”) had set up roadblocks around the city and were telling people not to leave their homes.
“They block the main street [with] sand and [with] some garbage,” she explained. “They are not officials, they’re just volunteers, with very old cars.”
“They are trying to protect us because they say it’s not safe outside our own area,” she said, adding that her husband had been blocked from going to work because he was told it was not safe to leave the neighbourhood.
Another Benghazi resident, who did not want to reveal his identity, spoke of being kept awake at night by the sound of bombs and rockets.
“Where I live is safe, for now,” he said. “But we hear the bombs and planes every night and we see the damage caused by the rockets that fall. Earlier in the year a device fell 100 metres from my house and destroyed buildings in the street.”
He complained about the local committees and said he would prefer it if the roadblocks were official and run by the army. “We don’t know who these people are,” he said. “It is not good to have civilians taking up weapons. This will only prolong the violence.”
International NGOs scale back
Due to the lack of security in Benghazi – and across the country in general – international aid organizations and UN agencies began removing their expatriate staff from Libya in June this year, many setting up remote operations in Tunisia.
The International Committee for the Red Cross (ICRC) pulled out its international workers in July following the assassination of 42-year-old Swiss national Michael Greub in Sirte, although national staff remain and are working closely with the Libyan Red Crescent.
This scaling back of humanitarian organizations from Libya has left behind a skeleton network of inexperienced local NGOs, hampering efforts to deliver aid to the growing caseload of displaced families. Many development programmes have also been suspended.
Francois de la Roche, the outgoing Libya country director for the International Medical Corps (IMC), whose international staff are operating remotely from neighbouring Tunisia, said health services were overwhelmed.
“A lot of people have been displaced and there is a lot of infrastructural damage,” he told IRIN. “The damage to the health system infrastructure. adds to the overload on the remaining facilities.”
In a bid to plug the gaps, IMC is aiming to deliver an emergency consignment of medical supplies – including surgical gloves, masks, intravenous kits and other medicines – to Benghazi.
The World Health Organization (WHO), meanwhile, is supporting the Libyan Ministry of Health by procuring various drugs and other items, and is due to deliver 50 medical emergency kits this week that will enable some 5,000 surgical inventions.
Over 380,000 displaced
In October the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported that across Libya 331,000 people were at risk and in need of humanitarian assistance.
More than 287,000 people are internally displaced within and around Tripoli and Benghazi and at least 100,000 are known to have crossed into neighbouring countries in recent months.
However, as the number of vulnerable people continues to rise, getting help to them remains a major challenge due to difficulties relating to access and a shortage of aid workers on the ground to map their locations and needs.
Muftah Etwilb, the North Africa regional representative of the International Federation of the Red Cross and Red Crescent, said: “Things are evolving very quickly and it is hard to know exactly where people are or know their needs because access restriction makes it hard to do assessments.”
The fighting in Benghazi is part of a wider conflict in the North African country, which last month marked three years since the overthrow of former long-time dictator Muammar Gaddafi.
Some of the rebel factions who assisted in Gaddafi’s ouster are now fighting for control of the country. Meanwhile, the government has split into two, with internationally-recognized Prime Minister Abdullah al-Thinni forced to move 1,287km away to the far-eastern town of Tobruk, while powers in Tripoli have reinstated the country’s previous parliament and set up a rival government.
