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How do you provide life-saving medical care in a conflict-ridden country?
Rent a van. An unobtrusive van with room enough for a doctor, a gynecologist, a pharmacist and a nurse, stock it with much needed pharmaceuticals, fill up the tank, and send it on its way.
This is how the International Rescue Committee (IRC) is responding to the dire need for health care in primary health clinics across Western Libya.
At least 1.1 million people are in need of health care in Libya. Primary health clinics are operating at less than half of their capacity. This means that if you are sick in Libya, you have less than half a chance of getting the medical services you require. Basic medicine is in short supply.
If you need a drug like insulin to treat diabetes or an antibiotic to tackle pneumonia you have a slim chance of being able to acquire it. If you are a woman, your chance of access to specific care is even less. According to WHO’s Service Availability and Readiness Assessment (SARA), only 2 percent of primary health clinics can provide family planning services.
Such is the reality of life for Libyan people. Three governments compete for control and well over a thousand militias fight for territory.
General lawlessness surrounds you. Intercommunity tension is high. Kidnappings and highway robbery are the norm. Which prompts many to question whether it is worth the risk to seek medical attention at all. Do you travel miles navigating rival militia check points to see a doctor? Or do you stay home and hope that what ails you will heal on its own.
In communities surrounding Misrata and Sirte in Western Libya, people don’t have to ask that question. The locals now know that on a particular day in a particular community, the IRC’s medical team will be there. They will pull up outside the local medical clinic in that unassuming, humble van, take up position in the treatment room, and deliver free health care.
And the people line up to wait. They are a mixture of locals and Libyans who have been displaced by the conflict. They will wait patiently to see the doctor or the gynecologist. Usually, when the van arrives, there is already a line outside the door.
The needs are immense.
Without treatment, a common cold can turn into pneumonia. A simple ear infection can become so bad a patient risks becoming deaf. Chronic illnesses like diabetes or high blood pressure can become life threatening. And a simple pregnancy can become complicated, purely for lack of care.
Add to this the fact that ongoing conflict wreaks havoc on a country’s economy. The patients who receive the IRC’s services have either very little money or none. Some have not been paid in months. There is no money in the bank. They have no access to cash. Generic drugs now cost three times their value. Medication is an extravagance they can no longer afford.
“All the patients who come to us, they are in need,” says IRC’s gynecologist, Dr. Hamida, “and they are happy for the services we are providing for them.”
For Dr. Hamida it is often about the lives to come – mothers bearing children whose lives will begin in a country torn apart by conflict. About fifty percent of the patients she sees are pregnant. They must receive the care and treatment they need to ensure a healthy baby. Because of the conflict and the high cost of daily items, fresh fruit and vegetables have become a luxury. These mums-to-be must make do with vitamins and supplements. Which will come from the back of this van.
Hamida says her patients talk about their baby’s future. “Sometimes,” she says, “They say, I hope they have a life better than our life.”
Given the circumstances in which they live, it is no surprise that most patients treated by the IRC suffer from post-traumatic stress disorder.
“People are stressed and angry because of the war,” Dr. Hamida says. “A lot of mothers, they mention their sons, and fathers, they mention their sons, who have died in the war.”
While the world’s attention is focused elsewhere, Libya continues to be a place in constant struggle. Not only do the people of Libya have to contend with the lack of a clear and central government, an economy in ruins, and a healthcare system in tatters.
They also have to find a way to support the thousands of migrants, most of whom have come to Libya in search of work, but who now find themselves caught up in the violence that permeates all aspects of life. So much more has to be done by all sides to find a resolution to the political impasse, and to support the humanitarian needs of those caught in the middle.
In the meantime though, every weekday, Sunday through Thursday, IRC teams load up that van, get the latest security briefings from their colleagues, determine their route and head out into the community. They will travel the highways of Western Libya and pull up at primary health care clinics in small communities to deliver life-saving care.
They are expected there now.
Lucy Carrigan is International Rescue Committee’s regional communications manager for Europe and North Africa.