Health Sector Working Group, Libya Situation Report No.4 April 09, 2019 - The Libyan Report

Health Sector Working Group, Libya Situation Report No.4 April 09, 2019

Situation Overview

On Wednesday, April 9, armed clashes between Government of National Accord (GNA) and Libyan National Army (LNA) affiliated forces continued in Wadi Al Rabie, Ain Zara, Qasr Ben Ghashir and Souq Al Jumua. The parties to the conflict used heavy ground shelling and airstrikes that targeted the abandoned Tripoli International Airport and Souq Al Khamis. Mitiga airport resumed its operations with flights allowed to land only between 1900hrs and 0700hrs. Civilians are caught up in the heavy shelling, airstrikes and sniper attacks that have targeted residential areas as both sides are building up their reinforcements to push for their gains. Access of humanitarian workers is being hampered and field emergency teams are running out of supplies. Hospitals inside and outside of Tripoli are receiving daily casualties. Total number of casualties of the four-day clashes is 322: 56 dead and 266 wounded. Total civilian casualties is 11: 6 wounded and 5 dead. Among the civilian casualties are two doctors and one female. An ambulance driver was also on Wednesday during his rescue operation after his ambulance was hit by a shelling.

There was a terrorist attack that targeted Al Fuquha town in Al Jufra that led to 10 casualties: 4 dead and 6 wounded, there were no civilian deaths in this attack.

The Displacement Movement Tracking (DTM) estimated that 895 families have been displaced but the exact number remains unclear. Internally Displaced Persons (IDP) are heading to Tarhouna, Garbolli, Baniwalid and Gharyan. There are residents who are still trapped in the conflict-affected areas. Despite the previous calls for humanitarian pauses, parties to the conflict did not stop the use the use of heavy shelling and airstrikes against each other.

There is a continuous shortage of gas and petrol in most districts in the west and western coast; in some areas the price of benzene in the black market has doubled.

Health Sector Response

On April 6, the Health Sector Working Group (HSWG) activated the Rapid Response Framework (RRF) to respond to the current crises. Consequently, the following activities have been conducted;

Tripoli Wounded Affairs Directorate (TWAD) deployed seven medical teams to act as first responders and provide field ambulance services. World Health Organization (WHO) supported TWAD with medical supplies. Discussion on increasing TWAD capacity is underway to expand the geographical coverage of the team as frontlines are expanding. The field teams have been providing field ambulance services as first responders despite the death of one of the doctors who was killed during the operation on Sunday. The field teams operate in Tripoli round the clock in close coordination with WHO and national health authorities. Tripoli Health Service Department (THSD) has activated field hospitals that have been deployed to conflict-affected areas to act as second line responders. WHO and THSD are considering the preposition of contingency stocks in six sites inside Tripoli: Tripoli center, Souk Al Jumua, Tajoura, Abusaleim, Hay Al Andalus and Ain Zara. WHO deployed an Emergency Medical Team (EMT) to Tarhouna hospital to upgrade the capacity of the hospital to cope with the current crises since the hospital is receiving casualties. WHO activated its two satellite logistics hubs in Sabha and Al Baida and its main hub in Tripoli were activated with the availability of emergency medical supplies and trauma kits that can treat 210,000 individuals and 900 injuries for three months. UNICEF delivered emergency medical kits to Zentan hospital that can treat up to 10,000 individuals. UNICEF and WHO have jointly pre-positioned emergency kits in WHO strategic warehouse in the Janzour district to avoid any access obstruction. IOM mobilized three medical teams in Tripoli to support the health emergency response. UNFPA mobilized 12 emergency reproductive health kits (kit 11B) that can support 862 Cesarean sections, 20 kits (kit 6B) that can support 900 normal deliveries and 14kits (kit 6A).

These kits are available for distribution subsequent to assessing the needs of Tajoura, Al Jalaa and Al Khadhra hospitals that are expected to see an increased caseload due to displacement.

International Medical Corps (IMC) mobilized medical teams with ambulances to be deployed according to the gaps identified by HSWG. International Rescue Committee (IRC) mobilized two mobile medical teams with ambulance services to be deployed according to the gaps identified by HSWG.

As the number of displaced families is increasing, HSWG are considering the deployment of Mobile Medical Teams (MMT) to respond to the emerging needs. IMC and IRC have committed to deploy MMTs as soon as the mapping of the collective centers has been finalized.

WHO is considering enhancing the capacity of TWAD with the deployment of additional five EMTs to support the first line responders.

Challenges

The capacity of field ambulance and field hospital teams is being hampered by the persistent conflict with the heavy casualties. WHO and partners are operating with minimum financial capacity to support the response as Humanitarian Response Plan (HRP) is 6% funded as of today. The volatility of the complex situation with the constant shelling is a serious threat to the lives of civilians of humanitarian workers. Access of humanitarian workers is being hampered by the continuous shelling and armed clashes.

There is no positive sign of ceasing clashes; parties to the conflict are far from reaching an agreement. The persistence of the conflict with the concentration of armed clashes around residential areas is obstructing smooth humanitarian response.

The current clashes are burdening the overloaded and weakened health system with consistent supply chain breaks.

For further information please contact:

Dr. Hussein Yunis Hassan

Health Sector Coordinator & Health Emergencies Team Lead

hassenh@who.int