LIBYA: Doctors Without Borders faces challenges in Libya
Among those responding to the conflict in Libya has been Doctors Without Borders, the international medical volunteer group. The Times spoke Friday with Michael Bates, the group's head of mission for Libya and Tunisia, from his base in Zarzis, Tunisia, about 270 miles from the Libyan border.
A: Over the last few days, the number of patients coming through has slowed down.
The majority of the wounds we have been seeing are gunshots. We’re not seeing any shrapnel wounds anymore.
Q: Have you heard anything about reported revenge killings?
A: We can’t see it in patients or from interviewing patients.
We were concerned about the number of civilian casualties a few days ago. We heard a large number had been hit by snipers, which is unacceptable for either side to partake in. It’s completely against all rules for civilians in a combat zone. More care has to be given to civilians, including medical personnel in the combat zone to give them free passage to enter the hospitals.
Q: Is it difficult to define who is a civilian in this conflict between rebels and Kadafi loyalists?
A: When you're receiving children and women, it’s pretty clear they are civilians.
Q: What else are you concerned about now?
A: There are still some insecure areas. We do have concerns that patients may have trouble in some areas reaching health facilities.
Also, getting drugs has been an issue. Doctors Without Borders and some groups have been able to resupply some stocks, including blood pressure drugs, diabetes medications.
Q: What have you seen the rebel government, the Transitional National Council, do so far?
A: They have done remarkably well to get supplies in. Our stance is neutral, so we’ve always tried to keep up a dialog with both groups.
Q: Have you heard anything yet about a new health ministry?
A: There is no new health ministry established yet that we have dealt with.
Q: How are people being brought to the hospitals? Can ambulances operate?
A: There are ambulances bringing people in in all the cities
When necessary, they are transporting to other cities to decrease the burden, to free up beds for the next influx of patients.
Q: Are there places your staff are still unable to reach or to work because of safety concerns?
A: Some hospitals in Tripoli are still in tense locations. We don't want to risk too much danger to our staff, and we don't want to bring our patients into an insecure environment
At the same time, we’ve really had to move and get to places near the front lines to treat patients without them having to travel long distances
Everyone’s been doing a remarkable job with what they have.
Q: There have been a lot of reports about a hospital in the Abu Salim area of Tripoli where bodies were found after staff were forced to evacuate; have you heard anything about that?
A: People were able to get into the place to evacuate quite a number of patients who were needing much better care because the environment they were in, staff were not able to give them care. We helped and so did the ICRC (International Committee of the Red Cross).
Q: What do hospitals need most now?
A: There are shortages in human resources, nurses, but as areas become safer, there are more and more people coming back to fill in the gaps.
Libya has been very reliant and had great support from foreign nurses from the Philippines and Ukraine. We have to give credit to many of the foreign workers who have remained during the conflict.
Many people haven’t been paid for the duration of this conflict.
Q: How do they get by?
A: They get food from the hospital. They’ve managed to survive. They hope they will get paid later on. Many, they feel that they can’t abandon the Libyan population.
There are also the diaspora, Libyan people who had left coming back.
Q: Are there any items hospitals need?
A: There’s always a need for life-saving medications, surgical kits. There will still be an influx of emergency cases and we have to be equipped to deal with that, as well as infections.
Q: How many patients have your teams been seeing?
A: In Zawiya we saw 70 patients three days ago, then 40 two days ago, then 30 yesterday.
We were hearing a lot more casualties were being treated at hospitals in Tripoli, so today we moved the team from Zawiya to Tripoli. They are still assessing where to work.
Q: Have any of your volunteers been injured?
A: No one on our teams has been injured.
Q: What is the situation like outside of the capital?
A: There are still some insecure places along coast of Libya west of Tripoli.
Boats have been transporting injured people from Zuwarah (a Libyan coastal city) to Zarzis. The roads were too insecure. The Libyans arranged for the boats.
The people were received by Tunisian ambulances at the port and taken to the nearest hospital.
There have been six boats since Tuesday, the latest this morning. They are just small fishing boats.
Q: How many people can the boats carry?
A: Yesterday one had seven, another 10 people. It's a journey of 10 to 12 hours.
They don’t have a proper, functioning hospital in Zuwarah.
One of the patients who came yesterday had a head wound, a bullet wound. These are very serious cases.
Q: Are other injured people still waiting to come to Zarzis?
A: We're still trying to get information about whether more people need to come. The situation can change very quickly. Maybe the roads will be more open and access will be more easy to manage.
Q: Do you plan to stay in Tunisia?
A: We plan to shift coordination to Libya soon. As the conflict has progressed, certainly more access has opened up, though I'm not sure how soon that could happen.
There is still an ongoing war and it’s too soon to say when there will be any resolution to the conflict.
Photo: (top) A team from the International Committee of the Red Cross evacuates patients from a hospital in the restive Abu Salim neighborhood of Tripoli on Friday. About 80 bodies were also found at the hospital, apparently victims of fighting that prevented the wounded from being treated, according to Reuters and Agence France-Presse reports. Credit: Patrick Baz/AFP/Getty Images.
Photo: (bottom) Michael Bates, who is coordinating Doctors Without Borders volunteer medical teams in Libya and Tunisia, spoke with The Times Friday about their work in several Libyan cities. Credit: Doctors Without Borders.