Libya Response External SitRep 79 September 23, 2011 Helicopter medical evacuation from the field hospital outside of Sirte to Misurata International Medical Corps Key Activities Sirte An International Medical Corps surgical team is providing support to a field hospital set up outside of Sirte. The team is working with Libyan Volunteer Doctors to provide lifesaving care to the high numbers of casualties, with more than 200 casualties received at the facility over the past week. Equipment and supplies are being provided to 9 ICU ambulances transporting casualties from the frontlines operated by the Misurata Emergency Ambulance Center. For serious cases, International Medical Corps is assisting to coordinate helicopter ambulance medevacs to Misurata. Bani Walid and Misurata: A medical team is preparing to deploy to the Bani Walid field hospital as needed and supplies and equipment are being provided to Misurata ambulances servicing the Bani Walid frontlines. In Misurata, International Medical Corps is continuing to provide nursing support to the Al Hilal hospital. Tripoli: Medical teams continue to provide support at the Al Khadra hospital, Tripoli Medical Center and the Tripoli Central hospital. Initial assessment findings of the Mental Health and Psychosocial support (MHPSS) assessment in Tripoli indicate that there are significant staff shortages in this field, with Psychological First Aid Trainings already planned to immediately equip healthcare staff with tools to address increased MHPSS needs. Western Libya: Continuing support is being provided to health facilities in Nalut, Kabaw, Jadu and Zintan in the Western Mountains, with 1863 patients provided with care September 12-18. An assessment of current needs has been undertaken, identifying areas of health care Libya/Tunisia border: International Medical Corps is operating two health posts which provided medical care to 585 refugees in the Shousha and Al Hayat refugee camps September 12-18. Medical equipment and medication supplies have been provided to the Ben Guerdane hospital, serving as the referral facility to the camp clinics. Eastern Libya: Over 250 people have been trained in Psychological First Aid (PFA) in Benghazi to date. Mobile health teams are providing primary health care in the Al Marj and Ajdabiya regions, with 305 consultations provided September 11-17 and nursing support is continuing to be provided in Benghazi and Ajdabiya. Physical rehabilitation services for war-wounded patients continue, with 55 new patients provided with 132 physical therapy sessions over the past week.
Introduction: While battles continue for the last remaining Gaddafi held areas in Libya, trapped civilians are facing difficult conditions, including associated risks from near-by fighting and shortages of food, water and medical care. Fighting outside of Sirte is now reported to be suspended for one week. This follows intensifying fighting outside of the city as rebels pushed closer towards Sirte, with significant casualties resulting. More than 200 injured casualties have been received at the field hospital outside of Sirte and reports indicate that at least 45 fighters have been killed. Over the last couple of days, a large number of IDPs have been evacuating, mostly from the eastern side of the city, with over 200 families who departed on September 21 and on September 22, there was a mass evacuation of civilians from Sirte. Information indicates that the IDP's are currently being located in a camp, in the Strada area (west of Al Hayshah) and that families vacating the city are being registered in Tawarga and then driving onwards to Tripoli. Heavy resistance from Gaddafi forces has also been faced by rebel forces in Bani Walid, with the NTC stating rebels had not yet taken Bani Walid due to concerns for civilians and difficult terrain. In the Jufra oasis area south of Sirte, Waddan, Hun and Sokna have been taken by rebel forces and with heavy casualties as a result of these efforts. However, further south, Gaddafi forces remain in control of the town of Al Fuqaha. In the town of Al Shaqiqah, south of Gharyan, a deadline of September 20 was set for Gaddafi forces to surrender their arms. As this deadline has now passed, imminent fighting is anticipated and wounded casualties are expected to be received at the Mizdah, Al Asabi ah and Zintan hospitals. International Medical Corps is supporting the Zintan facility to ensure that sufficient staff and supplies are available to provide needed care, and remain prepared to mobilize should support be required at other facilities in the region. Further south, rebels took control of most of the Gaddafi stronghold city of Sebha on Wednesday, with little resistance reportedly faced by the rebels. It is also reported that Awbari, a Tuareg town deep in Libya s south, has been taken by rebel forces. At the Tunisia border, IOM estimates that as of September 21, 206,675 third-county nationals (TCN) have crossed from Libya since February 20. In other developments, NATO has approved extending its air campaign in Libya for another 90 days and the African Union has now officially recognized the new Libyan government.
As of September 23, 2011: SIRTE An International Medical Corps surgical team is providing support to a field hospital set up outside of Sirte which is receiving casualties from the fighting for Sirte and the Jufra area. The hospital has been moved from the Al Hayshah location, to a new location 50 kilometers outside of Sirte in order to be positioned closer to the frontlines. The team, composed of a surgeon, a GP, an x-ray technician and two nurses, is working with Libyan Volunteer Doctors to provide lifesaving care to the high numbers of casualties. More than 200 casualties have been received at the facility over the past week, with most being male conflict casualties in their 20 s-30 s. However, patients from road traffic accidents, three cases of scorpion stings and two women who delivered babies have also been received at the field hospital. In addition to the medical team, International Medical Corps is providing emergency medicines and medical supplies, technical assistance and logistical support. To facilitate medevacs from the frontlines to the field hospital, equipment and supplies are being provided to nine ICU ambulances operated by the Misurata Emergency Ambulance Center. For the most serious cases, International Medical Corps has been assisting to coordinate helicopter ambulances to evacuate these cases directly from the field hospital to Misrata. The helicopter medevacs are also freeing up the ambulances to be able to service the frontlines, instead of making the long drive to Misurata. An International Medical Corps team is travelling to the IDP site in Tawarga, where many families from Sirte are travelling to, to assess the situation and current needs. BANI WALID & MISURATA In addition to supply support, International Medical Corps has a medical team stationed in Misurata which is prepared to deploy to the field hospital outside of Bani Walid as needed. The ICU ambulances, supported with supplies and equipment, are also providing medevacs from the Bani Walid area. In Misurata, International Medical Corps is continuing to provide nursing support to at Al Hilal hospital. TRIPOLI In the Libyan capital, International Medical Corps is continuing to provide support for healthcare during this period of transition. Nursing support is being provided to the Al Khadra hospital and volunteer physicians are providing assistance at the Tripoli Medical Center and the Tripoli Central hospital to address staffing gaps. Mental Health and Psychosocial Support (MHPSS) and Gender Based Violence (GBV) assessments are continuing in Tripoli. Through the MHPSS assessment, significant shortages of psychiatric nurses and psychologists have already been identified and International Medical Corps is planning to conduct psychological first aid trainings to enable first responders/health care providers to cope with increased mental health/psychosocial support needs. To further address these needs, International Medical Corps is also planning to recruit volunteers who will undergo similar trainings to bridge existing staffing gaps, particularly at the Tripoli Psychiatric Hospital. These plans are being coordinated with the newly formed Mental Health Working Group of the Health Cluster. WESTERN LIBYA In the Western Mountains, International Medical Corps is continuing to provide support to four health facilities Nalut hospital, Jadu hospital, Zintan hospital and Kabaw primary health clinic providing care for 1863 patients in the week September 12-18. Consultations related to emergency care for injuries continue to decrease at only 2.8% of the total consultations, compared to 15% the week prior.
In the Zintan and Jadu hospitals, International Medical Corps staff are providing surgical services which have now shifted from emergency surgical care to elective surgical operations. Staff at the Zintan hospital also remain prepared to receive any casualties from fighting in the area south of Gharyan. At the Nalut Hospital, International Medical Corps staff have been tasked with triage for incoming patients as additional medical staff have been now been provided to the hospital by another organization. The International Medical Corps-operated ambulance has been transferring patients mostly suffering from non conflict related life-threatening conditions to Tripoli and Tunisia as needs demand. As the care related to conflict casualties has significantly decreased, International Medical Corps has undertaken an assessment of current needs of health facilities in the Western Mountains. Through this assessment, longer standing health concerns have surfaced including: Insufficient number of nursing staff and need to strengthen skills of current nursing staff. Unequal distribution of medical staff among health facilities. Need to create referral systems from primary healthcare to higher level facility care in order to facilitate the decongestion of hospitals and encourage the utilization of primary healthcare services. Need to strengthen skill level of pre-hospital care staff. Need to improve the supply systems in place for medical supplies and vaccines from the central depot in Tripoli. LIBYA/TUNISIA BORDER AREA Two health posts continue to be operated at Al Hayat and Choucha Camps near the Ras Ajdir border. With the phase out of other camp health actors, International Medical Corps is now the main provider of primary and emergency health services in both of the refugee camps, providing 585 consultations during the week September 12-18. Each health post has an average daily patient load of 25 to 30 patients. Patients requiring hospital care are being referred to the Ben Guerdane Regional Hospital and to support care provided at this facility, International Medical Corps donated an ultrasound unit and medication supplies on September 17. EASTERN LIBYA International Medical Corps staff handing over medical equipment and medication supplies to the Ben Guerdane Medical Director International Medical Corps continues to support nine health facilities in the regions of Al Marj and Ajdabiya, providing 305 consultations in the fields of internal medicine, pediatrics and OB/GYN during the week September 11-17. In collaboration with the Jordanian Health Aid Society (JHAS), International Medical Corps is continuing to provide support for nursing care at major referral hospitals in Benghazi, Ajdabiya and Misurata. Following identified needs for increased nursing support in Tripoli, International Medical Corps and JHAS are planning to increase the number of nurses caring for patients at the major hospitals in the capital city. As part of International Medical Corps emergency rehabilitation services, 55 new patients were provided with a total of 132 physical therapy sessions over the past week. Support is also being
provided to equip the Rehabilitation Center at the Benghazi Medical Center with the necessary tools to increase the care to war-wounded patients at the center. To enable health care providers to effectively identify and manage cases requiring psychosocial support and counseling, International Medical Corps has to date provided Psychological First Aid (PFA) trainings to over 250 doctors, nurses, psychologists, teachers and volunteers in Benghazi. In addition, 20 schoolteachers in Derna (selected by the Ministry of Education) were trained psychological interventions for children in collaboration with Save the Children. These were training of trainers sessions which equip these teachers with the tools to train other teachers. Rabih Torbay VP, International Operations rtorbay@internationalmedicalcorps.org Hakan Bilgin Country Director - Libya hbilgin@internationalmedicalcorps.org Robert Lankenau Team Leader - Tunisia rlankenau@internationalmedicalcorps.org