LIBYA HEALTH EMERGENCIES

AND HUMANITARIAN UPDATE Health Sector Monthly Bulletin May 2018

Detention centers Beneficiaries from Health facilities reached by PHC PHC Measles 11 supported 12 services 9.1 K consultations 4.2 K vaccination

Number of beneficiaries by type of activity KEY HEALTH NEEDS - High prevalence of suspected tuberculosis cases and Primary Health Care Medicines/supplies/equipment scabies in detention centers (DCs), particularly in Measles vaccination , and Al Kufra were reported by IMC and Specialized Health Care Assistance to PWDs IRC. 0 2000 4000 6000 8000 10000 - Public Health issues related to nutrition, sanitation and shelter in Tripoli detention centers were reported by Number of beneficiaries from PHC by Mintaqa CEFA. - High prevalence of non-communicable diseases with Tripoli Misrata weak referral system were observed by IRC in Misrata Sirt and . Azzawya Sebha - Lack of medicines and supplies in all health facilities, Aljabal Algharbi particularly in Derna and Bani Waleed hospital Alkufra Zwara according to WHO Almargeb - Need for primary health care services in Tawergha city, 0 500 1000 1500 2000 2500 3000 3500 4000 especially that public health needs are expected to increase by the next months according to WHO Primary Health Care services provided in - Need for specialized health care services in the south, Mantiqa Primary Health Care services particularly in Ghat, and Al Jufra. General medical care, Reproductive health care, - Need for Primary Health Care services, particularly in Al Tripoli GBV clinical care; Mental health care; Health Kufra, Ejdabia, Almarj, and . awareness; Health behavior change - Need for equipment and capacity building in most General medical care, Reproductive health care, Misrata GBV medical care; Health awareness; Health health facilities (SARA 2016). The intersectoral behavior change assessment conducted in Sirte in May 2018 found that General medical care, Reproductive health care, hospital needs X-ray machines, Sterilization kits, Sirt Health awareness Mammograms, early detection of cancer machines and General medical care, Reproductive health care, MRI machine. Furthermore, capacity building trainings Azzawya GBV clinical care; Referrals are needed for local doctors. General medical care, Reproductive health care, Sebha GBV clinical care; Health awareness; Health CHALLENGES behavior change General medical care, Reproductive health care, Al Jabal Al Gharbi - CCS: The communication with the four primary health GBV clinical care care facilities in Ubari, that CCS is supporting, remains General medical care, Reproductive health care, AlKufra problematic since the communication means are GBV clinical care reduced and also for lack of a proper coordination General medical care, Reproductive health care, Zwara responsible body that can respond for all of them. GBV clinical care - CEFA: The number of migrants is increasing in Abu General medical care, Reproductive health care, Almargeb GBV clinical care; Referrals Salim DC. - IMC: In May 2018, there was a decrease in the number 1 of Rescue at Sea operations and the visitors approaching to the Community Development Centers IMC: IMC teams encountered access issues to the cells Provision of Medical Supplies and Equipment within the detention centers in Zwara and Tariq el Sekka DCs. There were also major changes within the DCs that In its continued efforts to response to the current measles IMC operate. DC was closed, while Azzawya Abu outbreak in Libya, the World Health Organization (WHO) Issa DC was reopened, and will be utilized as a transit supported Libya Ministry of Health (MoH) with measles and center. Furthermore, an overlap was observed in some DCs Rubella reagents kits. The kits are meant to support where some organizations were providing the same preparedness and response measures that MoH is services. currently putting in place. Furthermore, WHO supported MoH with antiviral medication (Oseltamivir) that blocks the RECOMMENDED ACTION POINTS actions of influenza virus in the body. This medication is sufficient for more than 350 cases as part of the - Provision of medicines and supplies to health facilities, preparedness for an expected outbreak of any such particularly in Derna and Bani Waleed. disease. - Provision of tuberculosis medicines and non- communicable diseases medicines to the health facilities. - Monitoring the return of IDPs to Derna and Tawergha and adapting the response. - Organizing more anti-scabies campaigns in detention centers. - Strengthening the referral system - Continuing the deployment of specialized health staff to hospitals in Ghat, Al Jufra and Ubari - Provision of primary health care services through the deployment of more mobile medical teams particularly to Al Kufra, Ejdabia, Al Marj, Tobruk and Benghazi. - More coordination among the actors is needed in the DCs, where it was observed an overlap. - Continuing the restoration of health facilities by the provision of equipment and the health staff capacity building. Figure 2. WHO providing antiviral medicines and reagent kits to MoH. HEALTH SECTOR ACHIEVEMENTS Source: WHO Libya Ensuring Universal Health Coverage for Inclusiveness With the financial support of the Italian Cooperation (AICS), of Migrants and Displaced Populations: medicines and monitoring equipment were provided by CEFA organization to Tripoli Medical Center. Furthermore, A high level mission of the World Health Organization a batch of basic medical equipment has been purchased by (WHO) visited Libya from 4 to 7 May to review the CCS, to be distributed in Ubari, while the procurement of migration health situation in Libya and to identify key public some orthopedic material and hygienically items is health immediate needs that WHO may consider. The ongoing. mission met several stakeholders and promoted actively a universal health coverage approach to make sure that Health Care migrants and displaced population are not left behind. Over May 2018, the WHO continued in collaboration with Ministry of Health, the support of mobile medical teams deployed to five health facilities in Sirt, where more than 4,000 people benefited from general medical care as well as specialized health care in Surgery, Orthopedics, Urology, Internal Medicine, Gynecology & Obstetrics, Pediatrics, Cardiology and Ophthalmology. Furthermore, 546 consultations in general medical care were provided to Tawargha IDPs since May 2018 in the makeshift clinic Figure 1. Minister of Health, Minister of Interior, Head of Mission WHO Libya, established by WHO in Gararat Al Qatef settlement. Officials from Ministries of Health and Interior, WHO-Libya staff and representants from WHO HQ and WHO EMRO. Source: WHO Libya 2

In May 2018, International Medical Corps (IMC) conducted Handicap International outreach teams identified and activities in primary health care and provided referrals for assisted 36 persons with physical disabilities through the patients under two different grants funded by OFDA and provision of home-based physical therapy, guidance and UNHCR. Primary health care services consisted on general PSS. Among them, 10 persons were referred to external medical care, reproductive health care as well as GBV health and rehabilitation services. Furthermore, 235 clinical support. Over 3,000 consultations were provided in persons with disabilities benefited from the provision of nine detention centers. Furthermore, 678 other assistive devices over May 2018. consultations were provided in the two static community development centers located in Gurji and Selahedeen Control of Communicable Diseases neighborhoods in Tripoli. Moreover, IMC supported the The Ministry of Health, The National Centre for Disease rescue at sea disembarkation points in Tripoli, Tajoura, Control in partnership with WHO, UNHCR, IOM and health Zawiyah and Misurata by providing general medical care to partners IMC and STACO, conducted lifesaving 265 migrants. In Tripoli, Misrata and Sebha IDP camps immunization campaign targeting children under 5 years in 1,624 people benefited from general medical care, health 5 detention centers in Tripoli. awareness as well as health behavior change. Capacity Building On the 13th - 14th May under the EU-funded SHAMS project, WHO in collaboration with the MoH called for a high level consultative meeting in the presence of the Minister of Health. This exchange forum was held in-order to develop a context specific resolution to the ongoing bottle-necks facing the supply chain resulting in critical medical shortages in Libya. WHO colleagues from headquarters and the regional office were also in attendance with MoH, Audit Bureau, Central Bank, Libyan Food and Drug Administration, Medical Supply Figure 3. IMC providing emergency assistance to people rescued at sea in Tripoli Source: IMC Libya Organization, Pharmacy Administration-MOH (NDRA), National Center for Disease Control, Pharmacists The International Rescue Committee (IRC) continue to Association and Customs office. deliver consultations in general and reproductive health care as well as health awareness in Misrata and Sirte A meeting with the new senior staff of Migrants Health Unit through a mobile medical team deployed in pre-existing and the Emergency Management Directorate of the Libyan health facilities. Furthermore, the IRC rehabilitated two Ministry of Health (MoH) was held by WHO-Libya in Tunis partially damaged Health facilities in Sirte (Zaafaran and from 27 to 28 May 2018. The expected outcome of the Khaled Ibn Walid) and started delivering health services in meeting is 2018-2019 plan of actions of Emergency two detention centers in Tripoli, in which Services include Management Directorate and Migrants Health Unit of general and reproductive health care as well as referral to MoH. The main discussed topics were the health specialized care. emergency management strategic action plan, WHO assessment on health of migrants and displaced population in Libya, Health sector coordination, Outbreak alert and response, Information Management, Supply chain management, and the resource mobilization.

Figure 4. IRC medical staff providing reproductive health care in Misrata Source: IRC Libya The Italian organization CEFA, with the financial support of the Italian cooperation provided psychosocial support services to 47 children in Abu-Salim detention center in Tripoli. Figure 5. WHO staff with the new MoH official. Source: WHO Libya

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The health project managed by CCS with the financial Ubari’s centers to Tunis in order to let them better perceive support of AICS, to strengthen the capacities of four the coordination mechanism and also to express their primary health care facilities in Ubari is continuing up to the concerns. The delegation had meetings with both the AICS end of July 2018. During May 2018 the activities have been and WHO. focused on health staff trainings in Basic Life Support, Advanced Cardiac Life Support, Advanced Pediatric Life Handicap International provided for 36 caregivers Support and Advanced Trauma Care Support, Basic individualized PSS and guidance on how to more effectively Emergency Maternal and Neonatal Care, Early Warning care for persons with disability and/or injuries. Moreover, Alert and Response Network as well as the organizational HI conducted a risk education training to community focal structure of an awareness campaign. Furthermore, Help points for 15 people who are Scout leaders and civil society Code has organized a visit of a delegation of doctors from activists.

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