Libya: 120 Day Response 1 Overview of the Situation in Libya After more than 40 years of Colonel Muammar al-Gaddafi’s leadership, the unrest spreading throughout the Arab world erupted in Libya in mid-February 2011. After living for decades under Gaddafi’s authoritarian regime, with repression of political and civic freedoms and persistent grievances regarding the unequal distribution of wealth, the people of Libya, encouraged by developments in neighboring countries, started to push for regime change. It began in the eastern Libyan city of Benghazi, with the eastern Cyrenaica region in opposition control by February 23 and opposition supporters later forming the Interim National Transitional Council. Uprisings also commenced in Misurata, Zawiya and the Nafusa Mountains region. Gaddafi responded, ordering his troops and supporters to crush the uprising in a televised speech, descending the country into civil war. While rebel fighters formulated an army and gained ground, it quickly appeared as though the battle would be mismatched, with Gaddafi forces possessing superior weapons and skills and outnumbering rebel forces. As Gaddafi forces advanced towards Benghazi, however, the United Nations Security Council approved the implementation of a no-fly zone over Libya, including ‘‘all necessary measures to protect civilians”. International coalition forces launched airstrikes on March 19, later coming under NATO command and preventing any further advancement of Gaddafi forces to the east. Thus far any negotiations for ceasefire arrangements have proved unsuccessful and fighting near Brega in the east, outside of Misurata, and in the Western Mountains region continues. Amid this conflict, the civilian population has suffered significantly. The conflict has halted traditional supply routes, displaced whole communities, inflicted civilian casualties and, in some cases, whole cities and towns have been besieged by Gaddafi forces causing extreme hardship upon the population. Libyan people have faced shortages of food, water, fuel, electricity and access to adequate health care. Health facilities have been stretched to their limits, facing increased caseloads due to the conflict. Concurrently, central supply chains for medications and medical supplies have been cut and large numbers of foreign nurses have departed the country, leaving facilities with urgent shortages of these critical staff. In Misurata, the overload on hospitals, with an average of 70 casualties a day at the height of the fighting, created a critical need for medical evacuations to reduce the pressure on these facilities. Assistance to lessen these hardships and provide medical support for the people of Libya will be needed as the conflict continues, and in the aftermath. As of June 27, 120 days after the commencement of International Medical Corps’ response in Libya, the conflict persists, including in the Western Mountains region, on the outskirts of Misurata and to the east, outside of Brega. Due to the conflict, almost a million people have fled Libya across its borders, with many also displaced internally within the country. 2 International Medical Corps’ Response Indicates where International Medical Corps’ has conducted assessments/provided support. International Medical Corps deployed an Emergency Response Team (ERT) to Libya on February 24, 2011 and was one of the first international NGOs to arrive in Benghazi on February 27. The team immediately began assessing health needs, with initial efforts focusing on distributing needed supplies to health facilities and also to populations of displaced people. Since this time, International Medical Corps’ efforts in Libya have expanded, in response to significant developments in the conflict, and the corresponding situation for civilians. Teams are currently in eastern Libya, the Western Mountains, the Misurata area and also along the Tunisian side of the Libya/Tunisia border, where large numbers of people have fled the violence. As access permits, International Medical Corps is also trying to reach additional areas in western Libya to provide needed humanitarian assistance. Throughout Libya and also on the borders with Tunisia and Egypt, International Medical Corps’ teams are providing: supplies and medical personnel to support health facilities; medical consultations and lifesaving surgeries; care for the medical evacuation of patients; essential supplies to people displaced by the conflict; and training to assist health care staff to deliver support to those affected by the conflict. 3 Emergency Response Summary 28 health facilities supported 12,390 medical consultations 1,465 major surgeries 466 medical evacuees provided care, including 50 ICU cases 142 qualified medical staff deployed: 79 nurses 63 doctors (51 volunteers) 300+ people trained: 140 hospital staff in psychological first aid 21 teachers and 74 refugee camp staff in psychological first aid. 36 hospital staff in gender-based violence guiding principles 36 ambulance staff in safe transportation and equipment 13 Interagency emergency health kits (each serves 30,000 people/ mth), trauma kits and surgical kits distributed 7,250+ hygiene kits distributed 20,000 kilos of food aid and 49,000 liters of bottled water 5,500 bars of soap, 1,300 blankets, 150 mattresses and other non- food items delivered to displaced populations 80 tonnes of medications & medical supplies delivered $1.76 M in medicines and medical supplies donated by our in-kind partners delivered to needed health facilities International Medical Corps would like to acknowledge the generous support from our donors and supporters for the Libya response including: USAID Office of U.S. Foreign Disaster Assistance (USAID/OFDA), The Australian Agency for International Development (AusAID), The UK Department for International Development (DFID), Church of Jesus Christ of Latter-day Saints, Stichting Vluchteling, AmeriCares, Heart to Heart, International Health Partners UK, International Relief Teams, MAP International, I-Go Aid Foundation, Libyan Aid, Merchant Community of Benghazi, UNICEF, UNFPA, United Nations World Food Programme, Medical Teams International, and our private donors. 4 International Medical Corps’ Major Events in Libya Key Response Achievements 5 International Medical Corps’ Major Events in Libya Key Response Achievements 6 Eastern Libya Indicates where International Medical Corps has conducted assessments/provided support. While the situation in Benghazi and much of the east has recently stabilized, the central hospitals in Benghazi and Ajdabiya have continued to receive casualties from the conflict and many people have been displaced from areas close to the conflict. In addition, health facilities have faced significant nursing shortages following the exodus of a large number of foreign nurses. At the Benghazi Medical Center, the largest health facility in eastern Libya, pediatric and gynecology wings were closed due to these shortages. These challenges, coupled with shortages of medical supplies due to severed central supply lines, have greatly impacted health care provision in eastern Libya. Following, International Medical Corps’ ERT arrival in Benghazi on February 27 and assessments identifying shortages of medical supplies and medications as well as staff shortages at hospitals, the team immediately began response activities. On February 28, medical supplies were provided to the Al- Jella Hospital in Benghazi and three doctors were seconded to hospitals in Benghazi. On March 2, the team distributed 300 blankets, lab supplies, chronic medications and other medical supplies to the community in the Benghazi governorate. From the initial Benghazi base of International Medical Corps’ response efforts in Libya, teams have conducted assessments and provided support as far as Ra’s Lanuf to the west and Derna and Tobruk to the east, as well as to the centers of Benghazi and Ajdabiya and surrounding areas. Response efforts in the east have focused on Jordanian Health Aid Society To provide needed medical staff in Libya, providing support to health facilities, internally displaced International Medical Corps has worked in persons and medical evacuations from Misurata. partnership with the Jordanian Health Aid Society (JHAS), a local Jordanian NGO. This A major response effort has been the provision of 51 partnership has been mutually beneficial, with nursing staff to support health facilities in eastern Libya, International Medical Corps helping to strengthen JHAS’ capacity and at the same time, including the Benghazi Medical Center, with further JHAS staff have been readily available to deployments planned for this ongoing need. International International Medical Corps to deploy to Libya to Medical Corps surgeons also provided assistance at the provide much needed support to health facilities. 7 Al Majory polyclinic. Medications and medical supplies have also been provided to numerous facilities, based on assessed needs. Supplies have been delivered to central health facilities, including Al-Jella hospital, Benghazi Medical Center, Ajdabiya hospital, Brega Polyclinic, Tobruk Hospital and the Quefia Chest Hospital in Benghazi, where more than a two-month supply of tuberculosis and antibiotic medications was provided. International Medical Corps has also provided medical supplies to smaller clinics, to support the provision of primary health care in the region, including in Soltan (north of Ajdabiya), Zweitina (north of Ajdbaiya), Albethnan (east of Ajdabiya) and Al Marj (north