Medical specialists in the Libyan city of Benghazi are struggling to work as lack of funding for supplies and equipment seriously hinders their efforts.
"The conditions here are bad," said Zainab al Beidi, manager of Benghazi's only public rehabilitation centre designed for patients suffering from spinal injuries or recovering from strokes.
There were 65 long-term residents at the centre, but when IRIN visited, it was clear that patients' recovery prospects were limited by a severe lack of equipment.
"We do the simplest things with whatever we have available, but I constantly feel we are not able to do enough," Al Beidi said. "The best we can do is to offer diapers and wheelchairs, and we don't even have enough of these. We have cases that should be treated abroad, but how can we send them there?"
Until two years ago, the centre was part-funded by the Libyan government in Tripoli. Then the money dried up without warning. Now it is funded by the Libyan Red Crescent and other local NGOs, but Al Beidi said the budget was limited. "It is heartbreaking that we cannot do more," she added.
She showed IRIN an outbuilding where a half-completed swimming pool has lain empty for five years. "When the money from Tripoli stopped coming, we couldn't pay the contractors," she said. "So nobody here has had any water therapy."
The centre purchased a CAT scanner in 2005, but shortly after, Al Beidi received an order from Tripoli to shut it down. "We were told that we do not have the authority to operate it," she said. "I suspect that the government wanted people to pay to use the machines at private facilities instead. But many patients cannot afford to do that. The government sent men here who broke the machine so that we can't use it."
Photo: Kate Thomas/IRIN
|The unfinished swimming pool at Benghazi Rehabilitation Centre|
Many of the centre's nursing staff left during the early days of the conflict. But despite the obstacles, Al Beidi says she is optimistic about the future for the first time in years. "If the regime eventually falls and Libya revamps its healthcare system, lots could change here," she said. "Because of the war, spirits are high among the staff and the patients. Even though we have limited resources, not one of the in-patients has complained of anything since the conflict began," she said.
According to Simon Brooks, head of mission with the International Commission of the Red Cross (ICRC) in Benghazi, emergency needs are not as pressing in the city as elsewhere in the country, such as Misrata, where the Italian NGO Emergency pulled out because of security needs last week.
"In Benghazi the emergency needs are not that great," he told IRIN. "But the chronic need is a different thing altogether. While ICRC is here it will be working on strengthening institutions in Benghazi and contingency planning so that there is a back-up of supplies."
At the Benghazi Psychiatric Centre, where doctors say admissions have increased by 50 percent since the beginning of the conflict, medical supplies are running low. Until February, the in-house pharmacy's shelves were stocked with just enough medication to treat the centre's patients. But there was no provision for more cases.
"Looking back, we always felt that we had enough drugs to treat everyone," said psychiatrist Kamil Rabai. "But the conflict has really brought home how little we had to fall back on." Doctors are now supplying patients with one to two weeks' worth of medication rather than four weeks.
Orthopaedic services have also been crippled for years. At the Al Hawari hospital in Benghazi, there are not enough fixtures to treat patients with broken limbs. "There has been an increase in cases because of the war, but it would be a mistake to think that we are lacking supplies for that reason," said Fouad al Mabrouk, a junior doctor specialising in orthopaedics.
Benghazi Medical Centre, the city's largest hospital, opened its doors 30 years ago. But one of its floors remained closed, awaiting completion, says Al Mabrouk. It never opened.
Under the Gaddafi government, healthcare is free and this system continues in the rebel-held areas of the country. Infant mortality - a good indicator of the success of a healthcare system - according to figures issued by USAID in 2009, is 20 per 1,000 live births. But the system suffered during sanctions imposed on the country during the 1980s, and has not yet recovered.
According to Murad Ali Lenghi, Libya's former health minister, the country's health service is "deficient in many areas... investment and development are required across the board". He cited staff shortages, especially in specialist clinics, the decline of standards, overcrowding of hospitals and the tendency for Libyans to seek medical treatment abroad as contributing factors to what he called "the poor state of affairs".