Although some detention centres closed in 2020, thousands of men, women and children remained held in overcrowded, unsanitary conditions with little access to healthcare, insufficient food and drinking water, and no possibility of physical distancing. Médecins Sans Frontières (MSF) continued to provide medical and mental healthcare in detention centres in Tripoli, Khoms, Zliten, Zuwara and Zintan. Our teams also worked to improve access to water and other basic services, reinforce COVID-19 infection prevention and control measures and refer the most vulnerable cases to protection agencies.

In February, a 26-year-old Eritrean man lost his life when a fire broke out in the overcrowded Dhar El-Jebel detention centre in Zintan. We offered psychological support to survivors of the fire and distributed basic necessities to replace items they had lost, while reiterating our call for the end of arbitrary detention of migrants and refugees in Libya.

The vast majority of the estimated 650,000 migrants currently in Libya live on the streets, exposed to arbitrary arrest and detention, human trafficking, exploitation and severe violence. Most of those detained are in clandestine prisons and warehouses run by people smugglers rather than official centres. In Bani Walid, our teams offered general healthcare and medical referrals to refugees and migrants who had escaped from captivity, and to victims of torture and trafficking.

Throughout 2020, refugees and migrants were subjected to numerous violent attacks; for example, at disembarkation points where the Libyan coastguard forcibly returns those who try to flee. On 28 July, our teams responded with medical and psychological care after a shooting at a disembarkation site in Khoms that left three teenagers dead.

Tuberculosis (TB) care is another focus of our activities in Libya. Our teams work in three TB facilities: two in Tripoli and one in Misrata, a 17-bed clinic that we opened in March.