MSF continues to support medical facilities, assist and train health staff and provide mental health care in Misrata. Today, the MSF team is made up of 44 Libyan staff and 30 international staff.
Surgery and trauma
In the late afternoon of Saturday 30th July, 10 wounded arrived in less than one hour at Qasr Ahmed Hospital, where MSF surgeons are supporting local medical personnel.
Among the wounded, two were severely injured; one with heavy burns on his body and another who was immediately sent to the operation theatre for a leg amputation. MSF surgeons worked until 1.30 in the morning to treat all the wounded.
As war trauma surgery is currently the number one priority for Libyan medical staff, it is creating significant gaps in other areas of care, such as obstetrical and paediatric care.
Training new medical staff
Another problem is the lack of paramedical and hospital staff. The Libyan health system was very dependent on foreign nurses, midwives and other hospital staff who fled once the war begun.
Junior doctors, medical students and also people with no specific competences volunteered to fill these gaps as best as they could but needed immediate trainings.
In response MSF started a series of trainings on war surgery, hygiene, sterilisation, bed-side assistance and waste management.
Misrata’s health facilities are also facing shortages of drugs and medical supplies (e.g. sterilisation machines, incubators, monitors for intensive care units, oxygen concentrators, reagents for laboratory) due to the long-standing fighting in and around the city.
Supporting medical facilities
Since beginning work in Misrata on 18th April, MSF has been supporting local medical staff in four health facilities:
Qasr Ahmed Hospital
In Qasr Ahmed Hospital, in support of the Libyan team, an MSF team of two surgeons (one general surgeon and one orthopaedic surgeon), two operation theatre nurses and one anaesthetist is in charge of the emergency room, the two operation theatres and the inpatient department.
In the past two month, the MSF team performed 200 operations. In July, 90 percent of the interventions were related to war surgery. The team is on call 24/7. A mass casualty plan training has been organised for all the hospital staff.
Abbad Hospital is one of the main health facilities treating war wounded in Misrata, together with Central Misrata Hospital and Al Hikma Hospital.
A referral system has been set up between Abbad Hospital and Qasr Ahmed Hospital to refer war wounded patients in need of surgery when Abbab Hospital is overloaded.
When requested, MSF surgeons support Abbad medical staff to treat war wounded.
Ras Tubah Hospital and medical centre
Ras Tubah Hospital is a former fertility clinic which has been adapted to a maternity and paediatric hospital. MSF created a sterilisation room, a shock room for maternity and a temporary laboratory and waste management area.
MSF has increased the hospital’s bed capacity by setting up paediatric and newborn wards.
The MSF team – a doctor specialised in gynaecology, an operation theatre nurse and a paediatric nurse – supports maternity, gynaecology and obstetric care.
Every month in Ras Tubah Hospital, more than 520 deliveries and 80 caesarean sections are carried out.
In Ras Tubah Medical Centre, an MSF doctor and an MSF nurse are training local staff and are supporting the intensive care unit (five beds) to assist women with maternal care complications.
Al Noor Hospital
In Al Noor Hospital, a facility located North-West of Misrata towards the northern frontline, MSF has opened a four-bed intensive care unit and is providing drugs and medical equipment to the operation theatre.
A doctor, an anaesthesiologist and two nurses are training the hospital staff on a new mass casualties emergency plan.
Support near the frontline
MSF has also provided training and medical supplies in the advanced health posts in Dafnya (North-West), Kararrim (South) and Abdel Rauf (West), located close to the main frontline.
The structures are properly equipped and the personnel are very skilled.
MSF provides training in basic life support, stabilisation and war surgery and supplies such as autoclaves, oxygen, spinal boards, burn kits, dressing kits, chest tubes, pain medication, antibiotics and other medical supplies.
Mental health: the invisible wounds
After more than four months of war, more and more people in Misrata are suffering from invisible wounds: psychological trauma.
To help them cope with this war situation, MSF has set up a mental health programme. Two MSF psychologists are working in close partnership with a network of 30 Libyan psychologists to provide both individual and group consultations in 11 health facilities (hospitals, clinics, physiotherapy centres).
In addition, a weekly training session for psychologists is organised so they can share experiences and knowledge in detecting the trauma and providing relaxing techniques to people in need.
A crucial component of the programme is its 'community approach', which consists of identifying social networks to support people affected by the war.
For instance, many women have been displaced with their families or come from parts of the city which have been badly damage.
MSF also provide psychological support to Libyan health staff and psychologists who everyday are confronted with horrible stories.
Healthcare in prisons
Together with local medical personnel, MSF started to assist detainees in the civil and military prisons of Misrata, focusing on primary health care and assistance to war-wounded.
The team is also assessing the needs for physiotherapy and psychological support among prisoners.
Physiotherapy and rehabilitation
MSF has carried out an evaluation of the needs for physiotherapy and rehabilitation for wounded patients in Misrata health facilities.
Training and support will be provided to local physiotherapists in Qasr Ahmad and Abad hospitals and in prison to increase the local health system’s capacity in this area.