UNHCR helps re-open health centre during lockdown in Libya

New parents, Alhadi, a refugee from Sudan, and his Somali wife, Umalkeyr, sit cradling their 20-day-old son in a blanket as they wait to see a doctor. The young couple have come to get medical care for baby Ayman, who has a persistent gastric problem.

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Libya is still grappling with the COVID-19 pandemic. While some movement restrictions have recently been eased, nighttime and weekend curfews are still in place and much of daily life in the country remains on pause. Only a few stores have re-opened, and most businesses and public buildings are closed. Access to health care remains a challenge for many.

But in the midst of the coronavirus lockdown, a primary healthcare centre in the Gergaresh neighbourhood of Tripoli – serving a catchment area of at least 30,000 people, including high concentrations of refugees and migrants from sub-Saharan Africa – has re-opened, thanks to the support of UNHCR, the UN Refugee Agency, and its partner the International Rescue Committee (IRC).

The centre, which is providing medical and protection services to those in need, is one of just three Primary Health Care Centres (PHCCs) that are currently operating in the whole municipality, an area where an estimated 450,000 people live.

"Everything was closed."

“This clinic is close by where we live – it helps,” said 19-year-old Alhadi. “This is a very good thing to find a place that is close by that would help us to get treatment. I’m very happy, especially because everything was closed.”

The young father said that travelling out of the house during lockdown to seek emergency medical help at a hospital could be very difficult, as you may be stopped by the authorities at checkpoints.

It was costly, too, he said: journeys required taxis, and even if you arrived at a hospital, there would often be problems gaining admittance since many facilities did not recognize UNHCR registration documents, or wanted up-front payments.

The Gergaresh PHCC was closed by the government when a state of emergency was declared as the first cases of COVID-19 appeared in March. It was an attempt to try to contain the spread of the virus. In the clinic, staff faced shortages of equipment, including PPEs, or personal protective equipment, and lacked training in how to manage and control infectious disease.

When UNHCR and its partner, IRC, offered to step in and provide services through an IRC medical and protection team, while also procuring equipment and offering training for local staff, PHCC manager, Belgasim Shibli, enthusiastically accepted.

"We are open to Libyans, to refugees, to migrants."

“There are big health needs in this municipality,” he said. “When the centre closed, that led to many Libyans seeking treatment in the emergency units in hospitals, which caused overcrowding.

“The services provided here have a huge impact on the local population. We are open to Libyans, to refugees, to migrants,” Shibli added. “We can provide integrated services and facilities to all, regardless of their background.”

The Libyan staff working at the centre, who are soon expected to resume their work alongside the IRC team, received several training sessions on infectious disease control and treatment.

UNHCR and IRC jointly procured gloves, face masks, goggles, sanitisers and thermometers and other medical and office equipment. A generator will also be provided, to ensure the facility has constant access to electricity during working hours.  

The IRC protection team visits the facility daily to provide psychosocial support for women and girls and case management services, especially for those who are affected by gender-based violence.

The centre has introduced social distancing measures to ensure smaller numbers inside the main waiting room, with others waiting in the shady courtyard outside. Patients are given masks and have their temperatures checked as they enter.

As well as providing health services to refugees and asylum seekers directly at several health care and community centres around the country, in response to the pandemic UNHCR has also stepped up its support for national health systems, providing generators, ambulances, medical tents and prefabricated units used as initial reception and examination rooms for COVID-19 detection.

UNHCR’s Assistant Public Health Officer, Dr. Meftah Lahwel, said it was important to be able to provide essential health services to all at a time of the COVID crisis, including reproductive health and mental health services.

“The health needs here are huge. We are working in this facility to provide free of charge health care access for all, regardless of their status,” Lahwel said. “This partnership is one of the steps to provide integrated health services for refugees and asylum seekers in areas where they reside in large populations.”

See also: UNHCR steps up emergency assistance in Libya as continued conflict and COVID-19 create more hardship

Libyan patients queuing alongside refugees and migrants in the waiting area were also happy that the centre was back in operation. Halwa, a Libyan mother who had given birth nine days earlier, and had come in for a check-up, said: “Everyone has put a lot of effort into reopening this place. It is really helpful for us to come here.”

Dr. Wafa Elmati is a member of the IRC team, which includes a gynaecologist, psychiatrist, psychologist, doctor, nurse and pharmacist, as well as protection staff who carry out psychosocial care, recreational activities for children and mental health counselling. 

Many cases involve patients with chronic issues such as diabetes and hypertension, requiring ongoing medication, which had been disrupted during the lockdown period. But Elmati said that she’d also seen cases of malnutrition, scabies and even tuberculosis.  

“I’m very happy to be working here. Many patients come in feeling very stressed and afraid, but they leave with a smile on their face.”