24 Aug, 11 | by BMJ Group
A few weeks ago, I arrived in Tataouine, a desert town in South Tunisia, on a hot sandy day. I was there to work with the Libyan Global Relief Committee (LGRC), a medical group comprised of Libyan nationals or members of the diaspora returning home to help. These doctors and nurses have created a system to accommodate and allocate volunteer medics, giving their time and expertise to care for those affected by the fight against Colonel Gaddafi’s regime. Doctors have responded to the urgent calls for help from the UK, Canada, France, and even from within Libya itself.
It’s through the LGRC that I found myself in Tunisia and Libya, as an A&E middle grade with one week to offer and a chance to record the experience for BBC Radio 4′s Crossing Continents.
The LGRC had set up their HQ in a local hotel, working out of the hotel manager’s office. A storeroom had been transformed into a pharmacy. This was just one of the examples I witnessed of Tunisians helping their neighbours, now fighting for freedom. I arrived at the same time as a group of female doctors from Benghazi. In amongst them was a cardiologist, a senior house officer, a midwife, and a gynaecologist. Now that Benghazi was free, they said, they wanted to help other Libyans still fighting for their freedom. Such was the commitment that one married couple, two dentists, were taking it in turns to work with the LGRC, whilst one of them stayed at home to look after the children.
Each day we would board a minibus for a different refugee camp. The problems I saw were common and mainly frustrations of camp life. In the Tataouine camp, run by the Qatar Red Crescent I saw four women in a row, ranging from the ages of 17 to 45 suffering from constipation. The food provided lacked fresh fruit and salad. This was a radical change to their normal diets and instead were eating bread, rice, and meat. I did wonder if some of the water melons lining the dusty streets outside the camp could not find themselves inside. After all it was high season for them.
Other problems were mainly caused by existing problems, such as exacerbations of asthma and uncontrolled diabetes. Everyone seemed to have red sore eyes too, from the sand that was constantly blowing into their faces. It took a while for my eyes to feel “grit” free even though I had my sunglasses on at all times. I suggested that the team take plenty of chloramphenicol with them on the next visit.
At the end of the day I was able to feedback all my concerns to the established team members who stay on a more long term basis. I gave them copies of my notes with patient details so that a follow up process could take place and I also informed my patients to seek a follow up when LGRC next returned. One particular patient I was concerned about was a woman who had presented initially with shoulder pain, but then on further questioning revealed an extremely low mood. Uncontrolled tears fell down her face, as she told me about the long three months she had stayed at the camp with her three young children. Her husband and their father were still back in their home town in Libya, and she was desperately worried about him. She spoke fluent English and was a school teacher by profession. In the camp she had been trying to help the children continue their education, to limit the severe disruption to their lives, but it was proving a challenge with the heat and difficult conditions. She was worn down by the ordeal and appeared depressed. She told me she was not alone in feeling like this and that many women in the camp were in a similar situation to her.
Later in the week we crossed the border into Libya and drove the 40km to the Berber town of Nalut, lodged in the scenic Western mountains. It was like a ghost town, now that all the women and children were in Tataouine. The men had stayed behind to safeguard their homes. Nalut’s modern 300 bed showcase hospital was built by Colonel Gaddafi to demonstrate his efforts to the Libyan people. There were only three in-patients there. Ironically they were wounded Gaddafi soldiers. The youngest was a 16 year old boy, press ganged into fighting when he had attended a pro Gaddafi rally, which he had been paid to attend. He had been shot at a checkpoint and his family had no idea of where he was or if he was still alive. As he lay in the hospital bed, answering questions through an interpreter, I was struck by how small and young he looked. I could not imagine him with a gun. He had been shot in the back and the leg and then had been brought to Nalut hospital. The surgery to remove the bullets had gone well and his wounds were clean and healing. He had even begun physiotherapy. I had wondered about how doctors felt about treating soldiers who had been fighting for Gaddafi.
“When anyone who is injured crosses the threshold of this hospital they are our patients and they will be cared for like anyone else,” said the surgeon who had cared for the injured men.
The other surprise came in the form of two tiny North Korean nurses dressed in pink scrubs. Gaddafi had recruited health professionals from regimes around the world he had befriended.
The two North Korean nurses along with their Philippine and Bangladeshi nursing colleagues had not been paid for three months. They were concerned about their families back home relying on their salaries. Usha, the Bangladeshi nurse, took me to the staff room just off resus and offered me the most perfect chicken curry and chapatti I had ever tasted.
As word spread that doctors had arrived in Nalut, fighters with old wounds needing attention started to come in from surrounding villages. A German orthopaedic surgeon, with the medical charity MERLIN arrived just as we were leaving to make the sprint across the border before nightfall.
Crossing the beautiful landscape of desert and mountains, we checked into border control with a sigh of relief. As we left, others were still trying to enter. Young men, with designer sunglasses piled into vans driving much needed supplies to the front line. I watched last moment farewell hugs amongst friends, between those staying behind and those going forward. The youth of Libya fighting for their freedom. Sights like that stay with you for quite some time.
Consent was obtained from all the patients mentioned in this blog.
Saleyha Ahsan is a freelance journalist.