Early June, Radwa Mtawwel, an internist at the Tobruk Medical Center (TMC), was serving a shift at the medical facility in the port city in eastern Libya. Mtamwei admitted a patient with an advanced condition but the patient’s family verbally and physically assaulted the young nurse.

In-patient with impatient family

Early June, Radwa Mtawwel, an internist at the Tobruk Medical Center (TMC), was serving a shift at the medical facility in the port city in eastern Libya. Mtamwei admitted a patient with an advanced condition but the patient’s family verbally and physically assaulted the young nurse.

In-patient with impatient family

“Accompanied by all members of her family, the patient was hospitalized unconscious due to high rates of urea in her blood. She had been suffering from heart failure for years, in addition to kidney failure and diabetes. Her only treatment was dialysis,” recalls Mtawwel.

Mtawwel gave the patient all initial treatments and called a nephrologist, a dialysis specialist, who then refused to conduct dialysis because the patient had hypotension, induced by a weak heart.

Shooting the messenger

The family’s violent reactions, says Mtawwel, started once she tried to explain their mother’s condition. The trainee practitioner told the family that they had to wait until the patient’s blood pressure improved before treating her. When some of the family’s members started assaulting her verbally, a nurse came and pulled Mtamwei away.

A few minutes later, Mtamwei received a phone call from the unit she’d just left, informing her that the patient’s pulse rate was decreasing at an exreme rate. “I went back and all the family were inside, which is forbidden to preserve sterilization and the rights of the other patients,” says Mtawwel. “A member of the family pushed me then the patient’s daughter cursed at me and pushed me towards the bed’s edge,” adds Mtamwei. 

“I tried to give the patient CPR and called an anesthesiologist to put her on the respirator, but she died. Had it not been for some young men in the Nursing Department, the angry family would have attacked me,” added the relieved nurse. The 85-year old patient died the same day.

“I thought their reaction was due to the shock and that they would apologize when they calmed down since I did everything I could. But no one did, even though I later ran into them several times inside the hospital,” recalls Mtamwei.

Repeated attacks on medical practitioners

Mtamwei’s story is a common one among overworked medical practitioners, trying to keep up with body counts and the blowback from Libya’s streets.

“This was not an isolated incident,” says Mtamwei. “A lady beat a gynecologist because she was late examining her. Another obstetrician and gynecologist was assaulted when he tried to prevent someone from gaining access to the ward. Verbal assaults, smashing the hospital’s windows and patients destroying facilities are now commonplace,” Mtawwel added.

Abdullah Tayel, a doctor at the Tobruk Medical Centre, says during his shift in the Accidents & Emergency (AE) ward, he was threatened with a Kalashnikov by a drunken patient who asked him to treat a friend with a wound in the head. “After everyone saw the gun, they left the AE Ward. I managed to take it from him while he was busy talking with his friend,” says Tayel.

Few resolutions

“I attended meetings with tribal elders and city officials to resolve the crisis, but the meetings didn’t have the desired result. If this situation persists, the attacks will not stop,” he believes.

The attacks don’t only target doctors, but all staff in hospitals. An orderly was stabbed in the back by a patient who was attacking a Syrian physician working at the TMC.

The TMC medical staff then staged sit-ins demanding the security services protect them and stop the attacks.

“A culture issue”

“It is a culture issue,” said Muhammad Bishr Shihabeddine, another doctor-in-training who also worked in Sirya. “The Libyans are generous and good people, but the current situation of lawlessness and weapon proliferation has created a favourable environment for such incidents.”

Following repeated protests by the doctors, the government says it will act to guarantee their security. “There is a need to create awareness and rehabilitation centers at a national level for those who commit such outrageous acts. Criminals should be rehabilitated too,” said the head of the Tobruk local council, Faraj Yassin Mabarri.

Government has plan

“A security chamber is being established to provide security to Tobruk in collaboration with the concerned security apparatus. Hospitals and medical centres will have enhanced security,” outlines Mabarri. “Given that there are no sufficient and secure prisons, the state has embarked on establishing a large incarceration facility inside the city limits to prosecute and punish all future outlaws.”

For now, Tobruk’s medical staff remain vigilant.