On one side of the old building, the word ‘hospital’ hangs on a dilapidated sign on a door. The surrounding buildings, former hospital facilities, have been damaged or destroyed by intense fighting in recent years. Inside a woman puts money in a box marked ‘Donations to the Maternity Section.’

On one side of the old building, the word ‘hospital’ hangs on a dilapidated sign on a door. The surrounding buildings, former hospital facilities, have been damaged or destroyed by intense fighting in recent years. Inside a woman puts money in a box marked ‘Donations to the Maternity Section.’

“When I was a patient here, I needed injections and special food and they were not available; the hospital then had only one doctor and one nurse,” the woman, who preferred to remain anonymous, told Correspondents.

The Al-Bahri Hospital – the only major medical facility in Zuwara, northwestern Liby – is now cramped into a former eye clinic, yet it continues to be the main health outlet for more than 45,000 people, says Dr. Nidan Al-Kilani, the head of the medical facility. Several of the hospital’s buildings have been out of use since the 1980s, forcing doctors and medical practitioners to attend thousands of patients in small, cramped spaces with extremely limited resources.

Doctor Al-Kilani says the hospital can still provide emergency treatment, internal medicine, surgery, maternity, gynecology, nephrology, pediatrics and a lab. “But most consist of one or two rooms. Some of these sections work around the clock despite all the odds, like the emergency, the maternity and the gynecology sections,” Doctor Al-Kilani told Correspondents.

“Primitive equipment”

“We treat our patients with basic equipment that is considered primitive in the rest of the world, but we do not have another choice,” says Dr. Hakim Al-Ghali, head of the intensive care unit, who now only performs major surgical operations in life-saving situations.

The hospital’s pharmacy is similarly depleted and out of stock. Dr. Najat Al-Azabi says that “the store is a drug store in name only, because it lacks most of the medications needed in the hospital. Supplies usually come by donation or irregularly. “The medical supply apparatus, that used to solve many of these problems, is almost entirely absent,” he says.

15,000 patients in 10 months

According to a recent study, shown to Correspondents by head of statistics at Al-Bahri Hospital, Nadia Moammar, since January 2016 until October, the hospital attended to more than 15,000 patients. More than 10,000 patients visited the emergency ward, with thousands more receiving care in the maternity, pediatrics and gynecology wards.

The lack of supplies has largely paralyzed the 360 medical personnel in the hospital, of which 38 are foreign. Many of the foreign doctors are set to leave as their salaries have not been paid since April this year. Hospital head Dr. Al-Kilani says that losing them would be “the knock out blow.” Dr Michael Alexef says that the crew will remain as long as possible to respond to the humanitarian call rather than the monetary issues. He says many of his foreign colleagues have already left because of the deteriorating security situation and contracts not being observed. “These conditions usually drive people away,” Dr Alexef told Correspondents.

In theory the solutions to these problems should be provided by the Ministry of Health, since it is the official entity that administers the medical facilities in the country. However, since consecutive governments in Libya have failed to administer hospitals and supply them with medical provisions, it has fallen on the local council to intervene and set mechanisms to support the hospital with the necessary material.

Council support

Basem Dahan, a member in Zuwara City Council, told Correspondents that his office has developed mechanisms to provide some financial support for the foreign crew along with medical supplies and other logistics to the hospital. It has also pledged to cover the debt of the hospital, which ought to be guaranteed by the ministry. Mr. Dahan added that “the city council is also holding regular meetings with officials from the ministry of health to find solutions to the problem and to contact donor and supporting parties. We call on government officials to intervene as soon as possible to save what can be saved.”

Despite the Zuwara City Council’s intervention, the hospital’s head remains concerned for the future prosperity and sustainability of the key medical facility, in a town in which most others have been closed, destroyed or remain out of use.

Call on philanthropists

He appeals to private sector and public sector donors to help keep the hospital open. Doctors Without Borders is one of the only organizations that supplies the hospital with basic medicines, for which Al-Kilani is grateful, but it is a drop in the ocean vis-a-vis demand for medication. “They give us what they have and not what we need” says Dr. Al-Kilani.

One of the key challenges is to restore and reopen the hospital’s damaged buildings. The buildings in use are inadequate for patients, says Shoily Faties, head of the maintenance division.

“We are afraid of what is to come”

“The water and sanitation systems are over worked and humidity is rife in the building, which is causing cracks in the walls. We are afraid of what is to come,” said Faties, calling for an intervention from the Ministry of Health.

The old lady who had placed a donation in the maternity box hands a bag of supplies over to a nurse. “We do not know whether we will have a hospital one day or not,” she says as she leaves.