Libya

Victim Assistance

Last updated: 04 October 2017

Libya is responsible for survivors of landmines and other types of explosive remnants of war (ERW). The total number of survivors is unknown. Outdated estimates ranged from 5,000 to 8,000 survivors through 1995.[1]

Victim assistance since 2015

In 2017, the Libyan Mine Action Centre (LibMAC) reported that the medical situation was very poor, for all hospital services, and that it had worsened since 2015. It also reported a decrease in physical rehabilitation services available.[2]

Handicap International (HI) carried out a health assessment in 2015 that surveyed 12 medical facilities in Tripoli, Gharyan, and Worshefana. The assessment documented casualties and reported on available health services. It did not specifically assess the needs of mine/ERW causalities.[3]

No victim assistance coordination or planning was possible; national and international efforts remained focused on providing immediate relief to the large numbers of war-wounded, including mine/ERW survivors, and rebuilding the health sector.

Victim assistance in 2016

Due to ongoing conflict, the civilian population struggled to access basic services such as healthcare, fuel, and electricity in 2016.[4]

Due to the political and security situation in 2016 no needs assessments were carried out and there was no victim assistance-specific coordination, active survivor or victim assistance strategy, or changes to relevant legal and policy frameworks. However, a national plan for victim assistance was developed in 2016.[5]

The situation of mine/ERW survivors and other persons injured in conflict remained critical in 2016. The escalation of violence and the rising number of wounded people strained an already weak health system. In 2017, HI reported that all persons with disabilities had insufficient access to essential services, regardless of the cause of the impairment.[6]

Assessing victim assistance needs

In May 2016, LibMAC appointed Victim Assistance Officers, who collected data and transferred the information to the database unit. However, there was no victim assistance needs assessment in 2016.[7]

Victim assistance coordination

Government coordinating body/focal point

Ministry of Health, Ministry of Social Affairs, and Ministry of Culture and Civil Society (MCCS)

Coordinating mechanism

None

Plan

None

 

On 1 December 2011, LibMAC was established within the Ministry of Defense to manage all mine action activities in the country.[8] Responsibility for victim assistance lay with the Ministry of Health and the MCCS.[9] The Ministry of Social Affairs was primarily responsible for physical rehabilitation in Libya, although the Ministry of Health and Ministry of Martyrs, Missing and War Wounded were also active in the field of physical rehabilitation.[10] There was no national plan for victim assistance.[11] In 2016, victim assistance was discussed at monthly mine action coordination meetings, led by UNMAS and LibMAC.[12] LibMAC reported that a national plan for victim assistance was developed in 2016, with the support of a technical advisor provided from ITF Enhancing Human Security.[13]

In July 2017, UNMAS, LibMAC, and HI facilitated a victim assistance seminar in Tunis. The aim of the seminar was not only to promote victim assistance, but also to clarify the role of each actor and elaborate a draft victim assistance strategy.[14] Following this seminar, and if funding is allocated, HI, with the support of UNMAS, will assist LibMAC and relevant ministries in finalizing the victim assistance strategy, prioritizing activities through a comprehensive action plan, and setting up a coordinated and effective approach.[15]

In 2015, Libya reported that an integrated social and economic policy in accordance with an integrated national plan that addressed the needs of persons with disabilities was necessary. The Ministry of Social Affairs is responsible for supervising and monitoring the operation of social care facilities, including centers and institutions for the education and training of persons with disabilities. The Ministry is also responsible for ensuring that those facilities and institutions work together to provide integrated services. The following specialized bodies coordinated by the Ministry of Social Affairs are responsible for the care of persons with disabilities:

  • The General Authority for the Social Security Fund;
  • The Centre for Training Persons with Disabilities, Benghazi;
  • The Centre for Training Persons with Disabilities, Janzur;
  • The National Commission for Persons with Disabilities.[16] 

Service accessibility and effectiveness

Victim assistance activities

Name of organization

Type of organization

Type of activity

Ministry of Social Affairs

Government

Managed Benghazi Rehabilitation Centre

Ministry of Social Affairs

Government

Managed Janzour Rehabilitation Centre in Tripoli. Basic rehabilitation services reduced due to lack of resources and trained staff

Médecins sans Frontières (MSF)

International NGO

Emergency medical care, support to medical system, and strengthening healthcare; training of medical personnel

International Medical Corps (IMC)

International NGO

Primary healthcare, psychological support and mental healthcare, strengthening physical rehabilitation

ICRC

International Organization

War surgery training, evacuation of mine/ERW survivors and other war wounded, strengthening physical rehabilitation; providing emergency and first-level care training for members of the ICRC National Society, emergency service and hospital staff, and civil defense personnel

 

Emergency and ongoing medical care

In 2017, the healthcare system had significantly deteriorated to the point of collapse. The already fragile health system came under increasing pressure, with hospitals struggling to absorb the number of patients and to cope with the shortage of staff, essential medicines, and supplies.[17] Only 45% of health facilities were functioning. As of October 2016, at least 274 health facilities had been damaged or destroyed.[18]

A number of injured Libyans, including soldiers, were sent abroad for medical treatment by the government, although the number of patients treated abroad and supported financially by the government decreased significantly in 2017. Persons with disabilities who needed assistive devices and wheelchairs were generally required to purchase them with private funds, or had to approach local charity organizations for support.[19]

Based on a “Rapid Assessment of Health Structures in Western Libya” report published in 2016, HI found that at least 40% of the health system was non-functional. Libya has both public and private facilities providing emergency and ongoing medical care. Overcrowding, obsolete equipment, lack of medical staff and supplies, damaged facilities, and insecurity limit the ability of the health sector to meet the needs of patients, including mine/ERW survivors. Inaccessible public buildings also hindered access to healthcare for survivors and other persons with disabilities. The majority of mine/ERW casualties were referred to the accidents and emergency section of Abu Salim Hospital in Tripoli.[20] However, the prosthetic and orthotic department of Abu Salim Hospital closed down at the end of 2016 due to a lack of resources. In spite of the lack of updated documentation, it is acknowledged among the aid community that the health situation has significantly deteriorated in 2017.[21] In 2016, only three of the seven major hospitals in Benghazi were functioning.[22]

MSF provided hospitals with medicines and trained medical staff.[23]

In 2016, the ICRC increased its emergency activities in order to respond to the rising number of wounded people.[24] Four hospitals received monthly support from the ICRC, which provided surgical supplies sufficient to treat 50 severely wounded patients, including mine injuries. The ICRC also provided ad hoc support to other hospitals. In 2016, 22 hospitals received such ad hoc support from the ICRC.[25] To respond to the influx of wounded people, between January and May 2017, 25 hospitals received ad hoc ICRC support.[26] In 2016, the ICRC trained surgeons and doctors on emergency trauma and clinical management of wounded patients. It also supported the national Red Crescent Society’s first-aid program.[27]

Physical rehabilitation, including prosthetics

There were three main rehabilitation centers in Libya: in Tripoli, Misrata, and Benghazi. In addition, some of the main trauma hospitals also offered physiotherapy services.[28] In 2016, there has been a steady decline in the availability of services. Many rehabilitation facilities closed down due to a lack of funding and/or personnel. Existing public and private services are overloaded and very costly, although the quality of services had also declined. By mid-2017 the only remaining prosthetics facility in Tripoli was unable to provide prosthetic devices due to a lack of materials and funding to purchase them resulting in a waiting list of 300 amputees needing prosthetic devices.[29]

HI provided physical therapy services to persons with disabilities and patients with conflict-related injuries, including from landmines and ERW, in Tripoli, Beni Walid, Msalata, and Tarhouna. Yet, due to the increasing demand in 2016, HI had to limit the number of assistive devices per beneficiary and focus on essential needs. As of June 2017, HI was supporting one rehabilitation center, Janzour Hospital, providing materials for prosthetics and orthotics, rehabilitation equipment, mobility aid devices, and technical training for staff.[30]

The ICRC supported the Misrata University Physical Rehabilitation Centre with prosthetics and orthotics material, as well as financial and technical assistance.[31] Although established in 2013, the Misrata University center first began to produce assistive devices in April 2016, activities having been delayed by security constraints and a lack of qualified personnel. The ICRC-supported orthopedic workshop provided services to 175 patients in 2016; eight prostheses delivered were delivered to mine/ERW survivors. The ICRC also supported orthopedic training abroad.[32] 

The health system lacked capacity in physiotherapy, prosthetics, and orthotics. Mobility aids were of low quality and many centers lacked the equipment and materials necessary to provide services. As of August 2017, the Swani rehabilitation center, located some 30 minutes from Tripoli was no longer functioning.[33] In June 2016, HI reported that the Swani rehabilitation center was the only center providing comprehensive rehabilitation in Libya. However, it was under-utilized due to its distance from Tripoli and other major towns in the Western Mountains. The distance and the poor security situation made it especially difficult for women to access the center.[34]

Three-quarters of the 13 health facilities surveyed by HI in and around Tripoli reported having physiotherapy services. However, only the University of Misrata had functioning prosthetic and orthotic services.[35]

Economic inclusion

No information was available on economic inclusion initiatives for mine/ERW survivors in 2016.

Psychological support

There is no official budget for mental health care. Health professionals identified psychosocial support training as a priority for capacity building. Strong stigma toward psychosocial disabilities and their treatment prevented some war-injured persons from accessing psychosocial support and mental health care.[36]

In 2016, there was an increase in psychosocial services provided by international NGOs. However, local capacities were not sufficient to meet the needs, and the shortage of medication to address the issue remained a significant constraint to the adequacy of services.[37]

HI provided psychosocial support services to persons with disabilities and patients with conflict-related injuries, including from mines/ERW. In March 2017, HI organized a psychosocial support training for local organizations such as CESVI and local NGOs.[38]

Laws and policies

It was reported that Law No. 5 of 1987, on persons with disabilities, remained in effect. The law provides for persons with disabilities rights to shelter; subsidized housing services; reimbursable assistive equipment; education; therapy or rehabilitation; suitable work for those who have received rehabilitation; follow-up for those who are working; tax relief for the self-employed; access to facilities for the use of public transport; customs exemptions for items that they must import because of their disabilities; and facilitated access to public spaces.[39]

The 2011 Constitutional Declaration addresses the rights of persons with disabilities and requires the state to provide monetary and other types of social assistance, but does not explicitly prohibit discrimination. In 2016, the government did not effectively enforce these provisions. Few public buildings were accessible to persons with disabilities, resulting in restricted access to employment, education, and healthcare.[40] The draft constitution of April 2016 includes a specific article (Article 69) on the rights of persons with disabilities. The article commits Libya to guaranteeing the health, social, educational, economic, political, sports, and entertainment rights of persons with disability on an equal basis with others and to make facilities accessible. The draft constitution also prohibits discrimination against persons with disabilities.[41] However, Libya’s Constitution Drafting Assembly failed to finalize a preliminary draft constitution in 2016.[42]

Article 1 of Law 4 of 2013, related to persons with disabilities “from the liberation battle,” created a new category of persons with disability for those who sustained permanent impairments while fighting for the 2011 uprising and against the previous regime and also for those persons who sustained injuries as civilians from attacks by that regime. This new category received more benefits as compared to other persons with disabilities. The NGO Lawyers for Justice in Libya noted that the disparity “highlights inequality in the treatment of people with disabilities as well as discriminating between them on the basis of political association.”[43]

Libya signed the Convention on the Rights of Persons with Disabilities (CRPD) on 1 May 2008. In 2015, on the occasion of Libya’s human rights Universal Periodic Review, it was reported that persons with disabilities in Libya had experienced “little to no progress in relation to their rights and treatment” since the previous review. Libya has taken few practical steps to integrate persons with disabilities into society, to improve education materials, or to adopt measures to reduce costs and thereby make transportation or education more affordable for persons with disabilities.[44]



[1] Ahmed Besharah, “World War II mines planted in Libya and its socio-economic impact,” Libyan Jihad Center for Historical Studies, Tripoli, 1995, p. 153.

[2] Response to Monitor questionnaire by Ezzedine Ata Alia, Administration Manager, LibMAC, Tunis, 29 March 2017.

[3] Email from Anne Barthes, HI Libya, 26 May 2016.

[4] Human Rights Watch (HRW), “Libya: Events of 2016,” undated but January 2017.

[5] Response to Monitor questionnaire by Ezzedine Ata Alia, LibMAC, Tunis, 29 March 2017.

[6] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[7] Response to Monitor questionnaire by Ezzedine Ata Alia, LibMAC, Tunis, 29 March 2017.

[8] UNMAS, “Libyan Arab Jamahiriya,” undated.

[9] Email from Abdulmonem Alaiwan, LibMAC, 17 June 2012.

[10] ICRC Physical Rehabilitation Project (PRP), “Annual Report 2013,” Geneva, September 2014.

[11] Response to Monitor questionnaire by Ezzedine Ata Alia, LibMAC, Tunis, 29 March 2017.

[12] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[13] Response to Monitor questionnaire by Ezzedine Ata Alia, LibMAC, Tunis, 29 March 2017.

[14] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[15] Ibid.

[16] Libya, National report submitted in accordance with paragraph 5 of the annex to Human Rights Council Resolution 16/21, 5 May 2015, A/HRC/WG.6/22/LBY/1, p. 15.

[17] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[18] World Health Organization (WHO), “Yemen Humanitarian Response Plan 2017,” February 2017.

[19] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[20] Email from Cat Smith, Head of Mission, HI, 2 August 2017.

[21] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[22] MSF, “Libya,” 23 June 2017; and MSF, “Libya: The challenge of medical aid,” 1 July 2015.

[23] MSF, “Libya,” 23 June 2017.

[24] ICRC, “Annual Report 2016,” Geneva, May 2017, p. 155.

[25] Ibid., p. 154.

[26] Response to Monitor questionnaire by Zaher Osman, Health Coordinator, ICRC, 12 June 2017.

[27] ICRC, “Annual Report 2016,” Geneva, May 2017, p. 155.

[28] Response to Monitor questionnaire by Zaher Osman, ICRC, 12 June 2017.

[29] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[30] Ibid.

[31] Response to Monitor questionnaire by Zaher Osman, ICRC, 12 June 2017.

[32] ICRC, “Annual Report 2016,” Geneva, May 2017, p. 155.

[33] Email from Cat Smith, HI, 2 August 2017.

[34] HI, “Rapid Assessment of Health Structures in Western Libya,” June 2016, p. 18.

[35] Ibid., pp. 15 and 20.

[36] HI, “Rapid Assessment of Health Structures in Western Libya,” June 2016, pp. 12–13.

[37] Response to Monitor questionnaire by Guillaume Limal and Martina Lukin, HI, 12 June 2017.

[38] Ibid.

[39] Libya, National report submitted in accordance with paragraph 5 of the annex to Human Rights Council resolution 16/21, 5 May 2015, A/HRC/WG.6/22/LBY/1, p. 15.

[40] United States Department of State, “Country Reports on Human Rights Practices for 2016: Libya,” Washington, DC, March 2017.

[42] HRW, “Libya: Events of 2016,” undated, but January 2017.

[44] Ibid.