As the number of coronavirus cases steadily climbs in Libya, fighting in and around the besieged capital of Tripoli continues to worsen by the day, as the forces of Gen. Khalifa Haftar continues a yearlong offensive against the UN-backed Government of National Accord.
The recent escalation in fighting has dashed hopes that the pandemic might succeed where previous attempts at diplomacy and sanctions had failed.
“We had hoped from the very beginning that the COVID-19 would have resulted in some sort of ceasefire or at least a truce.”
“We had hoped from the very beginning that the COVID-19 would have resulted in some sort of ceasefire or at least a truce,” said Kasper Engborg, the acting head of the United Nations Office for the Coordination of Humanitarian Affairs Libya Office (OCHA).
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“That, unfortunately, has not happened. The fighting has continued, it has even escalated in some areas over the past weeks,” Engborg said. “We still experience heavy shelling that indiscriminately impacts and hits civilian and urban areas where civilians are living,” he continued, citing recent attacks on medical facilities.
Fueled by competing foreign powers, militias, mercenaries and unending proliferation of arms, the latest fighting has become the worst in recent memory for Tripoli residents.
“I remember my mom telling me about a relative of ours who was hit while they were doing barbecue at night,” said Maysem Mabruk, the co-founder of a charity organization called Tripoli Good and a dentist by training.
Mabruk was living in Tripoli until September, when she moved to England to pursue a master’s degree in international development. Like many in the diaspora, she worries about what the tragic combination of the coronavirus and constant shelling will mean for her family and friends back home.
“These incidents aren’t happening in the suburbs of Tripoli or the outside. It’s actually happening downtown,” said Mabruk, who added that the city is now under lockdown due to COVID-19.
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“They don’t feel safe at home. But they don’t have the option to leave because there’s nowhere else to go,” she continued.
A fragile health care system
The coronavirus is also putting new pressures on a health care system already struggling with lack of medical personnel and medical supplies.
“Now in Libya, when you go to the public facilities, you often have to bring the gloves, the antiseptics, because the hospitals don’t have anything.”
“Now in Libya, when you go to the public facilities, you often have to bring the gloves, the antiseptics, because the hospitals don’t have anything,” said Libyan Dr. Mohamed Aburawi, who is currently living in Boston for a fellowship at Harvard University.
Before Libya closed its borders due to the coronavirus, residents who could afford it would typically seek medical treatment abroad. “If you go to the west or east [in Libya], you will see lines of ambulances bumper to bumper looking for health care outside of the country,” Aburawi recalled.
Digital solutions
When Libya recorded its first case of the coronavirus in March, many feared that the hospital system would quickly become overwhelmed, unable to manage a national epidemiological response.
“There was an issue about tracing, keeping track of people, screening, triaging,” said Aburawi, who stays in touch with colleagues in Tripoli.
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That’s when Aburawi received a call from local health officials. “To help them develop a platform that will basically screen and triage patients,” he said.
Aburawi is no stranger to finding digital solutions to Libya’s health care problems. In 2016, he founded Speetar, a mobile telemedicine platform to help address some of the key challenges facing underserved Libyans, especially those who cannot find specialists in local hospitals or afford to go abroad for treatment.
“We use telemedicine to connect physicians abroad who are qualified and have the same kind of cultural background to many of the countries that need their help,” he said.
Last week, Speetar launched a pilot version of an app for the coronavirus in partnership with the Libyan National Center for Disease Control (NCDC), which is leading the country’s response to COVID-19.
Libyans with the access code can log onto the mobile app to fill out a questionnaire about their symptoms and relevant health history.
“The application will automatically classify patients into low risk or high risk,” said Dr. Enas Ali Engab, who works for NCDC’s COVID-19 task force in Tripoli.
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Engab has been training local medical personnel to use the mobile app. “If they are high risk, they will be directed to doctors at the NCDC. Those are experts in dealing with COVID-19 cases,” she continued.
While still in its early stages, the mobile app could help Libyan health officials streamline their response to the virus and improve tracking and tracing of cases — and centralize data.
“We allow these patients once they test positive to go to their phone book and check all the contacts that they came across during the past 14 days, and those contacts will get automatic anonymous messages to tell them they have come in contact with someone who may have tested positive,” Aburawi explained.
Health officials rushing to contain the pandemic hope the mobile app, along with a national hotline dedicated to virus questions, will provide enough transparency to incentivize people to stay away from public spaces.
“COVID-19 is very contagious. It’s transmissible at a very high rate, so we don’t want people to go out of their homes. Because we don’t have the facilities to cover all of these patients.”
“COVID-19 is very contagious. It’s transmissible at a very high rate, so we don’t want people to go out of their homes,” Engab said. “Because we don’t have the facilities to cover all of these patients.”
Still, even the most ambitious mobile app will find it hard to maneuver around Libya’s ongoing civil war, where rival parties have divided the country into east and west, and continue to compete over the oil-rich country’s top institutions and resources.
Nor will it provide much relief for the hundreds of thousands of Libyans who are internally displaced, stranded or detained migrants and residents whose homes are no longer safe due to indiscriminate shellings.
Yet, with no end in sight for Libya’s conflict, Engab sees even more use for telemedicine and other digital solutions.
“Sometimes when there is a conflict or something the streets get blocked, and you might need to go to that hospital or meet with that doctor, but because the streets are blocked you can’t leave your house. Even before the COVID-19 pandemic,” Engab said.
“Telemedicine was required before, but now it is urgently needed,” she added.
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