Editor’s note: This is the seventh in POMED’s series of short interviews with civic activists, researchers, and others in our MENA network to spotlight the pandemic’s effects on rights and governance across the region. In this Q&A, we are joined by both Anas al-Gomati, founder and director of the Sadeq Institute, the first public policy think tank in Tripoli, and a doctor living in Eastern Libya who wishes to remain anonymous. This interview has been edited for length and clarity.
Background: The COVID-19 pandemic has hit hard in a country mired in years of civil war, with the attendant divided government, violence, destruction, displacement, and institutional and economic dysfunction. To date, Libya has reported 116,064 confirmed cases and 1,802 deaths from COVID-19, but the real numbers are suspected to be much higher.
POMED: Why have the COVID-19 cases in Libya increased rapidly since the summer?
Anas Al-Gomati: For at least three reasons. First, when the conflict shifted from the suburbs of Tripoli to the center of the country, some 200,000 Libyans were internally displaced. Their return home over the past several months certainly contributed to spreading the virus. The second reason relates to broad problems with electricity and water. To obtain fuel for generators and access clean water, many Libyans must travel across cities and stand in crowded lines, activities that spread infection. Third, in Libya’s cash-based economy, people must wait in long lines outside of banks or go to the black market to get local currency, which also spreads the virus.
Doctor: After initial strict lockdown measures, restrictions loosened as economic hardship worsened. The government in Eastern Libya lost control of managing the pandemic and people stopped taking precautions.
It’s important to note that the official case numbers reported by the Ministry of Health (of the government based in Benghazi) are not accurate. As there are not enough PCR tests, especially in the East, any official reported numbers should be multiplied by ten.
How has COVID-19 further strained Libya’s healthcare system? How does healthcare vary across regions?
Al-Gomati: The war has badly hurt the public healthcare system. Among other problems, hospitals and ambulances have been destroyed in targeted airstrikes. The Tripoli government set aside half a billion dinars for COVID-19 relief at the beginning of the pandemic, but by August the Ministry of Health was complaining of severe shortages. Many testing and treatment facilities in urban centers such as Tripoli, Misrata, and Benghazi are badly underfunded and undersupplied.
Doctor: The war has destroyed five hospitals in Benghazi, leaving only two functional public hospitals. Even before this pandemic, scarce medical resources forced doctors to ration care. There is one designated quarantine center that directly deals with COVID-19 cases and has personal protective equipment readily available for staff. Public hospitals are not as well equipped. Many people are choosing to stay at home when they exhibit symptoms and are arriving at the hospital when it is too late to save them or dying at home.
Are you seeing any coordinated efforts to combat the virus among the warring sides?
Al-Gomati: No. Both sides are wary about releasing accurate information on the pandemic for fear of provoking public discontent. We’ve seen protests over the apocalyptic conditions under which Libyans are living due to government failure to meet basic needs. Unfortunately, authorities in Eastern Libya have responded by intensifying the crackdown on public criticism. Doctors have been arrested and the head of the COVID-19 response committee in Benghazi stated that any criticism online or offline—even from Libyans living abroad—would be dealt with aggressively. The irony is that COVID-19 originally served as a distraction from Libya’s political crisis, but now, the virus is driving dissent.
How are doctors coping during the pandemic? And are you seeing coordinated efforts among health institutions across the country?
Doctor: Medical workers have become targets for attacks. People are frustrated when we do not have enough ICU beds, and this can escalate to physical attacks. We also receive threats for listing COVID-19 as the cause of death on death certificates–families do not want people to be discouraged from attending their relatives’ funerals.
There has been some coordination between the health ministries in Tripoli and Benghazi. As Tripoli has more resources, Benghazi usually requests more supplies. Other than the normal bureaucratic slow-down and transportation delays, these efforts have been somewhat successful.
Mariam Mahmoud works with POMED’s Research Program. Anas al-Gomati is the founder and director of the Sadeq Institute in Tripoli. Find him on Twitter @AGomati.