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Violent clashes in Libya in early 2011 forced hundreds of thousands of people to leave the country, many across the Tunisian border. Doctors Without Borders/Médecins Sans Frontières (MSF) staff in Ras Ajdir, a small coastal town on the border, were blocked from crossing into Libya to assist the victims of the conflict, and witnessed thousands of people arriving in Tunisia in search of safety.
Assisting Libyan refugees
Health centers in towns and villages bordering Libya were under enormous pressure. In the town of Dehiba, just a few kilometres from the border, MSF set up a stabilization centre, caring for people who had been injured in the conflict. The team treated nearly 60 emergency patients in March and April. Other teams set up mobile clinics in Dehiba, Remada and Tataouine, offering medical care as well as psychological support to refugees.
Healthcare for third-country nationals
In late February, the health authorities and local non-governmental organizations were able to cover most of the people’s medical needs. MSF identified a gap in mental healthcare, and a team began offering mental health services in Shousha refugee camp, close to Ras Ajdir, in March, later extending assistance to people staying in two other transit camps in the area.
By June, more than 600,000 migrants, refugees and asylum seekers had left Libya, and although many were rapidly repatriated to their country of origin, thousands remained stranded in Egypt, Italy, Niger or Tunisia, with great uncertainty for their future. For many, this stress, added to the traumatic experiences they had been through or witnessed while fleeing the conflict in Libya, and the persecution and ill-treatment some of them had survived prior to the conflict, was too much.
In Shousha, the largest camp, some 4,000 people, mainly sub-Saharan Africans, had still not been repatriated, months after arriving, mainly because of dangerous situations in their countries of origin. Poor living conditions in the camp, inadequate for a long-term stay, and growing security issues, led to violent clashes in May. MSF expanded its activities, to provide medical care, and distribute food, water and relief items, as well as offer mental healthcare.
The violence exacerbated feelings of despair among people living in the camp. Some refugees chose to risk their lives by attempting to cross the Mediterranean Sea, in the hope of finding a better reception in Europe. MSF called on the countries engaged in the war to better receive, assist and protect its victims. In From a Rock to a Hard Place: The Neglected Victims of the Conflict in Libya, MSF reminded all warring parties and neighboring countries of their responsibility, under international law, to keep their borders open and offer protection to those fleeing Libya.
Handover of activities
By August, the majority of Libyan refugees had returned home, and MSF began to scale down activities, stopping them completely in September. Thousands of third-country nationals remained stranded in Shousha, but there were enough organizations working in the camp to cover medical needs. MSF therefore handed its activities over to these organisations.
Between March and September, staff carried out 10,500 medical consultations and 21,000 mental health consultations. Before leaving, medical supplies and equipment were donated to health facilities in the towns of Tataouine and Medenine.
Medical evacuation by boat
In April, the Libyan city of Misrata was the scene of heavy fighting: residents were cut off from external assistance and hospitals and clinics were overwhelmed with casualties. MSF carried out two medical evacuations from Misrata to Tunisia. A team removed 135 patients by boat, with medical staff providing urgent assistance on board. Upon arrival, the Tunisian health authorities and the Tunisian Red Crescent transferred the patients to medical facilities in Sfax and Zarzis, and on the island of Djerba.
At the end of 2011, MSF had 6 staff in Tunisia. MSF started working in the country in 2011.