Addressing mental health after deadly floods in Libya

An interview with MSF Head of Emergency Michel Olivier Lacharité on the situation in Derna after floods left by Storm Daniel.

Rubble of buildings destroyed by flooding in Derna, where MSF is providing mental health support to survivors.

Libya 2023 © Ricardo Garcia Vilanova

Two weeks after Storm Daniel caused devastating floods in Libya that engulfed Derna and killed thousands, search and rescue operations are about to end and the reconstruction process is underway. The need for psychological relief is immense among Derna’s people. Doctors Without Borders/Médecins Sans Frontières (MSF) has begun medical activities, focusing on mental health support for people who lost everything, as well as for medical staff and volunteers. Michel Olivier Lacharité, MSF’s head of emergency, explains from Derna.  

How is the overall situation in Derna, two weeks after Storm Daniel?

We can still see that the population is profoundly affected by that disaster. Many people have lost their houses or family members—often both. Clearly, almost everyone in the city is mourning and in pain at the moment. For two weeks, teams worked to retrieve of bodies under the rubble, while some bodies are still being recovered at sea. According to the search and rescue teams, the water’s current will continue to wash up more corpses in the coming weeks. 

When we arrived in Derna, what was most striking was the scale of the destruction. We talk about flooding, it's true, but it's really the destruction of the two dams that occurred while everyone was sleeping, which destroyed the center of the city and swept everything and everyone away within a few hours. As a consequence of the massive flooding, there were relatively few people with wounds or trauma, but sadly, a high number of deceased. 

Now the authorities are focusing on rebuilding a bridge between the eastern and western part of Derna, as the city has been literally split in two. Their main priority, health-wise, is to make sure that everyone who is traumatized or lost everything due to the floods can now receive mental health support.  

A damaged bridge with water flowing through in Derna, where MSF is providing mental health care.

What is it like in hospitals in Derna right now?  

There has been only a limited increase in the number of patients related to the disaster itself. The hospital system is coping well despite the situation. Field hospitals were set up by foreign governments and operational a few days after the storm.  

Primary health care structures have been particularly impacted by the disaster. Some centers have been destroyed by the floods, and many medical and paramedical staff have either died in the flooding or are now mourning relatives or colleagues among the victims. Some primary health care centers are being supported by volunteers who came from all over Libya to help.  

Two weeks in, we can see that a lot of health personnel are still missing or in the process of mourning, and the volunteers who came to help in the first days are starting to leave. 

What is MSF’s role in the flood response? 

MSF started supporting two primary health care centers on September 20. To date, our doctors have already conducted 537 consultations in Embokh and Salem Sassi primary health care centers, and the Oum Al Qura school shelter. The consultations were mainly for non-communicable diseases (such as diabetes and hypertension) for adults and respiratory infections and diarrhea for children. Many patients seen by our doctors were still in shock, and some showed signs of psychological trauma. Some children would refuse to drink water for fear of drowning. Patients complained of flashbacks, of being unable to sleep between 2:30 a.m. to 5 a.m—the precise time the deadly wave engulfed the city in the dark of night on September 10. 

MSF prepares for medical response in Derna, Libya

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How is MSF treating these invisible wounds?

Our team of psychologists are providing mental health care to people who have lost everything and are now living in temporary shelters as well as medical and paramedical staff and volunteers. People working in health care facilities have sometimes also lost relatives, colleagues, and friends, and on top of that, they are working on the frontlines, providing care to survivors or even helping to evacuate dead bodies, which can be a traumatic experience for volunteers.  

In that context, we have been putting all our efforts toward our mental health activities, including individual consultations and focus groups in shelters and in the two primary health care centers that we support. We are planning to scale up our activities to offer mental health support to anyone who needs it. 

What are the challenges MSF teams are facing in Derna?   

While MSF staff were able to arrive in Derna only three days after the disaster—flying from western Libya, where MSF runs regular projects—our action deployment remains limited by the issuance of visas for international staff, which can sometimes be a long process and could limit our capacity to scale up our activities. However, our collaboration with the authorities and with locally hired teams has been very good. We'll see in the coming days how the structures are going to be organized and review our setup according to the needs and our added value.