In Libya, fears of rain, clouds, and climate change

Urgent need for mental health care

Official figures have stopped counting at 4,500 dead—but more than 8,000 people remain missing. Meanwhile, the survivors are struggling to cope with their shock and grief. 

"Derna is currently in a terrible state of grief and silence,” said MSF psychologist Asma Amaraa. “People are still in constant mourning."

The first MSF team arrived in Derna three days after the disaster to assess people’s medical and humanitarian needs and donate body bags and other emergency supplies to health authorities.

At the time, the most urgent need identified by our team was to provide psychological support to displaced people who had lost family members, homes, and belongings in the destruction, and had taken refuge in classrooms converted into temporary shelters. The other group they identified as needing support consisted of medical staff and volunteers—some of whom had themselves been bereaved by the floods—who were struggling to cope with exposure to the psychological distress of the survivors. 

Ten days after the disaster, the MSF team started providing general medical consultations at two health centers, one on each side of the destroyed city center, as well as psychological support through individual and group sessions. 

The psychological impact on physical symptoms

To date, MSF doctors have provided medical consultations to more than 4,480 patients (both children and adults) in Derna, the majority for hypertension, upper respiratory tract infections, and stomachaches. Many complained of headaches, chest tightness, shortness of breath, back and stomach pains, and hot flashes.

"We quickly noticed that in many cases, patients were coming with symptoms that were more psychological than physical," said MSF’s Dr. Mohamed Ibrahim Algablawi.

More than 230 patients were referred for mental health support from MSF’s team during primary health consultations, despite the stigma of mental health issues in the community. "In Derna, everyone knows everyone else,” said an MSF psychologist. “Coming to see a psychologist is still often stigmatized.” 

Since the disaster, MSF psychologists have provided mental health support to 1,000 patients. They report that many of their patients show signs of anxiety or violent tendencies; others cry constantly or describe feelings of distress, sadness, and fear. 

Healing and rebuilding begins

"[Our patients] have nightmares, they have the impression that the disaster could happen again, they are afraid of rain, clouds, climate change,” said an MSF psychologist. “They are haunted by the fear that the floods could happen again."

Despite the deep psychological wounds of many residents and the visible scars left in the flood-damaged city, life in Derna is now slowly returning to normal. The temporary shelters for displaced people have gradually been closed, and reconstruction has begun. When schools finally reopened, MSF psychologists also helped teachers cope with this particularly difficult start to the new school year.