Doctors Without Borders/Médecins Sans Frontières (MSF) has worked in detention centers in Libya since 2016, providing basic health care and psychosocial support to detainees. Our teams also run mobile clinics in various neighborhoods across Tripoli, the capital of Libya. MSF launched these activities in response to the humanitarian and medical needs of migrants and refugees in Libya who have fled their home countries in search of safety and a better life. Here, MSF's Libyan staff working in Tripoli talk about their experiences providing care to this community.
Marwa has worked with MSF since June 2016.
What drives me to come to work in the morning is the thought of providing assistance to people. We check what their needs are and how we can respond to them, regardless of whether they are medical, physical, psychological, or emotional needs.
Working with MSF has added a lot to my life: every day I'm exposed to new experiences and every day learn new things that I wouldn't know without this important job.
My work as a nurse is crucial. When our team is running daily mobile clinics, I make sure that the medications we need are available. I also make sure that each patient understands the instructions for how to take their medicine. I explain it in a language they understand, and I answer any questions they have.
My English has improved in the course of this job and I've also picked up new languages, like Tigyrinya [spoken in Eritrea and in northern Ethiopia's Tigray region], so I can convey important messages to our patients.
Dr. Hatem has worked with MSF since June 2018.
The most enjoyable part of my work is the teamwork and the team spirit. Leaving the office every morning to run our mobile clinics in the urban areas of Tripoli, our team rushes to load up the vans with medical supplies and medicines for our patients. It is beautiful to see these collective efforts and feel the harmony among team members working for the sole purpose of providing care.
When we arrive at the location where we set up our mobile clinic, the site of people waiting for us to arrive so they can have a medical check up fills me with happiness and relief.
On several occasions, when they receive their prescriptions, patients have asked me, "Where do I go to get this medicine?" When I direct them to my nurse colleague, who is standing next to me, the person smiles with relief as they don't have to go to a private pharmacy to pay for a medicine they desperately need.
One of the things that motivates me to go to work every day is being able to provide follow-up care for my patients. I work mostly with people who have suffered trauma injuries. I do the stitches for the patient or make a cast for their fractured limbs. Being able to directly witness the improvement in their condition, seeing their wounds heal, seeing them regain the mobility and functionality they had before their injury, seeing their satisfaction - all of this brings me joy.
The person I am today is completely different from the person I was before I joined MSF. I didn't know about the specific needs of the migrants and refugees we see in Libya, or about their living conditions and circumstances.
Now, I can speak about their needs and suffering and encourage others not to have prejudice or treat them unfairly.
It really affected me to learn that the people we meet through work have been forced to leave their homeland, their families, and their loved ones behind for the sake of finding a better life. When you learn what they've been through to achieve this—the risks they experienced on their hard and dangerous journeys to Libya, the ordeals they faced in detention centers, and at sea [trying to reach Europe]—has an impact on you.
Dr. Areej has worked with MSF since September 2017.
What is enjoyable about my work is the ability to provide medical assistance to migrants and refugees who have left their countries and are living far from their families and loved ones to find a dignified life. We are exposed to new people and new stories every day, and we see the direct and positive impact of our assistance when we see patients again and follow-up on their heal conditions.
During my work in the community, I have seen people who could not afford the medicine to treat even a simple headache or to manage their high blood pressure. We started providing care to them, following up closely on their conditions, and started seeing real improvements. People with chest infections that needed further examination are urgently referred to one of our supported clinics and receive treatment if it is tuberculosis.
I had one memorable night at work. It was almost three years ago. One of our patients, who was seven-months pregnant, was being seen by our doctors, as part of the maternal and child heath care we provide. She was a very calm woman from central Africa. She never complained about anything.
That night, I was the doctor on call. I received a call from a detention center saying they had a pregnant woman in a critical condition with abdominal pain. When she arrived at one of our supported clinics, her blood pressure was extremely elevated and her placenta was completely separated from the uterus, so she needed to undergo surgery.
The doctor at the clinic called me apologized that she could not operate on the woman as she did not have the specialist team to do so. She advised me to transfer her to the general hospital. I tried my best to get her admitted to the general hospital, but unfortunately, we have issues getting non-Libyans admitted to these hospitals.
Finally, I decided to accompany the woman myself, so that perhaps I could persuade former colleagues or friends in these hospitals to admit her as a favor. I convinced the medical staff there that this operation was urgent, otherwise the woman might die. I even signed a pledge in which I took full responsibility for her, and eventually they agreed to do the surgery.
Unfortunately, the baby did not make it, but the mother survived. She had an eclamptic fit, which is one of the most serious medical conditions and could have been fatal. She fixed her tired eyes on mine, and with a faint voice she uttered words of complete appreciation to MSF, and me, for our perseverance. This is one night that will always be carved in my memory.
Dr. Alhan has worked with MSF since June 2016.
What I admire about MSF is its principles and values, with which I feel very aligned. I see firsthand that our assistance is meaningful, and that we are genuinely reaching vulnerable people who, without our help, would be unable to access medical care or would have great difficulties accessing it.
I enjoy the fact that I meet different people through this job. I see their medical conditions and listen to their personal stories and convey their suffering, and I like the notion that I can be, in some small way, 'the voice of the voiceless'.
My work with MSF has really changed me. It has increased my self-confidence and taught me to stand up for my values. It has helped me adopt these values and principles not only at work but also in my personal life. This job has also taught me patience and endurance under all types of pressure. With MSF, I have also learned how to become more flexible and resilient due to the experiences we go through every day and the stories we hear on every visit.
I remember in one detention center, there were new arrivals—people who had been sent back to Libya from the treacherous sea journey. They were exhausted, some were traumatized, and they hadn't had food or slept.
Among the travelers was a group of minors, all under the age of 18. A guard stood by and watched as we talked to the migrants and refugees, including the children, to ensure there were no emergencies or patients in critical condition.
I was talking to a 14-year-old boy using my very basic knowledge of French, taking his name and personal information, when he interrupted to ask me, "Doctor, what are you planning to do with these children? They are only small children, how could they be traveling at sea, alone?" I did not know the answer to this question, but reassured the guard that we would do what we could for them, including referring them to specialist organizations that could help them. The guard impatiently asked me, "But what can I do for them?" I urged him not to put the children in the same place as the adults, and to let them out to breathe the fresh air and see the light of day.
The group of children that we referred to other organizations were voluntarily repatriated to their home countries. Surprisingly, the boy found me on Facebook and wrote, "Dr. Alhan, I am the boy you helped in the detention center with that guard." He assured me that he was safe and well, that he had restarted his education and that he was also working to help his father financially. I was very happy to learn that this brave boy was safely back at home and I was proud of myself for being able to help a person who was experiencing very dark days.
Alaa, Humanitarian Affairs Assistant
Alaa has worked with MSF since March 2021.
I think that my role as member of the humanitarian affairs department and as part of the mobile clinics team is an important one. I believe any medical entity or doctor in Libya would need the supporting role of humanitarian affairs to carry out their work effectively.
There have been times during the course of our work when people have refused the medical care we offer because they had humanitarian needs that, to them, were of a higher priority. Our work as humanitarian affairs officers is to drive positive changes in the overall situation of vulnerable migrants and refugees, especially those living in bad conditions. Without our support, the vulnerable people we meet would only receive medical care, without any concrete solution to their situation and without addressing their other humanitarian needs.
Working with MSF here in Tripoli, I’ve developed a different perspective on migrants and refugees. I’ve entered their world and their lives and gained a real understanding of their living conditions and their stories. I’ve become more empathetic towards them and the vulnerable people I see in the streets. Through this job, I have started to appreciate my life more, and to be content with what I have – as many of these people go without even the most basic and simple things I have. This work has really made a mark on my life.
Dr. Zaenab has worked with MSF since February 2021.
A man arrived at one of the detention centers in Tripoli one day. It seems he had become separated from his 10-year-old daughter. He kept asking where she was. He’d heard nothing of her since the day he arrived at the detention center. He didn’t know where she had ended up—was she in another detention center or somewhere else?
By sheer chance, my colleague heard the story and the name and description of his daughter, and realized that the girl was in the very same detention center as her father. She had been living in the same place as her father for over a month, yet neither one knew that the other was there.
Our team talked to the guards and explained the situation and we were able to arrange for them to meet. The reunion was heartbreaking to watch. It is a situation I will never forget.
Bahja, Mental Heatlh Counselor
Bahja has worked with MSF since February 2017.
Before joining MSF, I was a university lecturer and a professor of psychology, philosophy, and social services in Libya. I first worked with MSF in a mental health clinic. The patients were Libyans and other nationalities from the local community, including migrants and refugees. This was the first mental health project of its kind in Tripoli and it had a significant role in changing people’s perceptions of mental health.
I have always been fond of volunteering and humanitarian work, and MSF embodied both. My work here has changed me for the better and shaped my personality and character. I have learnt to be patient and to work under pressure and endure the difficult situations we go through. I have started taking initiative and I have become more courageous.
I am passionate about my work, especially the kind of work where you can directly see the impact. As a member of MSF’s mobile clinic team, I conduct regular psychosocial support sessions. When I see patients doing well on a psychological level and adopting a more balanced approach towards life, this is where my happiness lies.