The unsafe and complex journeys undertaken by migrants reaching Libya and beyond, expose them, as well as host communities, to multiple health risks which are augmented when migrants are detained, while intercepted/rescued at sea or captured from communities. Continuous and prolonged challenges in Libya have left the health system fragmented and ineffective, lacking the ability to respond to the health needs of the population, especially migrants, internally displaced persons (IDPs) and returnees. Since the start of the COVID-19 pandemic in Libya from March 2020, migrants have been further challenged in accessing both basic and critical services from a health system that has been further weakened by the exponential spread of the virus. 72 per cent of surveyed migrants have limited or no access to health care. Migrants have also reported increased discrimination and stigmatization from staff at health care facilities, which has heightened during the COVID-19 pandemic.
According to surveys from the Libya Humanitarian Needs Overview for 2021, 54 per cent of Libyan returnees have challenges accessing health services, followed by 52 per cent of displaced Libyan households and 50 per cent of surveyed Libyans. Many public health care facilities are closed and those that are open lack medicines, supplies and equipment. Many facilities have been directly attacked or damaged due to fighting and those that remain functional are overburdened or not maintained. Access to health, education and other public services are further restricted for people who have lost legal identity documents, or for those who do not have them, such as migrants and refugees.
The IOM Migrant Health programme provides health services to migrants and IDPs through regular visits to priority locations by mobile health teams. In addition to providing primary health care services and referrals to access lifesaving interventions and specialized care in hospitals, IOM offers health services to migrants in detention centres, at disembarkation points and in urban settings. IOM also conducts pre-departure medical screening for the resettlement of refugees and for migrants returning to their country of origin through the Voluntary Humanitarian Return (VHR) programme.
Health support is part of IOM’s Humanitarian Mandate before, during and after crisis. IOM’s health interventions aim to increase access to primary health care services and support health systems to recover from longstanding insecurity while responding to the ongoing COVID-19 crisis. In doing so, IOM promotes migrant inclusion to health systems and advocates for basic human rights to health, to ensure that no one is left behind.
Areas of Intervention
- Medical Consultation
Medical teams provide comprehensive primary health care consultations to migrants and host community members in need. The consultations include health check, health education and screening of critical needs outside of health, which may require referral, such as for protection and nutritional support. IOM also provides a comprehensive health check and medical escorts for migrants undertaking a voluntary return to their country of origin, offering medical support for any underlying illnesses and ensuring they are fit to travel.
- Mobile Health Teams
Affordability and safety of access are the main barriers to accessing health services for migrants, with more people impacted by rising costs of medicine and a higher incidence of social discrimination by authorities and host community members. Migrants’ fear of being reported or detained by authorities has been compounded by increased discrimination against migrants since the onset of the COVID-19 pandemic. By deploying mobile clinics in the cities hosting high concentrations of migrants, IDPs, and returnees, IOM medical teams expand primary health care delivery and can reach vulnerable populations in underserved and difficult to access areas.
- Interception/Rescue at Sea
When migrants are intercepted/rescued at sea and transferred to land, IOM medical teams go to disembarkation points and screen for critical health needs, conduct triage, provide critical health care onsite (such as for minor trauma) or refer migrants to secondary health facilities where needed.
- Lifesaving Referral
IOM provides referrals for life-saving, disability-saving and public health threatening cases, taking into accessibility and affordability of required health interventions/medical assistances for migrants. Referrals are made to pre-qualified public or private secondary and tertiary health facilities. IOM medical teams identify cases which need either further testing, medical investigations for a diagnosis such as tuberculosis and specialized or urgent medical operations. IOM then secures the patient’s transfer to the nearest health clinic for the necessary medical services and makes sure they happen in a timely manner.
- Public Health Risk Management
IOM conducts health assessments that include surveys on event-based syndromic surveillance. Assessments are conducted at migrant community settings, detention centres and points of entry.
IOM also conducts health awareness, promotion and disease prevention activities to manage disease outbreak and to increase migrant and authorities’ understanding of migrants’ health needs and how to respond to them.
IOM also coordinates with national health partners to build capacity in disease outbreak management. This support includes placement of technical specialists with authorities, training or provision of equipment to enhance service provision.
- Health System Support
IOM assists and strengthens Libya’s health system enabling it to deliver migrant inclusive health services that are accessible and affordable for migrants and vulnerable populations. This includes working with Libyan authorities and reaching communities to provide information on COVID-19 prevention, response measures and vaccines, supporting installation and rehabilitation of health infrastructure, contributing data and analysis on migrant and refugee populations to inform vaccine outreach, training authorities on migrants-specific health needs and vulnerabilities and COVID-19 vaccination implementation, and providing mobile ambulances, medical equipment and supplies to authorities.
- Partners and Locations
Together with local Libyan partners and in close coordination with the Ministry of Health, IOM Libya has established medical teams in different areas across the country, including mobile clinics. Medical teams cover over 20 areas with project sites in 19 mantikas, including migrant-dense municipalities in Al Jabal Al Gharbi, Al Jafara, Al Kufra, Azzawya, Bani Waleed, Benghazi, Ejdabia, Misrata, Murzuq Qatroun, Sabha, Tripoli, Ubari and Zwara.