How to provide rehabilitation care to cases presenting complications
Reem Mansour is a physiotherapist working for HI in Tripoli. She explains the importance of rehabilitation in post-war Libya.
In Tripoli, the HI team provides rehabilitation services to an amputee | © HI
Libya has been torn apart by a civil war that lasted from 2014 to 2020. In some places, the violence is ongoing. Rehabilitation needs are huge
“Since April 2021, HI has been providing rehabilitation services in three medical centres in the centre of Tripoli, including one rehabilitation centre. The rehabilitation teams are made up of one physiotherapist and three psychosocial workers and they see an average of 20 patients a week. Some of these patients are referred to them by other organisations, like the International Committee of the Red Cross or Médecins Sans Frontières. HI has been working in this sector in Tripoli since the end of 2016.
Services for the most vulnerable
As part of our intervention in Tripoli, we provide rehabilitation care to people injured in the war or in other forms of violence. They may be direct victims of the fighting - suffering from bullet wounds, for example, – or have fallen victim to explosive hazards. Other patients include people with fractures resulting from domestic or road accidents, people with chronic diseases like diabetes or people living with a disability (spinal bifida).
We support many vulnerable people who are on the move, such as internally displaced families, migrants and asylum seekers.
We have an efficient system in place with the ICRC for the supply of prostheses and orthoses: we provide all the technical information and measurements and they make the devices we need.
We recently had a case of a pregnant woman who was a migrant and had been badly burnt in a fire on a boat. As a result, she had difficulties moving. She was provided with a walking frame to support her mobility.
Many of the people seen at centre have come a long way. One family travelled 150 km from their hometown to Tripoli. We also treat a lot of people from the rural areas surrounding the capital.
Many people with complications
Sometimes, because of delays between the occurrence of an injury and the injured person’s arrival at one of our medical centres, we see many cases presenting complications. A bullet wound, for example, if not treated rapidly, can lead to infection or permanent disability.
Delays are usually due to a lack of information about services, and sometimes to the victims’ economic situation (transport costs, for instance).
HI has created a map of the medical facilities existing in the three regions and disseminated information on these facilities and the services we provide. Referrals between service providers are not always easy in Libya as organisations and institutions are widely dispersed.
Private facilities offering physical rehabilitation services are expensive and so inaccessible to Libya’s most vulnerable populations. Some beneficiaries report discrimination and safety concerns with referrals to public health facilities; they prefer the protective and accessible environment provided by HI's direct intervention.
Many people in Libya do not know what rehabilitation is and why it is so important, which is why we see so many people with complications. To address this problem, HI is raising awareness among the country’s vulnerable populations on why rehabilitation care is so essential.
The number of rehabilitation sessions and the duration of care varies according to each person’s needs. We often provide follow up by phone, as people can live a long way from the centres and not be reachable by our teams. Ongoing Covid-19 restrictions can also make it difficult for beneficiaries to access services (coming to a medical centre, for instance), but also for HI’s teams to make home visits, depending on the rules in place at any given time.
Thanks to our donor
HI would like to express its warmest thanks to ECHO for supporting its rehabilitation project in Tripoli, Benghazi and Misrata and making the provision of rehabilitation services accessible to the most vulnerable in Libya.