I am still in Tatouine at the hospital-I arrived three days ago, but it feels like a week. I have been following a small group of Libyan doctors who have volunteered to come and work in the hospital dealing specifically with Libyan wounded fighters (from both sides) and civilians. The injuries are pretty dreadful. I have been able to spend part of the day working medically and part filming.
My film characters include a London based Libyan called Nader- who is a structural engineer by trade. He co-created World For Libya originally having nothing more than a laptop and three friends with a common idea to help the people of Libya during the conflict. They now have offices in London and Tatouine and are planning a shift to Tripoli as soon as it is deemed safe to do so and when the need for their work here in Tatouine has ceased.
Another contributor is Dr Emad- a medical doctor who has now taken the role of senior doctor in the Libyan wing of this Tunisian hospital. He is from Tripoli and arrived in Tatouine two weeks ago to help after seeing reports on TV that the care of injured Libyans crossing the border was pretty chaotic. At the time of leaving Tripoli things were pretty quiet. Now he is torn. Should he stay at Tatouine hospital-were he is struggling against a flood of patients in need of care and his management skills for their safe transfer to specialities or should he return to help in Tripoli.
I was keen to move across the border as soon as possible with the team-who had thought they would be moving over before the end of Ramadhan-but yet again the plan has had to go on hold due to the influx of very sick and wounded patients. They are not able to leave the care of these patients to the Tunisian doctors or nurses-one reason being that the Tunisians are already over-stretched. Additionally there is of course inexperience in dealing with the kinds of injuries patients are presenting with. It just makes sense that Libyan doctors are on hand to support such patients.
The days are immensely long-starting at 10am and finishing sometimes at 3 am. The team have processed 250 patients in the last two weeks. Since I have been here they have received, treated and evacuated up to 60 patients, to further care. The work is being done by a team of 4 doctors (me being one of them) 4 drivers and one administrator. There is sporadic help from the Tunisian nursing staff-but there have been moments of tension. Anxious, tired and worried relatives confronting tired and over-stretched, under-resourced inexperienced staff. Despite this there is always the best interest of the patient at heart.
The injuries are pretty much awful. Gunshot wounds, road traffic accident injuries and amputations. The RTA’s are down to a tactic being used by Gaddafi forces of shooting at the wheels of cars speeding away, often filled with fighters but not always.
Yesterday I interviewed a 16 year old girl with a below the knee amputation after being hit by a 14.5 calibre anti-aircraft round by Gaddafi forces in Zawiya. Today I interviewed and filmed a 12 year old boy with a full leg amputation following an attack using the same kind of round. He was not able to say who had fired on him and his family as they stopped at a petrol station. They live in Tripoli, but were heading for Sabbah in the South at the time of the attack. This time however his family are pro-Gaddafi supporters. He had arrived from Gharian (where he had the operation) alone. His family did not accompany him because they feared coming into an area where there are a large number of anti-Gaddafi fighters. Nader had spoken to the mother via phone-and she had asked him what side he was on-he answered that he was on the side of the patient. The young boy-who was quite frightened became attached to Nader. He asked ‘Dr Nader’ if he would visit him in Tunis, which is where he was being sent to.
There was also a pro-Gaddafi injured fighter also today on the ward-and both of these patients were evacuated together, separately from the wounded opposition fighters being evacuated at the same time. It had to be done that way. Sensitivities obviously run very high and the core element is the safety of patients, whoever they are.
The difficulties incurred in patient evacuation revolve around a lack of ambulances and trained staff to care for the patient on evacuation. The crews with their patients travel huge distances with very sick people. The ambulance from London, brought over by Nader’s team, is only supposed to take 2 patients. I have seen it ‘packed’ with four patients. Two on stretchers, one on the floor and one on a seat at the back. The 7 hour journey to Tunis will is always hideous.
Interestingly enough-some of the injured-including a 16 year old girl-had come out of their homes believing it was safe. Sannae’s father said he had been watching Al Jazeera to follow the security situation and on being satisfied by the reports that it was secure, he took his family out in the car to get to the family farm. He had been looking for the right opportunity to drive away to further safety. They were then hit by small pockets of Gaddafi fighters and snipers. I just wonder how many more cases of this we will come up across. Sannae is the only child to her parents. They looked shattered, confused and still in shock with what had befallen them. Their daughter has lost her lower left leg and is now having to adjust to a life that will always carry the scar of this war. Freedom is such an expensive commodity, and one not to be taken lightly. People are paying for it with their blood out here.