World Wide Med: Helping Out in Libya

What were some of your memorable cases?

We spent some time at a field hospital near Sirte, where we delivered medications and supplies, and then treated several patients who had been evacuated by the Red Cross from the hospital in Sirte, where fierce fighting was going on. One of them was an elderly man with a chest wound that resulted in a punctured lung; he had a chest tube placed. Another patient was a young girl with a fractured pelvis and shoulder, and the third was a woman who had recently delivered a baby. She had injuries that looked like she had been injured by a bomb blast, and she was paralyzed from the waist down. I helped the nurse wash her and dress her wounds as best as we could before all three were transferred to a larger facility by helicopter. The man with the punctured lung told me that his family had been evacuated 2 days earlier, but that he was unable to leave because of his injury.

What were some of the other challenges of medical care in this situation?

You never knew what was going to happen next. At one of the hospitals, I was assisting with circumcisions that were performed twice a week. Right when one of the boys was being prepared for his circumcision, a young man with a gunshot wound just below his xiphoid was carried into the ER with low blood pressure and rapid heart rate. Soon he was intubated and fluids were poured in; blood seeped from his back into the stretcher. He was ashen and pale. Several times he lost his blood pressure and was given epinephrine, which boosted his blood pressure transiently. He finally got his blood transfusion and was transferred to another hospital by ambulance. I later learned that this young man did not survive.

Also, in the area for displaced persons, many women were reluctant to leave their temporary apartments and would send men to request medications for them. In contrast to other African countries, in Libya the fathers were usually the ones who brought their children for medical care.

How did you find the people of Libya?

During my last few days, I worked with Dr. Muhammad, a Libyan from Tripoli who spends his free time volunteering all over Libya. He showed up one day at the clinic and rolled up his sleeves and worked with me. He was quiet and gentle, with a calm demeanor and without a trace of bitterness about the situation of Libya. He expressed his hopes and desires for his country and for the people of Libya, that they would respect their new-found freedom and the rights of their neighbors, that they would not harbor malice or ill will toward past opposition, and that they would look past all that and work together to build a new Libya.

The people of Libya are very friendly and welcome foreigners with open arms. Theirs had been a closed society and under a long, oppressive regime; they had very little contact with the outside world. Now they are free to express themselves; however, more work needs to be done before the country is completely liberated.

Any advice for doctors who might consider going to a war zone to provide medical care?

Security during an ongoing war can be quite fluid. Pay attention to the shifts in security. Take cues from the local people who seem to know what is going on.

For more information about Medical Teams International, visit https://www.medicalteams.org/sf/Home.aspx.

Some of the responses were excerpted from Dr. Lai’s blog at https://libyakwankew.blogspot.com/.

-- Interview by Heidi Splete

Think globally. Practice locally.

U.S.-trained internists who have practiced abroad will receive a $100 stipend for contributing to this column. For details, visit the World Wide Med column at https://www.internalmedicinenews.com or send an e-mail to imnews@elsevier.com.