Thinking Aloud: “Caring for the Most Vulnerable Populations”

June 25, 2015 by Darius 

Today I attended the Middle East Institute’s conference “Cut Off from Care: The Health Crisis of Populations Displaced by Conflict.”

Laila Bugaighis is the founder of the Benghazi Medical Center and one of the panelists discussing “Caring for the Most Vulnerable Populations.”  She gave a picture of the medical situation right now in Libya.

In Benghazi, there was one obstetric hospital serving a city of more than 1 million people.  This hospital was heavily bombarded and effectively destroyed last October, closing for the first time since 1918.  The Benghazi Medical Center was founded in response to the closing of this hospital, but it remains perpetually under-resourced and understaffed.  Armed forces in Libya have not respected the health care system.  Doctors, nurses, and midwives have all been the targets of attacks, and there are at least two instances Bugaighis was aware of in which armed groups entered hospitals and killed enemies, in one case while he was on the operating table.  Libya is dealing with 400,000 displaced persons, including 27,000 refugees.  There is no national ambulance system, and rural areas are almost entirely cut off from the health care network.

Inka Weissbecker of the International Medical Corps discussed an issue that is often overlooked: mental health.  According to Weissbecker, in any country at any given time, 10-15% of the population suffers from mental health problems.  In a conflict zone, like Syria, that percentage can double or more in response to widespread trauma.

Weissbecker warned that mental health care for Syrian refugees is woefully inadequate.  There is very limited access to and availability of mental health services in countries neighboring Syria.  In Jordan, for instance, where the government provides subsidized health care to refugees, mental health is not included.  In Turkey, the problems are often compounded by language barriers.  Moreover, most general care providers are not trained in even the most rudimentary of mental health care issues.

However, according to Rabih El Chammay of Lebanon’s Ministry of Health, it is not impossible to create a good mental health care system in the face of a crisis.  In fact, over the last several years, Lebanon has managed just such a feat.  According to El Chammay, many types of mental health care have now been incorporated in Lebanon’s national health care system.  Not bad for a country with refugees comprising a third of its population.

Both Weissbecker and El Chammay mentioned the cultural taboos on acknowledging mental health problems, and all panelists referenced the difficulty of treating a population in flux, as patients are displaced from A to B and then forced to flee B to C.  Unfortunately, the international community’s response to a rolling disaster, like Syria, is far lower than it is to a natural disaster, like Nepal.



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