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International Medical Corps Libya, Egypt & Tunisia SitRep 67 External June 27, 2011 Introduction In addition to providing care for casualties of the conflict at the Dafniya field hospital, International Medical Corps is also providing training to Emergency Medic Students. Overall, the situation on the western front, outside of Misurata, has been quieter since last Wednesday when NATO began to target Gaddafi positions. In the past few days, the Dafniya forward aid station and field hospital have received fewer casualties from the front-lines. Shelling continues on a daily basis on all fronts, with artillery and Grad missiles forming the majority of attacks on the western front. Yesterday, a number of casualties were received at the field hospital as the result of a “Hound” launcher being utilized by anti government forces, which exploded as it was operated. This resulted in approximately six casualties and one death. The Dafniya field hospital received a total of 21 patients throughout the day. Today, there have been much fewer casualties on the western front, with just two patients attending the field hospital for treatment. Late this afternoon, a number of rockets were heard impacting close to the aid station. No injuries were received, but as these rockets were fired from the Southern front and not the Western front, this situation will be closely monitored. Power in Misurata is now back up and running, after some disruption to supplies last week caused by the city power generators being changed over from fuel to gas turbines. On Sunday, rebel fighters and Gaddafi forces battled over control of Bir al-Ghanem, approximately 35 km north of Yefren and only about 70km south of the capital. According to the rebels, they launched a surprise attack at dawn on the Gaddafi battalions stationed in the region of Bir alGhanem, and were able to advance to the outskirts of the town. In addition to using heavy ship missiles and launchers in defense of the town, there are unconfirmed reports that Gaddafi forces used the town’s residents as human shields. Following heavy fighting, it is reported that three rebels were killed and three were injured in the attack. Rebel forces now report that they are on the southern and western outskirts of Bir al-Ghanem. In addition to this offensive against Bir Al Ghanem, there are reports of the rebels preparing to attack Al-Ghazaya shortly and also reports of an anticipated battle outside of Zintan. A large number of Gaddafi forces are also reported to have arrived in Al Khmasyah, 90km south of Nalut, indicating that an imminent attack on Nalut is possible. As of June 27, 2011: LIBYA/TUNISIA BORDER AREA On June 26, a total of 5,438 people entered Tunisia via the Ra’s Ajdir and Dehibat borders. According to IOM, 1,095 Third Country Nationals who are residing in the Shousha, Al Hayat and UAE camps, await repatriation assistance. Yesterday, a total of 3,794 refugees were residing in the Ra’s Ajdir camp, while 1,588 were staying at the camps at the Dehibat border (778 at the Remada, and 810 at the UAE camp). These numbers have remained largely unchanged over the past week. International Medical Corps continues to provide services at the health posts in Ra’s Ajdir, Dehibat and the Shousha camp. It has identified that a vehicle is needed to transport referrals from the health posts in Ra’s Ajdir referrals to the Ben Gardane hospital and International Medical Corps is planning to respond to this need. Today, the International Medical Corps team at the Dehibat health post provided consultations to 41 patients, including eight children. Conditions treated included diabetes, hypertension, respiratory tract infections and intestinal worms. The team also stabilized four war-wounded from the Western Mountains (2 from Yefren, 1 from Jadu, and 1 from Zintan). Once stabilized, these patients were referred on to the hospital in Tataouine. WESTERN LIBYA International Medical Corps surgical teams continue to provide support to three health facilities in the Western Mountains region. In addition, supplies are currently being sourced to provide needed items to Yefren. In Misurata, International Medical Corps is continuing to support the Al Hikma, Al Hilal, and Rustoba Hospitals, with medical teams performing 18 operations and 112 consultations for the time period June 24 to June 26. To strengthen local capacity to provide life-saving care, International Medical Corps commenced Emergency Medic Training in Misurata on June 21. The training is attended on a daily basis by more than 50 participants, mostly senior medical students, with course components covered have thus far including basic life support, advanced cardiac support, patient assessment, and head trauma. At the same time, clinical rotations for students are being undertaken at the Dafniya field hospital to develop practical experience. By the end of the four-week course, trainees will be deployed to the front-lines, to staff ambulances, aid stations, and receiving hospitals. The overall aim of the training is to strengthen emergency medical and trauma care thereby reducing patient morbidity and mortality in acute situations. International Medical Corps’ Field Hospital in Dafniya has now been open for nine days and has seen a wide range of casualties, including gunshot wounds, blast injuries, shrapnel injuries, major fractures and head trauma injuries from the front lines. As of June 26, a total of 167 patients have been provided with care at the hospital. International Medical Corps is working on increasing the capacity of the field hospital, and will rotate in an additional eight nurses to Misurata to assist the field hospital from Benghazi. Current needs include medical equipment, as well as a full-time surgeon. EASTERN LIBYA Since the outbreak of the crisis, International Medical Corps has provided more than 40 nurses to eastern Libya, and is deploying an additional 15 nurses to Benghazi on June 27. As eight nurses from Benghazi will be leaving for Misurata shortly, International Medical Corps will assure nursing coverage in Benghazi Medical Centre until the new nurses arrive. Following the commencement of International Medical Corps’ Mobile Health Team (MHT) to Al Marj last week, MHTs have now started services in Ajdabiya and surrounding areas to also provide primary health care support in these needed areas. According to a schedule arranged in coordination with the health committee in Ajdabiya, services conducted by International Medical Corps will include two regular visits to Boshala polyclinic in Ajdabiya per week and a visit every ten days to surrounding areas including Soltan, Zwitina and Albydan. Each MHT includes two pediatricians, a general internist, an OB-GYN specialist, a nurse and a volunteer medical student to assist with patient registration, vital signs, and nutritional screening. The two pediatricians will comprise of a “junior” and a “senior” pediatrician, so that field visits will develop skills and experience of more junior pediatricians in outpatient primary care. International Medical Corps’ mobile health teams for eastern Libya have been provided with training on psychological first aid, gender-based violence guiding principles as well as clinical management of rape. By receiving this training, the mobile medical teams will better be able to provide support to those affected by the conflict, including cases of sexual assault. From June 21-26, International Medical Corps conducted an additional psychological first aid training course for medical staff at the Benghazi Medical Centre. An additional 46 people, including doctors, interns, medical students, nurses, pharmacists, an anesthetist and a dentist, were provided with this training. International Medical Corps is continuing to provide psychosocial first aid trainings to frontline health workers to strengthen their ability to provide support to those affected by the conflict. International Medical Corps is endeavoring to procure ARV drugs to meet the needs at the Benghazi Center for Immunology and Infectious Diseases where 426 children infected by HIV (iatrogenic infections) ten years ago are being treated. International Medical Corps is endeavoring to provide a short term supply of these needed medications to meet the interim needs until a longer term source can be found. In eastern Libya, International Medical Corps is also moving forward with plans to establish a rehabilitation program and is undertaking assessments to identify needs. Rabih Torbay VP, International Operations [email protected] Hakan Bilgin Country Director - Libya [email protected] Robert Lankenau Team Leader - Tunisia [email protected]