Belaid is a 38-year-old sociologist and assistant lecturer at Al-Kufra University. He is volunteering with the Libyan Red Crescent Society and joined the PUI community health team to contribute to promoting the COVID-19 vaccination campaign. Along with 22 other Community mobilizers, he was trained to play a crucial role in his community tackling misinformation and misconception about Covid-19 and vaccines.
He was also trained on how sharing information in line with the World Health Organization (WHO) and the Government guidelines can build trust among the community, to boost vaccine uptake and buy-in. He says: “Too much conflicting information on vaccines, misinformation, and disinformation negatively impacted people’s attitudes, beliefs, knowledge, and intention to accept vaccination. Thus, we were continually briefed on the misinformation, disinformation, and rumors around Covid-19 vaccines and how to build and maintain trust.”
Adopting a community-centered approach, PUI Community Mobilizers visited remote areas and hard-to-reach households, shops, gas stations, public spaces, and primary healthcare facilities up to Tazirbu and Rebyana, 400 KM far away from the main city of Al-Jawf. Through groups and door-to-door awareness sessions, they were answering questions, doubts, and fears around Covid-19 vaccines, and distributing information and education materials.
Messages on the importance, safety, and effectiveness of the vaccines helped patients to make informed decisions about getting the vaccine, particularly for the most vulnerable ones, at high risk of developing serious symptoms. Kadisha, one of PUI Community Mobilizers recalls:” I’m personally not able to forget this elderly man, who visited the primary healthcare facility where we were deployed. He was, seeking medical assistance for his chronic respiratory disease and when I asked whether he was vaccinated against Covid-19, he told me he was not yet. I explained to him that vaccination, combined with hand hygiene and other protective measures, is a critical intervention to protect from severe illness and reduce intensive care admissions numbers. I was thrilled when he decided to take the vaccine and the boosts.”
Moreover, throughout the ongoing Covid-19 immunization campaign, alongside community awareness-raising sessions, an evidence-based advocacy campaign was launched on Al-Kufra local radio station, one of the main trusted local communication channels. The PUI team has worked closely with Al-Kufra Department of Health Services, the National Centre for Diseases Control, and local government representatives to promote positive messages around Covid-19 vaccines and to garner support for vaccinators and healthcare providers. Through live radio sessions and tailored messages, the demand for the vaccine increased. In fact, it was recorded that 72% of the overall visitors of the vaccination centers seek the Covid-19 vaccine as a result of the community outreach and communication campaign strategy.
With the generous contribution of the European Union, Swiss Confederation, and Italian Cooperation, since 2019 PUI has supported more than seven healthcare facilities across Al-Kufra region and continues to provide support to the Department of Health Services in promoting equal access to quality healthcare services for Libyans, refugees, and migrants.
When the response to the Covid-19 pandemic became overwhelming to Al Kufra local authorities, doctors, and nurses, Première Urgence Internationale medical team rushed to the rescue. Al Kufra is a forsaken region in South-East Libya, isolated and marginalized. The area suffers from severe shortages of medical equipment and specialized staff. With the financial support of the European Union and The Swiss Confederation, Première Urgence Internationale (PUI), promoted the local community’s access to the Covid-19 vaccines through technical and logistical support.
Suhail Al’Aneizi – 35 years old – is a medical doctor who had just started working with PUI when the activities to promote the national vaccination campaign and safe access to Covid-19 vaccines were launched in Al Kufra district. Along with his colleagues, in July 2021, Suhail was deployed to Al Kufra, in deserted and hard-to-reach areas located 1150 km from Benghazi city. He joined PUI medical team to support the work of the Department of Health Services in the roll-out of the Covid-19 national immunization campaign notably across neglected and isolated areas of Al Tullab, Al Kufra Al Jadidah, Al Shura, Al Jawf, Al Hweiwiri, Rebyana, and Tazirbu.
He explains:” With the significant increase of serious covid-19 cases and the launching of the Covid-19 vaccination campaign, the health care units in Al Kufra having limited capacities were struggling with the roll-out of the campaign in the region.”
PUI medical team, adopted an inclusive approach, to reach all Libyan and non-Libyan communities. Through regular capacity building and on-site supervision, PUI medical team enhanced the technical capacities of more than 90 Covid-19 vaccination personnel, supporting the capacities of the Department of Health Services and National Centre for Diseases Control during their journey to the successful rollout of the Covid-19 national vaccination campaign. In addition to supporting the two main vaccination sites in Al Jawf, the main city of the district, PUI contributed to the operationalization of two additional sites in Rebyana and Tazirbu, located respectively 200 and 400 km far from Al Jawf.
Within the supported vaccination centers, PUI medical staff carried out pre-check medical consultations for Covid-19 vaccine seekers and constantly followed up on the medical staff’s vaccination process, contributing to raising awareness and providing information to the visitors of the centers.
On this matter, Fatima Werfali, 45 years old, PUI vaccination nurse recalls:” People to whom we provided medical assistance prior to getting the Covid-19 vaccine were encouraging their friends, neighbors, and families to visit PUI medical team in the vaccination center and this was reflected in the increasing number of vaccine seekers”
Indeed, the number of doses administrated significantly increased from less than 500 monthly doses to over 2000 doses prior to PUI intervention across Al Kufra region.
Additionally, Première Urgence Internationale in close coordination with the Department of Health Services and the National Centre for Diseases Control took a major part in the safe delivery and storage of the vaccine to Al Kufra district by donating cold chain equipment and organizing delivery operations within a matter of days following the request. Suhail adds:” The vaccines are available in the main vaccine storage center in Benghazi city. 1150 km is the distance separating Al Kufra from Benghazi city, 400 km of the road is unpaved sand desert, so the process involved some challenges, which were mainly related to transportation”
Fatima and Suhail explain that this intervention was a success and a personal accomplishment for both. They believe that with financial support from the European Union and The Swiss Confederation, the prompt medical response, technical assistance, and acquired knowledge could be expanded in other parts of the Libyan Southern East isolated area or in any future medical emergencies.
With the generous contribution of the European Union, Swiss Confederation, and Italian Cooperation, since 2019 Première Urgence Internationale has supported more than seven healthcare facilities across Al Kufra region and continues to provide support to the Department of Health Services in promoting equal access to quality healthcare services for Libyans, refugees, and migrants.
A decade of protracted conflict and related instability that dominated Libya since 2011 has compounded the already limited healthcare services in the isolated Southern East region of Al-Kufra. The burden on the few health facilities was worsened since the beginning of the COVID-19 pandemic in March 2020.
In response to the pandemic, as soon as vaccines have been made available, Al-Rifi Al-Hweige primary health care center was appointed as the main COVID-19 vaccination point in the region in April 2021, among six other vaccination sites. Currently, only two vaccination centers are operating for an estimated population of sixty thousand inhabitants. Al-Rifi Al-Hweige center is located in Al-Jawf city center and serves more than ten thousand people in the area.
Ahmed Salah, thirty-three years old, Head of the primary health care unit within the Department of Health Services (DHS), like most health services managers, has been dealing with the additional burden that responding to the Covid-19 pandemic has created on the local weak health system and the barriers in promoting the vaccination campaign due to the reluctance to get vaccinated among the local population. Ahmed was concerned that, after a decade of significant shortages in equipment and supplies, the increasing number of confirmed cases would only go higher. He explains “After the widespread of the covid-19 virus, and the launch of the vaccination campaign all over the world, and particularly in Al-Kufra region, we as healthcare providers and patients visiting the vaccination center were overwhelmed with inaccurate information and misconceptions about the restrictions, preventive and protective measures, and lack of trust in the vaccine, which unfortunately contributed greatly to the vaccine hesitancy phenomenon.”
In July 2021, Première Urgence Internationale (PUI) in close coordination with Al-Kufra Department of Health Services and the National Centre for Diseases Control (NCDC), with the support of EU Humanitarian Aid’ and The Swiss Confederation (SDC), has launched a project to promote the national vaccination campaign and safe access to COVID-19 vaccines, in Al-Kufra region. PUI medical staff trained the health staff of the vaccination centers in line with WHO guidelines to help improve their technical capacities and to equip them with the necessary information to reduce vaccine reluctance amongst patients. “With the training sessions provided by PUI, the health staff learned how to correctly administrate and safely store the vaccines, how to safely dispose of the used medical items, the importance of promoting the benefits of the vaccine, and good practices to increase the vaccine acceptance amongst patients. I honestly felt a dynamic activity and tangible results among the medical staff “
The PUI team was present daily in the supported vaccination centers, supporting the medical staff by carrying out pre-check consultations for patients and providing awareness sessions about the benefits of the Covid-19 vaccine and its major contribution to protecting them and their families. Ahmed believes that this particular step has reassured patients and was a key factor in the increase of the vaccination rate across Al-Kufra. “By March 2022, we were able to administrate almost 2,000 doses per month which resulted in a higher rate of vaccination, almost 16.6% of the population have received two doses. In January 2022, for instance, when the Omicron variant hit Al-Kufra, only 16 patients were admitted to Attiah Al-Kasseh general hospital for complications associated with COVID-19, unlike other waves, when we had more than 100 active hospitalized cases”
On this matter, with more than 20 years of experience as a vaccinator, Mariem, forty-nine years old vaccination supervisor, believes that the project contributed significantly to increasing the quality of the health service provided by the medical staff and facilitating the vaccination process. The activities implemented in Al-Rifi Al-Hweige vaccination center have notably improved the vaccine acceptance of the local community of Al-Kufra, she adds: “Patients now do not get the vaccine directly. They are directed first to the vaccination pre-check room where PUI team receives them for a medical pre-check examination by PUI medical doctor while the rest of the team continues the registration process. They provided us with the latest updates, leaflets, answers to multiple questions and reversed rumors and misconceptions about the vaccine. A lot of people were hesitant about the Covid-19 vaccine, but together with PUI team we were able to help them make an informed decision to finally take it.”
With the generous contribution of the European Union, Swiss Confederation, and Italian Cooperation, since 2019 PUI has rehabilitated more than seven healthcare facilities across Al-Kufra region and continues to support the Department of Health Services in promoting equal access to quality healthcare services for Libyans, refugees, and migrants.
Aisha is in her forties, and originally from Sudan. She lives with her five children in the Al Ajhar village in Al Kufra Region. Her house was constructed by her son on a small piece of land donated by one of their neighbors for a temporary period. She has neither a bathroom nor a kitchen in her modest house, and the roof is made of corrugated steel panels.
Aisha’s living conditions were further worsened when her house caught fire, while her son was trying to connect the electricity to the house. “I lost all my documents in that fire. Now, I am unable to provide the basic needs for my family. My children cannot go to school because we do not have the required legal documents. This is why I am undertaking their education by myself at home. I do not want them to be illiterate! I want them to be able to read and write some basic sentences, at least!” says Aisha. She is also the main breadwinner for her family; selling home-made food in order to gain a living.
Aisha struggles with many health conditions and difficulties in her daily life. She suffers from hyperthyroidism, hypertension, and cardiac arrhythmia. Additionally, she has a general anxiety disorder that has affected all aspects of her life. When she heard about Première Urgence Internationale’s (PUI) Mobile Health Team providing medical services in the Al Ajhar healthcare center, she visited PUI’s doctor seeking medical assistance. Thanks to a PUI’s project financially supported by the European Union Civil Protection and Humanitarian Aid (ECHO) and the Swiss Confederation, primary healthcare services were provided for Aisha on a regular basis. Medical consultations, advice and medications for her chronic diseases along with psychosocial support were provided to her. To her credit, Aisha’s overall condition has improved: her thyroid function has normalized, her hypertension is now under control and her anxiety has reduced. On the other hand, she is still in need of further imagining and cardiac care for her heart condition which are only available in Benghazi at about 1,000 km away.
Aisha struggles to fulfill her basic needs, to access comprehensive healthcare, and to ensure the education for her children. She dreams of a decent life. However, despite all these conditions, she still prefers to live in Al Kufra. She says that: “Everyone has abandoned me and let me down. Despite all of this, I still prefer to live here in Al Kufra, because life in Sudan is much more difficult for me”.
Première Urgence Internationale’s mandate is to reach the needs of the most vulnerable populations and to help them regain independence and dignity regardless of their nationality, ethnic origin, race, gender or any other affiliations. This is why, the organization is committed to provide basic needs to people like Aisha, alleviate their sufferings, and make their voices heard!
“If our hopes of building a better and safer world are to become more than wishful thinking, we will need the engagement of volunteers more than ever.”
Najwa is a young lady from Al Kufra Region who has been volunteering with the Libyan Red Crescent (LRC) for nearly twenty years. Her passion about community work stems from her deep belief that every person can make a difference by serving society even through small actions. Recalling her memories, she said: “I started volunteering at a very young age when I was a little kid at primary school. I strongly believe that small actions can make a difference and I find true happiness in helping others and making them happy”.
On the general conditions in Al Kufra Region, she affirmed that: “The Al Kufra Region has its own peculiarity. It is about 600 km far from the nearest city and more than 1,000 km from the main coastal cities, which makes the living conditions difficult”. She is concerned because the region suffers from a shortage of basic materials, dilapidated infrastructure, a shortage of fuel, high prices of basic items, and a lack of medical services including specialized ones, due to the lack of available health workforce. Amid these circumstances, she decided to take action in order to contribute to alleviating the impact of these conditions especially with the growing needs in her region.
Currently, Najwa is a volunteer from the Libyan Red Crescent and one of the 11 community health workers who are collaborating with Première Urgence Internationale (PUI) on community health activities in Al Kufra as part of a project implemented by the organization and financially supported by the European Union Civil Protection and Humanitarian Aid (ECHO) and the Swiss Confederation. The project aims to strengthen the resilience of the most vulnerable populations and to contribute to improving their access to essential services. With her fellow colleagues, Najwa conducts awareness raising activities in her community, as well as regular screening whether for malnutrition in children under the age of 5, or for pregnant and lactating women. These women are also asked whether they have received appropriate preventive care and people with chronic diseases benefit from home follow-up visits. In case of need of a medical consultation, patients are referred onwards to the Première Urgence Internationale’s Mobile Health Team. Additionally, during the COVID-19 crisis, Najwa contributed to the organization’s efforts to sensitize communities about the risks of the disease and impact on the health system, its symptoms, and preventive measures to reduce transmission, as well as the stigma around being sick. Being passionate and enthusiastic about her work, she proudly affirmed: “One of the most important reasons that motivate me to continue this work is to see the remarkable change in the habits and behaviors of people in my community. They are now more aware about some health topics especially with the spread of COVID-19 in the region”. In a remote context, deprived of different services, community activities are the first layer to be strengthened in order to ensure early care and combine the necessary awareness raising with all health programs.
Première Urgence Internationale’s mandate is to support populations affected by crises by providing them with the skills to take their future back into their own hands. This is why the organization relies on the contribution of Najwa and other community health workers to create change. Première Urgence Internationale believes that change should come from within a community in order to ensure the sustainability and the impact of its activities. The organization, therefore, seeks to enhance the skills and capacities of the Community Health Workers, in order to reduce the barriers to access to basic services and improve the quality of health care, in Al Kufra, at community level.
Haleema ’s hikaya , a 60-year-old lady who faced barriers accessing health care in Al Kufra Al Jadida
Haleema, is 60 –years old and lives in Al Kufra Al Jadida; a remote village located in the Al Kufra Region. She has chronic diseases that affect her daily life and have made her unable to carry out her daily activities normally.
Haleema suffers from hypertension, diabetes mellitus, and osteoarthritis. She has faced many challenges to access regularly to quality health care, as there is only one health care facility in her village lacking qualified medical staff such as a medical doctor. The necessary medicines for the control of her chronic diseases are also missing or inconsistently present. Additionally, her village is far from Al Jawf, the main city in the region where fairly better health services are available. There are no public transportation services available in the area to get there. Haleema relies on her relatives to overcome these challenges; “When I urgently need to see a doctor, I rely on my nephew Mohamed, may God bless him, to drive me to Al Kufra center. Mohamed spares no effort to offer me help, but I don’t want to bother him all the time. I’m keeping him only for hard times”, says Haleema. Besides to the lack of medications that she continuously needs to control her blood sugar and blood pressure levels, the lack of financial resources and her modest income from home bread baking further hinder Haleema from getting the medicines she needs when they are not available for free at the public health facility‘s pharmacy.
When she heard about Première Urgence Internationale’s (PUI) Mobile Health Team providing comprehensive medical services, on a weekly basis, in the Al Kufra Al Jadida Health Center, Haleema sought care. During her visit to the doctor, she explained her situation, and the doctor provided a complete consultation: patient’s interrogation, medical examination, related medical counselling and prescriptions of drugs and blood test, which she could have filled by the onsite pharmacy. Currently, Haleema regularly sees the Première Urgence Internationale’s Mobile Health Team to monitor her chronic diseases and receive full treatment. A significant improvement in her health has been recorded. This was reflected in both her blood pressure and glycemia, as well as the relief of most of the pain associated with osteoarthritis. When she was asked about how she feels now, Haleema replied: “Today, I am able to cope with and control my chronic diseases. I’m following the advice of Première Urgence Internationale’s doctor’s, and I am no longer facing any issues to get my medications and the necessary health care. This helped me regain my activity and lead my life in a healthy way with no sufferings”.
Haleema is not the only person in Al Kufra Al Jadida who is in a dire need for proper health care services. There are many “hikayat” in the village like Haleema’s “hikaya”! This is why Première Urgence Internationale is committed to provide medical services for people in the most remote areas of Al Kufra, especially during the COVID-19 crisis, which added further burdens on an already challenged healthcare system. Thanks to its project funded by the European Union Civil Protection and Humanitarian Aid (ECHO) and the Swiss Confederation, Première Urgence Internationale was able to alleviate the sufferings of many people like Haleema. Première Urgence Internationale’s continued efforts aim to provide support to populations affected by humanitarian crises and to be ready to help whenever and wherever needed.
Al Kufra is a district of the south-east of Libya with three municipalities including Al Jawf, Tazerbou and Rebyana gathering around 70,000 inhabitants. The population of Al Kufra has limited access to services, particularly health care, due to the remote geographic location of the region, the lack of skilled health personnel as well as the limited medical supplies and equipment even in main cities.
Khalil is a seven-month-old baby who was born in the Al Kufra Al Jadida area to a modest family with scarce financial resources. Since his birth, Khalil has been suffering from several health problems including malnutrition, respiratory problems and frequent urinary tract infections. This has added a heavy burden on his mother Ahlam who works hard to fulfill the daily needs of her children. The difficulties that she faces to access proper healthcare for her child were further deepened with the remoteness of the Al Kufra Al Jadida area that is located far from the main city of the Al Kufra region and the lack of transportation services.
During one of their field visits to the Alkufra Aljadida neighborhood, the Première Urgence Internationale’s (PUI) community health workers visited Ahlam and her child at their home where they noticed Khalil’s low body weight and stunting. He weighed only 5 kilograms at the age of seven months which is below the lower thresholds of growth curves. Thus, Khalil was referred by the community health workers to Première Urgence Internationale’s (PUI) Mobile Health Team for a medical consultation. After the medical investigations, it was revealed that the baby was suffering from severe acute malnutrition with complications requiring specialized healthcare and admission to the hospital. The Première Urgence Internationale Mobile Health Team made all the necessary preparations and transported Khalil to the main hospital of the city in order to help him receive the necessary renutrition to correct organ failure and resume growth. Meanwhile, the community health workers conducted awareness sessions on infant and young child feeding for Ahlam in order to provide her with additional knowledge to empower her to best care for her son’s nutritional needs.
The baby’s situation has now improved and Ahlam has updated that “Khalil is now in good health and his life was saved! This made a huge difference in my life”. Indeed, every person should have proper access to quality healthcare. This is why, with support of the European Union Civil Protection and Humanitarian Aid (ECHO) and the Swiss Development and Cooperation Confederation, Première Urgence Internationale continues to strive to provide quality healthcare for people in need, especially in remote areas of Libya where the healthcare services are limited.
Al-Tullab is a small remote village located southwest of Al Kufra city. The village inhabitants are living in challenging conditions due to their isolation from the rest of the city and the difficulty of moving on a sandy, unpaved road and poor infrastructure. In addition, the village lacks basic infrastructures such as a pharmacy and a gas station.
Mr. Boushnaf added that Première Urgence Internationale (PUI) medical team has been conducting weekly medical visits for more than year to respond to the most urgent health needs of the Al Tullab inhabitants. Indeed, Première Urgence Internationale’s medical team is composed of highly qualified professionals including a general practitioner, an obstetrician-gynecologist, a nurse and a psychosocial support worker. The team members work together to ensure a holistic and multi-disciplinary health approach in order to address the needs of the patients and their families. In the area, PUI has also established a partnership with the Libyan Red Crescent and its network of community health workers who refer patients whose health condition requires it. This contributes to alleviating the sufferings of the Al Tullab inhabitants.
Première Urgence Internationale’s priority is to provide a high-quality medical assistance to people in need and to improve their access to essential services. This current project of Première Urgence Internationale is financially supported by the European Union Civil Protection and Humanitarian Aid (ECHO) and the Swiss Confederation. It aims to contribute to alleviating the suffering of conflict-affected populations in Al Kufra region via the provision of essential health integrated services.