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 “

PUI medical doctor providing a workshop to AL-Rifi Al-Hwiege Vaccination Center staff ©Première Urgence Internationale
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.”

Vaccination nurse providing the Vaccination center with a mask ©Emrajaa Moahemd
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.