From ... in Health — May 7, 2020

Despite Covid-19, Libya War Rages, with Civilians at Risk

Three men in full combat gear wearing protective face masks against Covid-19, in Tripoli, Libya on March 25, 2020 In early April, a photograph of three fighters on one of Tripoli’s front lines grabbed social media’s attention both for its poignancy and the absurdity of the situation.

The photo was of three heavily armed men in full combat gear wearing protective face masks against Covid-19. In Libya, the war to conquer Tripoli has intensified, with devastating consequences for the civilian population, since the country confirmed its first case of Covid-19 at the end of March. Forces affiliated with the Libyan Arab Armed Forces (LAAF) under the command of Khalifa Haftar have increased their shelling of residential neighborhoods close to the front lines in the southern suburbs of Tripoli.

The UN says that Haftar’s forces, who get most of their military support from the United Arab Emirates, inflicted the vast majority of civilian casualties in the first three months of the year. Meanwhile, the Government of National Accord (GNA) and affiliated forces, supported mostly by Turkey, have made major advances since mid-April, but show little sign of changing their methods. In the past, they have failed to ensure that there were no civilians adjacent to the military facilities they targeted, heightening the risk of civilian harm.

These attacks contributed to the World Health Organization decision to include Libya among the countries at high risk from Covid-19.

The organization also said that Libya had weak capacities to detect and respond to Covid-19.

The risk of a total system being quickly overwhelmed should the disease spread in Libya is acute.

The authorities, particularly in the conflict-ridden west and south, won’t be able to cope with large numbers of patients. In its first quarter civilian casualty report for 2020, the United Nations Support Mission in Libya noted an increase of 45 percent in civilian casualties from the fourth quarter of 2019. Over the past year, we have documented serious violations of the laws of war by groups affiliated with the GNA and LAAF as well as their foreign backers. Both sides are guilty of indiscriminate and other unlawful attacks against civilians that have resulted in hundreds of civilian deaths since the conflict began in April 2019.

The attacks that often killed civilians included airstrikes and drone strikes as well as shelling of homes, businesses, schools, and health facilities. According to the UN, which attributed most of the casualties to the LAAF, airstrikes were the leading cause of civilian casualties in 2019. After years of political divisions, neglect, and armed conflict, Libya’s health structures were already decimated, long before the coronavirus outbreak. But the pandemic does not seem to have led either side to take more steps to protect civilians in the war, in which hospitals and medical staff have been repeatedly attacked. During a December visit to Tripoli, I saw first-hand the devastating effect of the use of explosive weapons in populated areas that damaged vital civilian infrastructure, including healthcare facilities. I visited hospitals that had been damaged or shuttered, and field clinics that had been attacked, and documented cases in which ambulance drivers and emergency first responders were killed or injured in the line of duty.

The pandemic does not seem to have led either side to take more steps to protect civilians in the war, in which hospitals and medical staff have been repeatedly attacked. In the Salaheddin southern suburbs of Tripoli, I visited two private clinics close to the front lines that had been affected by the fighting.

The al-Umuma Clinic was shuttered after a rocket attack killed an ambulance driver and damaged the hospital.

The driver Salem Infeis, a father of three, was killed by an LAAF airstrike that struck the ambulance he was driving in October. A lone mortar in November killed a 9-year-old boy who was accompanying his mother, a patient at the nearby Al-Nukhba Clinic, another private hospital that was still treating a small number of patients. Tripoli authorities accuse the LAAF in both incidents.

The World Health Organization reported 13 attacks on healthcare in Libya in 2020 through early May, damaging eight healthcare facilities and three transport vehicles.

The attacks also resulted in 5 deaths of healthcare personnel, with 17 injured. International humanitarian law – the legal framework governing the Libyan conflict – covers the conduct of the fighting, including the protection of civilians, not whether there should be a cessation of hostilities during a pandemic. But it stipulates several key provisions relevant to a pandemic according to the International Committee of the Red Cross.

The parties are forbidden to attack, destroy, remove, or leave useless objects that are indispensable to the survival of the civilian population, such as drinking water installations, and are obligated to take constant care to spare civilian objects. Given the current crisis, water supply facilities are of critical importance as any disruptions mean that civilians would no longer be able to do basic prevention by washing their hands frequently, which could lead to further spread of the virus.

The conflict parties in Libya tore up the rule book many years ago and have been operating with impunity, virtually unchallenged Well-functioning and well-equipped medical facilities are necessary to provide medical care on a large scale, as necessitated by the Coronavirus outbreak.

The parties are obligated to respect and protect medical personnel and their facilities and transports, as well as to respect and protect wounded and sick peoples and to make every effort to evacuate them without delay. I can report that the parties to this conflict have violated these provisions many times over. In fact, the conflict parties in Libya tore up the rule book many years ago and have been operating with impunity, virtually unchallenged, despite the International Criminal Court’s mandate over war crimes, crimes against humanity, and genocide there since 15 February, 2011. I have some hope that the UN Human Rights Council in Geneva will establish an International Commission of Inquiry during its upcoming session in June. As a first step toward accountability, such a commission should document violations, identify those responsible, including external actors, preserve evidence for future criminal proceedings, and publicly report on human rights conditions in Libya. Emboldened after years of getting away with their crimes, armed groups in Libya are continuing to destroy the country’s fragile health infrastructure during a deadly pandemic. What’s clear, though, is that masks will be of little use to anyone if those fighting in the war continue to destroy the little that is left of the Libyan medical and public health establishment whose job is to fight the spread of a virus so deadly that it has practically immobilized the whole world.

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Despite Covid-19, Libya War Rages, with Civilians at Risk

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