Doctor sets out to heal Libya’s health care

Libya’s new health minister says rampant corruption and nepotism have taken a “terrible toll” on the North African nation’s health care system.

Dr. Fatima Hamroush told The Washington Times that hospitals have been stretched to the breaking point by the thousands of people wounded in the eight-month uprising that toppled Moammar Gadhafi’s 42-year regime.

“I am not inheriting roses from the previous government. I am inheriting a very corrupt health care system,” Dr. Hamroush said in a phone interview from her home in Dublin.

“When corruption is on such a large scale, like an infectious disease, it is incompatible with progress.”

Last week, Libyan interim Prime Minister Abdurraheem al-Keib appointed a 24-member Cabinet with Dr. Hamroush, an ophthalmologist, as one of two female ministers in the government. The other is Mabrouka Jibril, who will serve as the minister of social affairs.

The Cabinet will run the interim government until the election of a national assembly in eight months.

Dr. Hamroush, who left Libya 17 years ago, said the health care system will require a major overhaul. “We have to have a clean start. It is not one man’s task. It is a colossal task,” she said.

Contracts to procure hospital equipment often are decided not on the basis of quality, but on the size of the bribe. Hospitals end up with defective equipment that hinder doctors’ abilities to do their jobs.

“The goal of those signing the hospital contracts is not to get the best services for the hospitals, but to get the best deals in their pockets,” said Dr. Hamroush. “That is why a lot of them are rich beyond imagination.”

When it comes to hiring hospital staff, social connections often trump qualifications, and that undermines the quality of care, she added.

High among Dr. Hamroush’s priorities is rooting out corruption and nepotism, but she acknowledges that such a task will take generations. “We have a lot of mess that we need to clean up. It is a very serious stage in our history,” she said.

One solution would be to enforce laws. “In Gadhafi’s time, no one feared being taken to task for corruption. They felt they were above the law,” she said.

Another of Dr. Hamroush’s priorities will be to ensure proper medical care for the thousands of people wounded in the uprising against Gadhafi. Those patients are among thousands sent to Ireland, the U.S. and other countries for treatment not available in Libya and to ease the pressure on Libyan hospitals.

“We will need to set up a system in the country that looks after them. Sending them abroad is an emergency measure,” Dr. Hamroush said.

Gadhafi’s regime was toppled by an uprising that started in February. The conflict continues to exact a toll on Libyans weeks after it ended. Unexploded bombs litter towns and cities.

In Gadhafi’s former strongholds of Sirte and Bani Walid, where fighting was fierce in the last weeks of the war, residents have been maimed while clearing war debris.

The civil war has produced another challenge: an untold number of female and male victims of sexual crimes, including rape. Libya is a conservative Muslim society, where victims of sexual assault are reluctant to report the crimes.

“People prefer not to talk about it publicly. It has got a lot of stigma,” Dr. Hamroush said.

Weighed down by the vast numbers of people seeking treatment, hospitals have struggled to provide some services.

“Libya has good doctors, but they have had problems dealing with specific war wounds — bullet wounds and shrapnel wounds, etc.,” Soaade Messoudi, a spokeswoman for the International Committee of the Red Cross, said in a phone interview from Tripoli.

Care for those wounded in the conflict has become an “explosive issue,” said a resident of the western Libyan city of Misrata who spoke on the condition of anonymity, citing his close ties to the government.

“The sheer number of people who need multiple operations and prosthetic limbs is overwhelming,” the resident said.

In Misrata alone, the number of wounded exceeds 13,000. More than 3,000 have been sent abroad for treatment.

“There are good intentions, but it is not being translated into good action yet,” the Misrata resident said.

Ali Othman Bezanti, a Tripoli-based doctor who is coordinating treatment for wounded Libyans in the United States, said in a phone interview that only those who require advanced surgery are sent abroad.

“We can manage here, but some people will need special care,” Dr. Bezanti said.

Many of the wounded also suffer from psychological problems, including post-traumatic stress. Most of the revolutionaries were professionals with no military training.

International sanctions prevented the sale of medical equipment to Libya, further compounding the crisis in hospitals across the country.

Dr. Hamroush said Libya has enough money and talent to set up a health care system of international standards. “I don’t think we need financial assistance. Libya is one of the richest countries in the world, and we are only 6 million people,” she said.

However, she added, the international community could play a key role in programs to train doctors and nurses.

Dr. Hamroush said she is honored to have been picked for the job, but wishes the Cabinet had more women.

“Two is a low number really, but it is a start,” she said.