Casualties Overview

In 2013, there were at least 59 mine/ERW casualties in the State of Libya.[1] Children made up 63% (26 of 41) of all civilian casualties,[2] an increase compared to the percentage of child casualties (36%) in 2012. Most child casualties were boys (22); there were four girl casualties in 2013. Men were 52% (30 of 58) of all civilian casualties in cases in which the age was known, a slight decrease compared to 2012 (58%). Two casualties were women. Intentional engagement with ERW was the leading cause of casualties among civilians where the age and gender were known.[3] In 2013, 80% of all casualties recorded occurred in the province of Misrata.[4]

Most casualties for whom civilian or military status was known were civilians.[5] There were no military casualties reported in 2013. There were two casualties confirmed among deminers in 2013, an increase compared to 2012 when no military or deminer casualties were identified.

At 59, the total number of casualties identified for 2013 is a significant decrease compared with the 222 casualties in 2011 and similar to the 66 casualties in 2012.[6] This may be, in part, due to the lack of availability of casualty data to the Monitor. However, it also corresponds with the findings of the UN Mine Action Service (UNMAS) and the ICRC that there were fewer people being injured by mines/ERW since 2012, as compared with 2011, in the midst of armed conflict.[7]

The total number of casualties in Libya is not known; all available estimates predate the 2011 conflict, when many new casualties occurred. The Libyan Demining Association (LDA) and the Libyan Civil Defense Department had registered 1,852 mine casualties by the end of 2006.[8] Previous estimates were approximately 12,000, with the Libyan police reporting 11,845 casualties between 1940 and 1995 (6,749 killed; 5,096 injured) and the Libyan Jihad Center for Historical Studies reporting 12,258 (3,874 killed; 8,384 injured) between 1952 and 1975.[9]

Cluster munition casualties

The number of cluster munition casualties in Libya is not known. There were no casualties from cluster submunitions identified in 2013.

There was no available information on casualties during the cluster munition strikes that occurred in 2011. Media reports identified four casualties from unexploded submunitions between April and June 2011: three in Ajdabiya in the Al Wahat district and one in Misrata.[10] However, it was not possible to distinguish the devices that caused these casualties from other types of ERW. Two of the four reported submunition casualties, boys 10 and 15 years old injured in Ajdabiya, were also later reported to have been injured by a hand grenade.[11] The explosive device type of the remaining two casualties could not be confirmed and were recorded as ERW casualties by the Libyan Mine Action Centre (LibMAC).[12]

Victim Assistance

Libya is responsible for survivors of landmines and other types of ERW. The total number of survivors is unknown. Outdated estimates ranged from 5,000 to 8,000 survivors through 1995.[13]

Victim assistance since 1999[14]

Throughout the period since 1999, mine/ERW survivors were able to receive free medical care through the reasonably well-developed Libyan healthcare system. Between 2000 and 2008, Italy provided support through building renovations, training, and planning to the Benghazi Rehabilitation Center, the only physical rehabilitation center in the country. However, during the period, the center was unable to operate at full capacity due to a lack of qualified staff, materials, and a data management system. When Italy withdrew support in 2008, the center stopped producing prosthetics and orthotics.

There was no information available from the new Libyan government on economic and social inclusion initiatives or psychological support to survivors during the period. At several Meetings of States Parties to the Mine Ban Treaty, Libya called on countries who had used mines in Libya to “provide…assistance to the victims, and to rehabilitate them.”[15]

All victim assistance, but especially emergency and ongoing medical care, was disrupted by the armed conflict that started in February 2011. The availability of medical care decreased in 2011 as thousands of foreign medical professionals working in Libya returned to their countries of origin, and power cuts, lack of funding, and a lack of medical supplies prevented the remaining medical professionals from responding to the increased demand for emergency care from mine/ERW survivors and other victims of the conflict.[16] International organizations responded to this disruption and assisted hospitals to resume care provided to the increasing numbers of new mine/ERW survivors. In August 2011, the Benghazi Rehabilitation Center resumed production of prosthetics and orthotics.[17]

Victim assistance in 2013

By 2013, there were three prosthetics and orthotics service providers and two rehabilitation centers in the country. In 2013, the University of Misrata worked to set up, within the compound of the University hospital, a small physical rehabilitation center for disabled people in the area, with the support of the ICRC.[18] Other organizations limited some activities or withdrew from the country.

No victim assistance coordination or planning was possible in 2013; national and international efforts remained focused on providing immediate relief to the large numbers of war-wounded, including mine/ERW survivors, and rebuilding the health sector.

Assessing victim assistance needs

In 2013, the government was not able to differentiate the needs of mine/ERW survivors from the needs of all conflict victims in the country.[19] However, the ICRC assisted the LibMAC in collecting and sharing weapon contamination data and in establishing a casualty data management system.[20] By the end of 2013, a total of 228 mine/ERW casualties which had occurred in recent years had been recorded.[21]

Victim assistance coordination[22]

On 1 December 2011, the LibMAC was established within the Ministry of Defense to manage all mine action activities in the country.[23] Responsibility for victim assistance lay with the Ministry of Health and the MCCS.[24] The Ministry of Social Affairs was primarily responsible for physical rehabilitation in Libya, although the Ministry of Health and Ministry of Martyrs, Missing and War Wounded were also active in the field of physical rehabilitation.[25] There was no national plan for victim assistance in 2013.

Service accessibility and effectiveness

Victim assistance activities[26]

Emergency and ongoing medical care

Following World Health Organization (WHO)-supported consultations with the Ministry of Health and other stakeholders in 2011 on rebuilding the healthcare system, the Ministry of Health assumed leadership for its reconstruction throughout 2013 with a focus on ensuring basic medical care, including mental health, throughout the country including rural and remote areas.[27]

In 2013, the ICRC continued to provide medical equipment and supplies to treat the injuries of mine/ERW survivors and other victims of the armed conflict.[28] People wounded during clashes received emergency care at five ICRC-supported hospitals. Some victims, as in Benghazi, Derna, and Tripoli were administered first aid from Libyan Red Crescent Society volunteers using ICRC-donated materials.[29] The ICRC also assisted in the renovation and expansion of a health clinic at Zliten, near Misrata, which improved access to healthcare for people affected by the ongoing violence in the area.[30]

In 2013, the ICRC continued to provide training to address traumatic war injuries, such as those caused by mines/ERW, to doctors and medical personnel.[31] The ICRC provided direct support to hospitals and first aid stations; some 270 people, including Libyan Red Crescent Society volunteers, scouts, emergency services personnel, civil defense staff, and nurses, strengthened first-level care provision, while 55 doctors and surgeons from across Libya upgraded their skills in emergency room trauma management. Eighty-seven surgeons and anesthetists received war-surgery training.[32]

Physical rehabilitation, including prosthetics

After ceasing direct assistance to the Benghazi Rehabilitation Center in 2012,[33] the ICRC worked closely with Misrata University and the associations of weapon-wounded people in 2013 to set up an orthopedic workshop for disabled people in and around Misrata, an area with a high number of war-wounded people.[34] A building was constructed within the compound of the university and two ICRC specialists were assigned to work in Misrata to support the opening of the center in 2014.[35] Also in 2013, the IMC continued to support rehabilitation centers in Libya both through the provision of equipment, as well as in-depth training for physiotherapists and nurses.[36] Merlin, an international organization, no longer provided rehabilitation services to mine/ERW and other war victims in Nefusa mountains.[37]

In line with a 2012 agreement, Tripoli University and the ICRC worked during 2013 to set up a physical rehabilitation undergraduate course with a view to expand the number of trained professionals. The lack of a location, the late arrival of the budget from the university, and various administrative constraints hampered the progress of this project in 2013. However, it was expected that the program would start in 2014.[38] In 2013 the NGO Human Study e.V. organized a series of workshops in Tripoli for 20 clinical Libyan rehabilitation workers with a view to enhancing capacities of the Libyan rehabilitation sector in order to provide comprehensive assistance to people with disabilities.[39]

Economic inclusion

There was no information available on economic inclusion initiatives for mine/ERW survivors in 2013.

Psychological support

In August 2013, MSF opened a mental health center in Tripoli to help people suffering from physical and mental health problems related to violence. The center treated people who have been affected by any form of violence, be it physical, psychological, sexual, or conflict-related. The team also trained doctors from the Ministry of Health and established a referral system from basic healthcare facilities and from Libyan and international NGOs.[40] IMC continued its mental health and psychosocial support program in Benghazi, Misrata, and Sirte to increase access to war trauma counseling and develop long-term mental health capacity in the country.[41]

Laws and policies

The 2011 Constitutional Declaration addresses the rights of persons with disabilities and requires the state to provide monetary and other types of social assistance, but does not explicitly prohibit discrimination. In 2013, the government did not effectively enforce these provisions due to administrative incapacity. Few public buildings were accessible to persons with disabilities, resulting in restricted access to employment, education, and healthcare.[42]

Libya signed the Convention on the Rights of Persons with Disabilities (CRPD) on 1 May 2008.