21 December 2017, Sabha, Libya - When Dr Ahmad*, a surgeon at Sabha Medical Centre, was kidnapped in November by an unknown group, his colleagues decided to act.

Dr Ahmad was the second health worker to be kidnapped within months in the town of 100 000 people. On 18 November, all non-essential health services at Sabha Medical Centre, the biggest hospital in southern Libya, were suspended for 10 days.

"We went on strike after the kidnapping of Dr Ahmad because we wanted to send a message to Sabha's authorities that doctors are in severe danger. Health services cannot operate properly if health workers are not safe," said Dr Ayman*.

Years of conflict have severely disrupted health services in Libya, and the recent rise in abductions of health workers threatens an already fragile health system.

Of the 8 abductions documented by WHO in Libya since 2012, 4 occurred in 2017 alone, the highest number of kidnappings of health workers recorded in a single year. In Sabha, the abductions have had a significant impact on local access to health care.

"The kidnappings are seriously affecting the health sector as there is a brain drain of health workers fleeing to safer cities. More than 10 professors at Sabha Medical School left because of poor security," said Osama al-Wafi, spokesperson for Sabha Medical Centre.

According to al-Wafi, only 2 days after Dr Ahmad's abduction, an unknown group attempted to kidnap an internal medicine specialist, but the doctor managed to escape.

It takes years of education and practice to train doctors, and southern Libya is running low on qualified health workers.

"We have only 10 specialized doctors left in the town, which is facing an influx of thousands of migrants. We are trying our best to provide health services for everyone in need and the doctors are doing a great job despite the pressure, but I am not sure for how much longer," al-Wafi added.

Sabha's health system has been further strained by the arrival of migrants making their way towards Libya's northern coast and across the Mediterranean to Europe, many of whom seek treatment at local medical facilities. Dr Ahmad, a renowned surgeon in Sabha who operated on both locals and migrants, was released after 12 days in captivity.

Many doctors and health workers are hesitant to speak out, afraid that they will be targeted next. One doctor who asked not to be named said that health workers in Sabha are sometimes targeted inside health facilities.

"Many times there were shootings inside the emergency department; sometimes fights would start outside the hospital and then continue inside it. In May, one patient was shot on the operating table when armed men stormed the hospital," she said.

Sabha Medical Centre hires security guards to protect health workers, but even this is not enough. According to Sabha Medical Centre employees, two security guards were shot and killed in the street in May this year after they had left the hospital for the evening.

On 1 January 2018, the World Health Organization (WHO) is launching its Surveillance System for Attacks on Health Care, a global data collection tool that will allow WHO to report on numbers and trends related to attacks on health workers and health facilities worldwide. The project is part of the Attacks on Healthcare project, a priority project of WHO's Health Emergencies Programme.

*Names have been changed


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