Michel Cousins TRIPOLI – Within a couple of weeks or so, probably just after Eid, there will be a ministerial change of guard. A new prime minister and government will be appointed by the recently-elected National Congress. It remains to be seen whether some or any of the existing ministers are reappointed. The present administration led by Prime Minister Abdurrahim Al-Kib has been in office since November last year. It has not had an easy time of it, balancing enormous expectations against severe limitations, in terms of not only of human and financial resources, but of infrastructure and systems that were either broken or downright non-existent. No minister has been under more pressure or come in for more criticism in that short time than Fatima Hamroush, the Health Minister. She has taken the flak, not just because of the failings of the Libyan heath service, which was in a dire state when she took over, but also because expectations of improvement that have been wildly optimistic. The public seemingly thought she had a magic wand to turn the service into an instant success — and then resented the fact that the impossible did not happen. The health ministry and health service has not been totally turned round. Libyans who fall ill still opt to head to Jordan or Tunisia or Turkey if they can afford it, but Hamroush is proud of what has been achieved in the nine months since taking over. “A good bit of work” has been done, she says. It has been a case of effectively rebuilding the health service, if not from scratch, not far off it. It was very different last November. “We inherited a mess”, she says. Stores were drained, assets frozen, buildings and facilities wrecked, staff dispersed. Worse, it was not just that the system was not working as a result of the revolution. “There was no system”, she says. Most of the other ministries were in the same boat, she admits, but the difference was that people's demands were so much greater in the case of healthcare. “Add to that the human resources”, she notes. The quality of staff both within the ministry and in hospitals had deteriorated. “It was good years ago, but in the past 15 to 20 years, it went downhill.” Under the Qaddafi regime, she says, students were accepted for medical training who were well below standard. “There was no proper planning for the future. They took 1,000 medical students a year”, even though that was far too many for the country's healthcare needs. As a result there is now a surfeit of qualified medics without a job or who have never had a job at all in the sector. Another problem has been infection control in hospitals. “Doctors have been giving out antibiotics to everyone”, says the minister. As a result there are now untreatable strains of bacteria. “There are young injured with untreatable wounds due to the development of resistant strains“, she explains. One of the biggest headaches, for has been the lack of funding. “We had no money”, Hamroush says. Apart from paying salaries, the budget only came into effect on 1 June. “But we managed to run the system. We kept it going. Despite all the various crises, we ran it well.” One crisis was the lack of medications. “There were no drugs to treat HIV for a whole year”, she reveals. Dealing with this took time. But it has been dealt with, she points out. “Apart from a few exceptions, stores are full of everything we need.” A considerable proportion of the supplies was brought in from Britain using Libyan frozen funds abroad. But matters have not been helped by the lack of computerisation. Linkages between hospitals, stores and pharmacies has had to be done manually. “It has caused delays”, Hamroush says. “But again, we dealt with it.” The biggest crisis she had to face was the treatment of the injured revolutionaries abroad and the massive abuse of the service. In fact it was not a ministry of health matter. It was administered by the Committee for the Care of the Injured, which was in effect a separate ministry. But because of the general perception that Hamroush's ministry was in charge, it and she were blamed. – Libya Herald
