Renegade general Khalifa Haftar’s assault on the capital of Libya, prompting thousands to flee their homes, may result in a deadly outbreak of several infectious diseases if it blocks aid workers from importing medicine and forces the displaced to consume dirty water, the World Health Organization (WHO) warned on Friday.
Haftar, whose Libyan National Army (LNA) is believed to control up to two-thirds of the country, invaded Tripoli this week intending to overthrow the internationally recognized Government of National Accord. Branding himself an anti-Islamist strongman seeking to impose order on the African country, Haftar enjoys the backing of Russia, France, Egypt, and several other nations around the world.
The United States and most of Europe oppose his efforts to overthrow the legitimate government. America issued a statement urging him to withdraw from the city. The European Union has not done so, reportedly as a result of diplomatic efforts by the French government.
As of Friday, Haftar has given no indication he will heed demands from the State Department and international organizations to leave Tripoli.
The WHO’s representative in Libya warned Friday that medical aid workers in the capital only had two weeks’ worth of medicine and may soon struggle to care for injured or diseased civilians, which could lead to an outbreak of any one of many infectious diseases.
Hussein told reporters that the WHO has tallied 75 deaths and 323 injured since Haftar invaded early this week, most fighters for either the LNA or the official Libyan army.
“We fear that prolonged conflict will lead to more casualties, drain the area’s limited supplies and further damage health infrastructure,” Dr. Syed Jaffar Hussein told reporters. Hussein listed tuberculosis, measles and diarrheal diseases among those his organization is most concerned will spread if Haftar’s invasion continues to force thousands to flee their homes and disrupts medicine, food, and water supplies, according to Al Jazeera. He also suggested that the fighting may displace “thousands if not hundreds of thousands,” potentially spreading diseases outside the country.
The United Nations estimated on Wednesday that 4,500 civilians had already fled Tripoli, prompting concerns that the fighting could trigger another migrant crisis in nearby Europe.
Disease outbreaks during conflict – whether official war or irregular institutional violence like in the Libyan case – tend to be common, as the fighting prevents regular shipments of food and medicine, forces hospitals and clinics to shut down, and prompts civilians caught in the fighting to flee, often overwhelming neighboring countries’ immigration officials. The civil war in Yemen, for example, has resulted in a severe outbreak of cholera, a water-borne illness that has not threatened American lives in any significant way since the 1800s. As cholera does not spread through contact with an infected person, an outbreak requires a significant population to consume water contaminated by the disease. In Yemen, fighting between the legitimate government and the Shiite Houthi rebels that have overrun Sanaa has forced thousands to choose between dying of dehydration and risking contaminated water, learning to over one million suspected cases of cholera.
Similarly, conflict in the Democratic Republic of Congo (DRC) has helped the spread of Ebola, which is highly contagious through the blood of an infected person. The ongoing DRC Ebola outbreak is the second-largest in history – behind the 2014-2016 outbreak in Liberia, Guinea, and Sierra Leone – exacerbated by rival militias fighting over mineral resources. Murder, rape, attacks on treatment centers, and civilian flight deterring contact tracing have all helped the Ebola virus spread.
DRC is also suffering from cholera and measles outbreaks.
Libya has endured a state of consistent instability since the overthrow of dictator Muammar Qaddafi in 2011, at one point becoming the largest area of terra nullius, or land without a government, in the world. As recently as 2018, clashes between the GNA, Haftar’s army, and the many smaller militias vying for influence in the OPEC nation triggered a measles outbreak in at least four cities.
The current fighting in Tripoli has killed two doctors since it began this week, the WHO announced on Monday.
“It is unacceptable for health workers to be targeted during armed conflict,” Dr, Ahmed Al Mandhari, WHO Regional Director for the Eastern Mediterranean, said in a press statement. “Parties in such conflict must respect international humanitarian law and ensure that health workers and facilities are safe. These doctors risked their lives to evacuate wounded patients from conflict areas, and targeting them and health facilities at such times worsens the situation for civilians caught up in conflict.”
Haftar has not appeared to make any significant advances in his attempt to conquer Tripoli since bombing the nation’s only airport on Monday. The Libya
Observer reported “fierce battles” in the south of the city on Thursday and the presence of invading LNA soldiers throughout much of the rest of the city.