Ryan Calder, a Ph.D. candidate at UC Berkeley has been publishing a series of dispatches from rebel controlled Benghazi. Buried at the end of his latest dispatches is a remarkable vignette about the changing relationship between the city’s health system and its citizens.
Before the revolution, some Libyans took their frustrations out on Libya’s doctors. “Just a few months ago,” remembers El-Fakhery, the anesthesiologist, “people hated Libyan doctors. They’d run off to Tunisia or Egypt for something as simple as a common cold.” She recalls that a surgeon at her hospital was even physically attacked after a failed surgery. “We didn’t have the facilities [to provide proper care],” she says.
But with the revolution, people in Benghazi began showing an outpouring of support for their doctors. She recalls how on March 19, as Qaddafi’s tanks were rolling through Benghazi’s streets and Revolutionary Committee members were shooting at civilians, she and other doctors were overwhelmed by the number of wounded they had to treat — and by the kindness that ordinary citizens were showing them. “In the hospital, men as old as my father would run around the ICU [intensive care unit] at Jala Hospital [in Benghazi], passing out milk and juice and boxes of dates to the doctors,” she says. “They’d stuff them in the pockets of my lab coat and shake my hands, and they’d hug the male doctors. They’d bring pillows and blankets from home, giving everything they could to the hospital.”
The more I research and write about health systems during conflict, the more I am convinced that they are one of the most important points of contact between citizens and their political leaders — both democratic and otherwise. The relationship between the population and the health system often parallels the relationship betweens citizens and the government at large. Health systems are tasked with providing care during the most vulnerable times in a citizen’s life (childbirth, illness, etc…). How well health systems fulfill that role reveals the importance governments place in their citizenry. Governments requiring the support of the people build strong and effective health institutions, believing that they are a means to gain legitimacy in the eyes of population. Governments able to gather resources elsewhere — either through external support or natural resources — have little need to make such costly investments. In Libyan, the rebels need the support of the people, Gaddafi did not.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.