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WHO Libya biweekly operational update1-15 NovemberGeneral developments: political & security situationFour shipwrecks in the space of three days have claimed the lives of more than 110 people in the Mediterranean, including at least 70 people whose bodies have washed up on the beach of al-Khums, in western?Libya.Participants to the Libyan Political Dialogue Forum agreed that the national elections in Libya should take place on 24 December 2021. Humanitarian Coordinator for Libya, Yacoub El Hillo, strongly condemns the killing of a 15-year old Eritrean asylum seeker in a shelter in Tripoli, calls on Libyan authorites to investigate and bring the perpetrators to justice. UNSMIL strongly condemns the killing of lawyer Hanan al-Barassi, who was shot, in broad daylight, in Benghazi by unidentified armed men. Ms. al-Barassi had been a vocal critic of corruption, abuse of power and human rights violations. The Joint Military Commission (5+5) held its 6th meeting in its HQ in Sirte to advance the implementation of the Ceasefire Agreement signed in Geneva on 23 October 2020 and to build on the progress achieved in Ghadames. The meeting attended by UNSMIL team.The Libyan Political Dialogue Forum (LPDF) took place, under the auspices of the United Nations, in the Tunisian capital. The Libyan Political Dialogue Forum discussed a draft political roadmap for the preparatory phase (draft roadmap attachment). UNSMIL welcomes the decision by the Civil Aviation Authority on 4 November 2020 to permit the resumption of flights to all airports in the Southern region of Libya. Amid these positive developments, the Mission notes with great concern that between 1 and 5 November, a number of individuals from the east who travelled to Tripoli were arbitrarily arrested by armed groups. Oil production in Libya has already exceeded 1.2 million barrels per day (bpd). Libya’s state National Oil Corporation (NOC) reported yesterday that total oil revenues for September and October this year totalled US$ 347 million.Statement, UNICEF and WHO sound the alarm over 250 000 children at risk of vaccine-preventable diseases in Libya: 2021 HNO was prepared by WHO. Overall 2021 HRP funding envelope is estimated at 190 million USD, including 40 million USD. OPERATIONAL UPDATESCOVID-19 responsePillar 1: Coordination Continued to provide technical guidance to national and regional COVID-19 committees and disseminate daily and weekly updates on the disease. Follow up on daily basis with the local health authorities and the crisis committees in Sabha and the South and provided the needed technical support. Conducted the monthly subnational health sector group meeting with INGO, NGO and crisis committee in South.Attended the COVID-19 National Response Plan review organized by the MoH on 11 November 2020. Participants from WHO country office staff and experts from other institutions and directorates reviewed the epidemiological situation and the three plans (prepared by the National Centre for Disease Control (NCDC), the multi-sector Supreme Committee and the National Council of Planning, respectively) and agreed to prepare one consolidated plan to be endorsed by the end of November 2020. The review was structured around the nine pillars of WHO’s operational planning guidelines and the five pillars of the United Nations’ Socio-Economic Framework for Libya.Met with the COVID-19 Supreme Committee in Benghazi (east Libya). The committee highlighted COVID-19 needs in the east and requested additional support from and strengthened coordination with WHO. Pillar 2: Risk communication and community engagement (RCCE) Conducted a follow-up meeting with team leaders of community health volunteers from four different municipalities in Tripoli. The purpose of the meeting was to finalize arrangements for home visits and the distribution of COVID-19 promotional materials. During the meeting, WHO distributed 2000 flyers and 1000 masks to the volunteers for distribution in their respective municipalities.Pillar 3: Surveillance, rapid response teams and case investigation Continued to follow up with the NCDC on daily registered COVID-19 cases and the epidemiological situation Coordinated with rapid response teams (RRTs) to organize follow-up visits to disability rehabilitation centresin Tripoli and Benghazi. Two patients with COVID-19 (one recovered and one suspected and placed in isolation)were reported from the disability rehabilitation centre in Benghazi.Discussed with the NCDC standard criteria for reporting confirmed COVID-19 cases based on notifications rather than the dates of test results and transmission classifications. The recommendations will be finalized next week.Pillar 4: Points of entry Conducted a field visit to the Libyan-Egyptian border and assessing the laboratory capabilities and major obstacles at Emsaed lan border crossing point.Pillar 5: National laboratory Completed installation of the two GeneXpert PCR machines donated by WHO to health facilities in the east (one to Al Mansoura isolation department in Shhahat Chest Hospital in Shahhat and one to Al Wahda Hospital in Derna). Each hospital conducted its first tests in early November. This is a very important achievement, since the main cities in the east now have the capacity to test for COVID-19. Moreover, Shahhat Hospital is a major TB centre, and can use its GeneXpert machine to diagnose TB, including multi-drug resistant strains.Conducted training on the GeneXpert PCR machines targeted 4 laboratory staffs in Al-Mansoura and 8 laboratory staffs in DernaInitiated recruitment process of recruiting three senior and nine junior laboratory officers to strengthen capacity in Libyan laboratoriesFacilitated approval of six training workshops (4 in Tripoli and 2 in Benghazi) for laboratory technicians. The activity will commence on 15th , 22nd, 29th November and December 6 for Tripoli and 15th and 22nd November for Benghazi.Pillar 6: Infection prevention and control (IPC)Prepared distribution plan and distributed PPE to primary health care centres and isolation health facilities in western region. Followed up with the IPC officers for their orientation and supervision modalities. Conducted an introductory meeting between the IPC consultants and the medical teams in Sabha Isolation Center, Sabha Triage Centers, Brak Ashshatti Triage Center, Al Gurtha Ashshatti Triage Center and Bent Baya Isolation Center regarding the IPC measures applied at their facilities. A detailed assessment will be conducted on regular basis by the consultants after a field visits to each health facilities involved in COVID-19 response.?IPC consultants have started their assessment to the health facilities in the south involved in COVID-19 response.Pillar 7: Case managementFacilitated and organised with MTI different teleconference sessions on IPC, ARDS case management and Triage in Tobruk.Leadership Prepared proposal for changing the quarantine policy for UN staff in Libya for CMT endorsementReviewed TORs for steering committees for the EU grants for TB and Covid-19 grantsReviewed final report to ECHO for funding support 2018-2019 for emergency response Issued joint PR with UNICEF on the risk of vaccine preventable diseases in LibyaReviewed proposals from two national academic institutions on COVID-19 responseFollowed up on the unacceptable poor water supplies to UN staff in Oea and provided concrete solutions to UNSMIL senior managementVirtual meeting with IFRC regarding support to sustain their community ang first aid projects across the country.Finalized with DFID funding support for Mental Health for WHO LibyaVirtual meeting with MOFA Norway to review status of implementation of current grants and potential funding support for 2021Virtual meeting with FP at the German Embassy in Tunis regarding input to Berlin to showcase implementation of specific activities under the German grant in Libya.Acted as DO a.i. and RC/HCCoordination and Health Information ManagementPrepared a review of a frequency of reporting for health sector information management documents, including monthly 4W matrix; bi-weekly operational update; and monthly health sector bulletin. Prepared a flash update on the attack on health care: Bani Waleed general hospital, 1 November. Provided inputs for OCHA health access snapshot. Produced health sector field directory, Libya. Updated health sector partners with the background reference information for Project Module.Shared with existing assessment templates with the MoH Health Emergency Department planning to conduct assessments across all IDP sites in the central and western parts of the country. Finalized and produced an infographic of WHO operational response, January - October 2020.Prepared a monthly snapshot of 2020 HRP key indicators reported through 4Ws, October 2020. Produced a map of health sector partners operational presence across Libya, October 2020. Updated the link for?Health sector?interactive?analysis for the 4Ws?Finalized and shared with OCHA the data on health sector monitoring framework caseload under 2021 HRP. Supported the national HIS unit by revising the Statistics Booklets of DHIS2 Libya which includes the data collection forms for the routine HIS.Provided technical inputs to the NCDC COVID-19 team by revising the national weekly COVID-19 report.Provided a list of standard analyses and health indicators for PHC to the national HIS unit. HEALTH OPERATIONSSub-office BenghaziCoordinated with the local health service directorates preparations of trainings of PHC doctors on management of common diseases. This training will be conducted next week in Al Bayda, Derna and Tobruk. Participated in a one-day workshop organized in Benghazi by the Center of Moral and Social Support with the aim of coordination to provide psychosocial support to ex-combatants to be integrated in civil life. ? Followed up on impact of rainfalls on health facilites across Al-Jabal Al-Akhdar district. Rapid needs assessment visits were completed. Organized an online workshop on pharmaceutical planning, management and monitoring for health experts in Tripoli and Benghazi. The event was facilitated by the experts of WHO Regional Office and Dubai hub. Participated in the celebration on the World Diabetes Day in coordination with Tobruk Health Services Administration and the Diabetes Centre.Conducted a meeting with the chest hospital in Benghazi, discussed the hospital needs (mainly TB medicines, TB lab equipment, outreach teams for TB screening surveys), and emphasized for further enhanced coordination between WHO and NCDC Benghazi branch and Benghazi Chest hospital.Sub-office SabhaConducted the sub-national health sector group meeting on 12th of November.Supported local health authorities in drafting a plan of action for resumption of the health services at PHC and hospital levels. EMTS.NoTeamDonorSpecialtiesLocation CoveredMajor surgeryMinorsurgeryConsultation1Alzintan EHT?Germany?Orthopaedic??Alzintan General Hospital5152602Tarhouna?EHT?GermanyAnaesthesia, Neuro Surgery, Vascular Surgery, Internal medicine?Tarhouna General Hospital5519212033Misrata EHTGermanyAnaesthesia,Orthopaedic,? General Surgery,Vascular SurgeryMisrata Medical CentreNotprovidedNotprovidedNotprovided4Al Jofra EHTGermanyGeneral SurgeryAl Afia General Hospital (Houn)NotapplicableNotapplicableNotprovided5Sabha EHTGermanyAnaesthesiaSabha Medical Centre110Notapplicable6Ghat EHTGermanyPaediatric, GynaecologyBerket PHCNot applicableNot applicable6977Tarhouna MMTGermanyEndocrinology,Gastroenterologist, Gynaecology, PaediatricPolyclinic, Suk Alahad PHC, Al Khdra polyclinic(Tarhouna)Not applicable512728Benghazi MMTGermanyPaediatric, Cardiology, GP, GynecologyAl Majori polyclinic,Tawergha IDPs Camp,Sidi Khalifa polyclinicNot applicableNot applicable13829Ajdabiya MMTGermanyPaediatric, Internal medicine, Dermatology, GPTawergha IDPs clinic,?Abu Shaala PHC, Ajdabiya Diabetic centreNot applicableNot applicable85510Leishmania MMTGermanyDermatologyTawergha General Hospital, NCDC MisrataNot applicableNot applicable91511Al Zwitina MMTItalyPaediatric, Internal medicine, GPAl Zwitina PHC,?Soltan PHC, Al Baydan PHC (Al Zwitina)Not applicableNot applicable63512Al Bayda MMTItalyPaediatric, General Surgery, DermatologyAl Guba Rural Hospital, Al Abraq PHC,?Al Gigb PHC (Al Bayda)Not applicableNot applicable74613Al Sahel MMTItalyDermatology, Internal medicine, GP (diabetes)Toukrah Rural Hospital, Tulmitha PHC, Batta rural hospital (Al Sahel?)Not applicableNot applicable683TOTAL:612228,648EOCIdentifying the urgent needs and responses to the health situations across Libya.Disseminated the links for WHO hosting Global Commemoration World Day of Remembrance for Road Traffic Victim 2020 and materials for WDR 2020PHCProvided comprehensive presentation on WHO NCD kits content to Primary Health Care Institute (PHCI).Shared MoH official endorsement on Libya Primary Health Care country and vital signs profiles with regional office, UHC/Health Systems (UHS) and Science, Information, and Dissemination (SID), and the Primary Health Care Measurement and Improvement (PHCMI) Initiative unit.Convened an online meeting with PHCI to conduct a series of training workshops funded by the German Federal Foreign office project “Supporting all-hazard emergency health management in Libya at strategic and operational levels”.Supported Libya presentation of Sexual Reproductive Health and Rights (SRHR) country progress and attended regional virtual meeting on the implementation of SRHR project in the eastern Mediterranean region.?? Shared a list of primary health care centers in Tripoli municipalities with Danish Refugee Council for rehabilitation of health facilities.Convened meeting with MoH-ICO and explained the program budget of 22-23 with reflection of MoH anized Italian Government funded PHC project launch meeting with the Director and technical staff of Primary Health Care Institute of MoH.Participated in a meeting with World Bank to discuss health care financing projects in Libya.Participated in two preparatory and the main virtual meeting on the implementation of Sexual and Reproductive Health Research (SRHR) project in EMR.Assisted RMNCAH focal person of MoH with the preparation of the presentation for the virtual meeting on the implementation of SRHR project in Libya.Participated in the preparatory meeting and shared with MoH the concept note, provisional program, areas to be discussed in the round table discussion related to the Joint Virtual Meeting with Ministers of Health on Continuation of Essential Reproductive, Maternal, Newborn, Child and Adolescent Health Services in the Context of the COVID-19 Pandemic, which will be held on 17 November 2020.GBVConducted a joint training with UNFPA on clinical management of rape for 25 general physicians in Tripoli. A presentation was provided on mental health and psychological impact. EPI/AFP/ Measles surveillance programTC with UNICEF with aim of following up the planned joined activities with NCDC - EPI administration. First draft of Immunization handbook for immunization services providers has been reviewed and technical inputs/contributions were provided to EPI officials and UNICEF.Consolidated and disseminated AFP weekly epidemiological update reports (Epi week 44 and 45).2 AFP cases from (Sabrata 1, and Benghazi 1) reported during the last two weeks and stool specimens have collected and stored for transportation. 15 AFP stool specimens (collected from 7 AFP cases and 1 contact) will be transported to institute Pasteur lab in Tunisia.Disease surveillanceOrganized the NCDC meeting with EMRO’s on the expansion of Early Warning, Alert and Response Network (EWARN) sites from current 152 to 250. The expansion was based on 3 important criteria (administrative division, population and high-risk areas). The meeting concluded with 3 additional criteria on the expansion of sites (high risk populations, municipalities reported outbreak in the last 5 years and previous response/feedback) including involvement of private health facilities, detention centres, and internally displaced populations as well conducting EWARN evaluation. The list of additional sites will be finalized during the next meeting. Initiated discussion with EMRO’s health information unit and the NCDC on establishing event-based surveillance in Libya.Support NCDC to issuing EWARN weekly bulletin for epi week 45.TB Reviewed the NTP National Guidelines and recommendations made for updating shared with the NCDC.Held a meeting with MSF-F to discuss isolation and treatment of MDR-TB patient in Misrata.Participated in TB partners Group meeting; to discuss TB cases registration using similar certificates used by UNHCR; addressing defaulting and loss of follow up among migrants and refugees by implementing DOT and community training; implementing HIV testing for TB patients.Submitted first monthly TB grant report to the EUD, delineating the achieved activities to implement the TB grant for the past 3 months.Conducted a meeting with UNHCR to initiate collaboration for TB treatment, follow up and case/contact finding among refugees.Conducted a meeting with NCDC-NTP, Directors of Pharmacy and Laboratory to discuss procurement of TB FL/SL drugs for 2021, as well as laboratory accreditation/updating and technician training. Operational Support and LogisticsOut of Tripoli: Distributed 158 oxygen concentrators to 35 health facilities: CityToOxygen concentratorsMisrataMisrata Medical Center10AlasabaAlasaba hospital6AlasabaAlasaba isolation center4AldawoonAldawoon Rural hospital4SbeaSbea Hospital5MisallataMisallata General Hospital5MisrataMisrata isolation center 1&210AlzentanAlzentan General Hospital4Bani WaleedBani Waleed hospital6TarhounaTarhouna Teaching Hospital6Al-RiainaAl-Riaina hospital3Al-RiainaAl-Riaina isolation center3AlgarabolliAlgarabolli General Hospital4JaduJadu Rural Hospital4Al-KhumsAl-Khums Isolation center3Aljabal AlgharpyFessano Rural Hospital4AlzentanAlzentan Isolation Center4KeklaKekla Rural Hospital3GharianGharian Isolation Center4GharianGharian Hospital8Gaser AkhyarAmareen Polyclinic (Gaser Akhyar)2Al-RohibatAl-Rohibat Rural Hospital4NesmaNesma Rural Hospital4Thaher AlgabalThaher Algabal Isolation center2Aljabal AlgharpyAl-Khalayfa isolation center4GhadamisGhadamis isolation center3YefrinAlghalaa hospital (isolation center)4GhrianGhrian Polyclinic3GhadamisGhadamis hospital4HawamedHawamed Rural Hospital3YefrinYefrin Hospital4TejiTeji Rural Hospital4AlsawaniAlsawani isolation Center.3TripoliTripoli health services administration12AlghwasemAlghwasem PHC.2Provided PPE to the following facilities in Tripoli: CityToMask KN95GooglesGownsThermometerCoverallGlovesFace masksFace shieldTripoliPHC services1000030010001020012400260004000TripoliDisability Rehabilitation center????50001500?Dispatched lab supplies, trauma and NCD kits to 5 health facilities: CityToMurex HBSAG V3 (480 test)Blood bagBlood bagKIT, TRAUMA - ANCD kit, 1aNCD kit, 1cTube CryogenicWipeGilson Pipetman Diamond TipackTripoliNCDC central Lab9820101310ZlitenNCDC Zliten Lab61016101215TobrukTobruk Blood Bank54200920TobrukTobruk Medical Centre1TobrukEndocrinology and Diabetic Centre11Received 2 shipments in Tripoli: PO NoDescriptionUnit of MeasureQuantityWeight in KgPort of Entry202507409AMPHOTERICIN B liposomal complex, 50 mg ,powderEach20093.00Misrata Airport202342949Oxytocin 10IU/ml, 1ml ampouleEach120100.00Misrata AirportOut of Benghazi: DescriptionQuantityCityToGloves, size L3000BenghaziMoSA HcapSurgical Masks6000BenghaziMoSA HcapFace Shield400BenghaziMoSA HcapGown200BenghaziMoSA HcapOut of Sabha: Distributed 42 oxygen concentrators to 15 health facilities. LocationDistrictOxygen concentratorsJarmah Triage CenterUbari2Taraghin General HospitalMurzuk2Murzuk General HospitalMurzuk3Ubari General HospitalUbari2Ghat General HospitalGhat3Brak General HospitalWadi Ashshatti4Qirah Rural HospitalWadi Ashshatti2Edri General HospitalWadi Ashshatti3Bergen PHCWadi Ashshatti2Bergen General HospitalEdri4Bent Baya Rural HospitalUbari5Um Al Araneb Rural HospitalMurzuk3Murzuk PolyclinicMurzuk2Tasawah Rural HospitalMurzuk2Al Gatroun Rural HospitalMurzuk3Distributed PPE to 6 health facilities: LocationDistrictSurgical MaskSurgical GlovesExamination GlovesFace shieldGownsGogglesThermometersDisinfectant Alcohol 70%Ghat General HospitalGhat300010001005050Brak General HospitalWadi Ashshatti12Qirah Rural HospitalWadi Ashshatti30002000100010010050212Edri General HospitalWadi Ashshatti2000500100505012Bergen General HospitalEdri12Bent Baya Rural HospitalUbari300010001005050312Distributed 1 trauma kit: LocationDistrictTrauma Kit Type BQirah Rural HospitalWadi Ashshatti1Funding situation: Donor NameAward NumberProjectFunding Received in 2020Funding Carry OversTotal AmountBill & Melinda Gates Foundation70028COVID-19400,0000400,000China70077COVID-193,602,13303,602,133Department for International Development (DFID), United Kingdom69998COVID-19145,0000145,000Federal Foreign Office, Germany70268COVID-19134,8000134,800Ministry for Europe and Foreign Affairs (MEAE), France70381COVID-19300,7600300,760United Nations Central Emergency Response Fund (CERF)70164COVID-191,000,00001,000,000United States Agency for International Development (USAID)71011COVID-192,830,00002,830,000Miscellaneous CFE69796COVID-1920,000020,000European UnionAward in ProcessCOVID-196,825,93906,825,939Miscellaneous (HQ Funding)70199COVID-191,500,00001,500,000State of Libya (African Development Bank)Award in ProcessCOVID-19480,0000480,000Sub-total:17,238,632017,238,632Administrative support (AS)69500Regional Office379,1870379,187Assessed Contributions (AC)69479Regional Office294,4000294,400Assessed Contributions (AC)69480Regional Office566,4900566,490Department for International Development (DFID), United Kingdom67121Supporting PHC services in Libya 070,04170,041Department for International Development (DFID), United Kingdom69138Humanitarian and health assistance to Libya0167,165167,165Directorate-General for European Civil Protection and Humanitarian Aid Operations (ECHO), European Commission68101Support emergency and basic health services0180,236180,236Federal Foreign Office, Germany68355Support all-hazard emergency health management02,251,7972,251,797Libya60016Public health support0178,689178,689Ministry of Foreign Affairs, Italy68292Enhancing diagnosis and treatment for migrants in detention centers0103,179103,179Ministry of Foreign Affairs, Italy69191Support basic health needs0406,176406,176Ministry of Foreign Affairs, Italy69745Improving access of vulnerable groups to healthcare services and decreasing premature death from chronic diseases 01,100,1101,100,110Ministry of Foreign Affairs, Italy70809Improving access of vulnerable population to quality PHC services4,038,00504,038,005Ministry of Foreign Affairs, Norway69740Support emergency response 0611,169611,169Ministry of Foreign Affairs, Norway70428Contribution to WHO emergency response activities in Libya - Addendum 1579,5420579,542United States Agency for International Development (USAID)68097Improving access to essential and life-saving health care0134,031134,031United States Agency for International Development (USAID)70987Improving access to essential and life-saving health care1,000,00001,000,000European UnionAward in ProcessTB response3,754,26603,754,266Solidarity Fund70397Sero-epidemiology studies30,000030,000Sub-total:10,641,8905,202,59315,844,483TOTAL:27,880,5225,202,59333,083,115KEY GAPS & CHALLENGESSame as for the last reporting period. RESPONSE PRIORITIESSame as for the last reporting period. ................
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