It is important for us to understand the role of a family physician before we begin our discussion on the importance of family physicians in any health care system of the community. Many reforms have been made in the health care systems of various communities all over the world. Almost all of these reforms lay their focus on the prevention as well as the treatment of any disease along with the promotion of health and management of conditions that have become a chronic problem for the patients. All of these areas are the center of the family physicians and therefore family medicine has a huge role to play in here.
In this paper, we shall look at the current health care system in Libya and see how the government and other organizations like WHO are playing their role to improve the health care system in the country as they lay emphasis on the role of family physicians. Moreover, we shall also shed light on the general perception that the people have about family physicians and how they are important in the provision of better health facilities to the public.
Health care system in Libya
In Libya, all citizens are provided with the health care facilities. All the regulations in training, health, education, rehabilitation, family issues, housing, old age benefits and disability are made in the country according to "Decision No. 11" of the General People's Committee that has been formed on the Promulgation of the By-Law Enforcement Law No. 20 that was based on Social Care Fund of 1998. It should be noted however, that the health care system is not solely run by the state and there are many small private hospitals in different areas of the country. Moreover, when we compare the statistics of Libya with those of other countries of the Middle East, we find out that the average health of the people in Libya is above average, which is not the case elsewhere in the Middle East. Childhood immunization is taken special care of and all the new born children are vaccinated. One of the reasons that have led to this improved state of health in the country is the improvement in sanitation and provision of clean water for drinking. The two main hospitals of the country are Benghazi and Tripoli (Libya: Health, 2011).
When we look at the statistics, we find out that number of dentists and doctors increased by almost sevenfold between the years 1970 and 1985. This means that there is one doctor for every 673 citizens, which is not a very bad average. In the year 1985, almost one third of the doctors in Libya were born in Libya, meanwhile the rest were foreigners. Moreover, the number of hospital beds also increased during the same years. In decade of 1970s, it has been reported that the major endemics that the country was challenged with were that of paratyphoid, typhoid, leishmaniasis, infectious hepatitis, meningitis, rabies, schistosomiasis and venereal diseases. Malaria had been eradicated by then and efforts were being made to eradicate leprosy and trachoma. In the year 1985, the infant mortality rate was recorded to be 84 deaths per every 1000 children. As for the year 2004, this mortality rate dropped to 25.7 per 1000 children. There have been other reports on this that reveal that the infant mortality came down to 20 per 1000. There were about 7000 estimated cases of HIV. These cases were derived mainly because of the intravenous drug abuse. It was also recorded that many people had developed multi-resistance to tuberculosis in many areas of the country where these drugs were being used (Libya country profile, 2005).
Re-building the Libyan health care system
The Ministry of Health of Libya has been taken a lot of significant steps for the betterment of the country's health care system. Towards the end of the year 2011, the Ministry asked WHO to help the country revitalize their declining health care system so that the people can get access to quality health care services and so that all the citizens are provided with the same amount of services, irrespective of their financial status.
One of the critical problems that were identified in the provision of primary health care facilities was that there were no concrete concept of a family physician and there were not many district hospitals and local clinics in the country. The total population of Libya is 6.5 million for which there are only 1,500 local clinics. Therefore, the people are unable to get routine checkups and they have to wait for hours outside the national hospitals to get themselves an appointment with a specialist. Moreover, since there are no family physicians, there is no one to guide these people as to how to go about the treatment protocol.
In some places of the country, these facilities were actually very rare to find. On the other hand, the places that had these facilities, they were in very bad condition. The matters were made worse by the fact that when there was a conflict in Libya in the year 2011, most of the foreigners who were working there as medical personnel, fled to their native lands. This further created an increased demand for nurses and doctors and especially in the rural areas.
After the conflict, the health needs of the people have also changed and demands have increased. Adel Mohamed Abushoffa, who was the Deputy Minister of Health of Libya, was reported as saying that there are many critical areas that need special attention now. He pointed out at the psychosocial support and mental health after the conflict. He said that as the conflict took place, there are many people who need help to get over the whole trauma of the conflict. He also said that we do not have many psychiatrists in the country and it was actually shocking to find out when he said that there were only 14 of them in the whole country.
As the needs have changed, there is and has always been a constant need for the improvement in services that are provided to pregnant women so that childbirth is made a safer process and so that the newborn child is given the appropriate conditions for a healthy life. Apart from this, there is also a need for improvement in the emergency health services.
Since the health care system is damaged in the country, not just the health of the people is suffering, but also the government has to pay millions of dollars per day when the people of Libya have to go abroad to get these services that are not available in their own country.
Actions that are being taken to reform the Libyan health system
As a first step that was taken for rebuilding the health care system in Libya in collaboration with WHO, a senior delegation from the country visited the headquarters of WHO in Geneva, where the two parties decided to work together to improve the conditions of the health care system in the country. It was decided in this meeting that the team will be focusing on the six main areas that need improvement. The first area would be the improvement in the provision of primary health care to the people. The second area is the improvement in the main aspects of health service organization. The third area is to make the laboratory services stronger along with improving the management and supply pertaining to drugs and finally there needs to be an increase in the number of trained nurses in the country.
Some of the preliminary ideas were jotted down what the basic plan of what needs to be done and what should the action plan to cover all the six areas that have been mentioned above. The next stage of these reforms was to discuss the action plan and the ideas with the other people involved in the health care system in the country.
The WHO Representative in Libya, Dr. Samir Ben Yahmedsaid that this will be an important platform that will bring the stakeholders of the health care system, consumers as well the as the health authorities who would be selected through questionnaires after meetings that would be held across Libya so that they all come together and reconcile in a way that would be acceptable to all, regarding the re-building of the health care system in the country.
On the other hand, the Assistant Director-General for Health Systems and Services at the WHO, Dr. Carissa Etienne said that it is a major challenge to re-build the whole health care system in Libya and that is also an opportunity. It is an opportunity for the country to make a fresh start so that such a system is created that provides quality and equality in the health care services. Moreover, he said that such a system should be constructed so that expectations and needs of the people are catered.