8 February, 2021
Libya: The denial of non-Libyan citizens’ right to health must be investigated and remedied

The right to health is a fundamental and inclusive[1] human right, encompassing health care, safe drinking water in hospital facilities, adequate sanitation, adequate nutrition, and housing. Functioning public health care facilities, goods and services should be available, accessible, in acceptable conditions, and of good quality. States should provide this right to all persons without any discrimination[2].

The undersigned associations call for an urgent investigation into allegations of the right to health being denied to migrants and asylum seekers in Libya, resulting in consequence with the loss of the most fundamental right of all: the right to life. These vulnerable persons struggle to survive in precarious circumstances exacerbated by the prolonged pandemic, and find themselves trapped and left in Libya to die from illness.

On January 6th, Shuaib Ibrahim, a 19-year- old Somali asylum seeker, died in Tripoli as result of inadequate health care. His tragic case is of course not the first where the denial of the right to health caused the death of an asylum seeker. Many other asylum seekers, migrants, and other vulnerable persons will meet the same fate unless urgent action is taken by the Libyan authorities, international organizations, and the international community.

Shuaib was among dozens of Somalians – themselves among hundreds of other abductees of different nationalities -kidnapped by human traffickers in Bani Waled, a town in western Libya where armed groups systematically practice forced labor and torture. For the potential to be freed by their abductors, migrants are compelled to pay ransom through their relatives. If not, they are tortured and exploited for forced labor at the expense of their health -often becoming gravely ill. Ailing migrants and asylum seekers do not have access to care. If they become too ill to work, they are forced out of informal detention centers and left in the streets in miserable conditions.

Yaseen, a Somali minor, witnessed the aforementioned death of Shuaib in Tripoli. He had been stricken by tuberculosis and survived the kidnapping and torture in Bani Walid. Yaseen is currently hospitalized and will require sufficient and inclusive physical and psychological support to heal.

Victims of grave human rights violations including torture require specialized physical and psychological medical care, especially when also suffering from chronic health conditions such as tuberculosis.  Such medical care is extremely difficult for migrants and asylum seekers to access in Libya.

Private clinics are costly, and public hospitals (largely destroyed by the prolonged war, corruption, and the pandemic) are inaccessible for migrants and asylum seekers without official legal status in Libya. This      de facto discrimination against vulnerable persons is coupled with their fear of entering a public hospital, which could result in arbitrary detention or harassment by representatives of Libya’s fragmented security sector. Medical facilities and staff are themselves subject to attacks by armed groups.

Restrictions on freedom of association throughout the country by both governing authorities in east and west, in addition to threats by state-sanctioned armed groups against representatives of civil society organizations (CSOs) and activists, prevent local and international associations from adequately supporting victims of human rights violations.

In December 2020, Mahjah was only 17 months old and cared for by her father, a Sudanese asylum seeker in Libya. She direly needed a bone marrow transplant, which was not available in Libya. Refugee resettlement and emergency evacuations – already extremely limited and slow – stopped completely when the pandemic began. Mahjah was one of many who suffered the consequences, paying the ultimate price with her life.

On August 2020, Abul Rahman Jama’a Abdi, a Somali asylum seeker, died in Tripoli. His body was left for more than eleven hours until the Somali embassy intervened. Abdul Rahman was one of the kidnapping victims in Bani Walid and arrived in Tripoli ill, clearly needing treatment and hospitalization as reported by local associations.

On January 14th, thirty-two local associations denounced the United Nations High Commissioner for Refugees (UNHCR) for its negligence and inadequate support in regard to the untimely death of Shuaib Ibrahim, who was registered with the UN refugee agency. The UNHCR was also lambasted by the associations for its lack of reactivity, and the lack of skill on the part of its field partners, in aiding victims of human rights violations and vulnerable groups in general. Members of the Libya Platform, a coalition of civil society organizations that work closely with migrants in the country, also denounce the dearth of support provided to vulnerable persons.  For instance, the hotline service for support is rarely answered, and even if answered, the health care received is limited and basic, without adequate or any follow up for medical care.

In 2019, an internal audit of Libya’s operations for the Office of the United Nations High Commissioner for Refugees noted that the mission was “unable to demonstrate it used its resources effectively and efficiently in providing for the essential needs of persons of concern. The lack of reporting also increased UNHCR’s reputational risk”.

In 2020, no less than eleven thousand migrants and asylum seekers were pushed back to Libya, according to the UNHCR. 2020 also witnessed the deaths of nearly 700 people crossing the Mediterranean Sea in an attempt to escape Libya, according to Médecins Sans Frontières/Doctors Without Borders (MSF).

Recommendations on:

1/ The protection of migrants, refugees, and asylum seekers

The signatories call on the Italian government and the European Union:

• To withhold support from Libyan coastal and naval agencies until they adhere to the appropriate benchmarks, show due regard for structured management, and operate according to human rights principles.
• End aggressions against migrants and attempts to criminalize rescue ships operated by international humanitarian organizations, allow these organizations to work freely, and respect international obligations in this regard.

The signatories call on the Libyan authorities to:

• Enable civil society organizations to visit detention sites without restriction periodically.
• Stop arrest and arbitrary detention of migrants in the country, especially asylum seekers and refugees registered with UNHRC.
• Strengthen legal protection for migrants subjected to human rights violations within and outside of detention centers.
• Take the necessary measures to release all persons detained for attempting to cross borders into Europe as refugees and respect all relevant international obligations.
• Structure the legal framework to apply the right to protection through a transparent instrument that accords with Libya’s constitutional, regional, and international obligations.
• Establish a statutory framework for the legal status of people who want to regularize their status in Libyan territory for work, based on the labor market’s needs.

The signatories call on the UNHCR:

• Ensure the training of field staff to be able to provide support to vulnerable groups and victims of human rights violations.
• Ensure more presence and accessibility for adequate medical support for the persons of concern.
• Ensure an adequate support program for victims of human rights violations – notably women and minors – with sufficient and inclusive physical and psychological support.

2/ Justice and medical and psychological assistance for victims of human rights violations

Our organizations call on the European Union, the United Nations (UN Support Mission in Libya or UNSMIL, and the Office for the Coordination of Humanitarian Affairs), and the Ministry of Health to form a committee under the auspices of UNSMIL, comprised of doctors, international experts, and civil society representatives. The committee’s role should be to:

• Assess the legal framework and medical assistance services, including services for rehabilitating the mental health of domestic violence victims and other victims of gender-based violence      and human rights abuses.
• Submit a proposal to develop the legal framework and improve access to legal aid services or victims of human rights violations.
• Provide for community-based medical centers, with the participation of civil society organizations, especially organizations that offer psychological and rehabilitation services to those most vulnerable to violations: women, children, the homeless, migrants, asylum seekers, refugees, and residents of peripheral areas.

3/ Freedom of association:

Our organizations call on UNSMIL and the EU to pressure the Presidential Council, the Civil Society Commission (CSC), and the House of Representatives to protect freedom of association, specifically by:

• Repealing CSC Decrees 1 and 2/2016, and Presidential Council decision 286/2019, which undermine all civic action and contravene the constitutional declaration and Libya’s international and regional obligations.
• Issuing a new associations law (law regulating civil society) drafted by Libyan legal experts and civil society. The law should protect the freedom to form associations in line with the International Covenant on Civil and Political Rights and the constitutional declaration.
• Lifting the administrative restrictions on the CSOs and supporting their technical role in assistance and support, to prevent the Civil Society Commission from becoming a repressive, authoritarian body. Repeal all arbitrary, restrictive decisions issued by the executive authorities.
• Taking urgent action on necessary legislative amendments.
• Preventing attacks by armed groups affiliated with the security establishment.

Signatories:

• Cairo Institute for Human Rights Studies;
• Libya Platform human rights coalition
• Pakistan Fisherfolk Forum [PFF]
• International Women’s Rights Action Watch Asia Pacific
• The Association for Juridical Studies on Immigration (ASGI)

[1] Many of the important characteristics of the right to health are clarified in general comment N° 14 (2000) on the right to health, adopted by the Committee on Economic, Social and Cultural Rights
[2] General e Committee on Economic, Social and Cultural Rights, comment N° 14, para. 18.

Photo: Migrants settle in Libya after failing to reach Europe. REUTERS/ Esam Omran Al-Fetori