Perched on the edge of a rugged escarpment, Nalut has been rendered a ghost town by the civil war in Libya. Stores are shut in this rebel enclave, and women and children have been whisked to safety across the border to Tunisia.
At first glance, the only presence appears the rough-hewn rebel fighters, racing through town in battlewagons smeared with sand to battle troops loyal to Col. Muammar Qaddafi.
On closer look is another group that quietly clings to their duties despite nearly three months of conflict and a Katyusha rocket crashing into their compound: 50-odd foreign doctors and nurses assigned to the Nalut Central Hospital. Coming from as far afield as Ukraine, Pakistan, and North Korea, they have spent years caring for Libyans and have now chosen to stand alongside them despite the risks.
“After we are here for six or seven years, when it was good, when it gets bad we escape?” asks Dr. Hussein, a long-bearded doctor from Egypt, as if the thought never crossed his mind. “That does not say much for human character. It is not a shame to run away, but it is our duty to stay.”
“If all foreign doctors leave, who will treat the injured in Libya?” says another Egyptian, surgeon Mohammed Ibrahim Bhiey, who has spent two years in Nalut out of 12 practicing in Libya. “All of us are supporting each other.”
The foreign makeup of the staff at this vast – and today largely empty – regional hospital reflects that of Libya’s health system nationwide. With relatively few trained Libyan doctors and nurses, Colonel Qaddafi has paid foreigners and their governments with oil money to fill the gap. Their deployment took on new meaning when Libya’s uprising took hold in mid-February, sparking a civil conflict that divided the country east and west and created frequently bombarded rebel-enclaves like this one, which spans the 90-mile-long western mountains.
Above the main entrance of this hospital is a small printed sign that reads: “We are with the Libyan people wholeheartedly.”
'We treat both sides'
Through those doors in recent days have come five severely wounded pro-Qaddafi soldiers from the front line – their presence and life-saving treatment raising a commotion – along with four rebels wounded in the same battle.
“For us a patient is a patient; this is about medical ethics,” explains Dr. Mohammed Zahir, a Pakistani who has worked in Nalut for nine years. “Outside, he does what he does. Inside we relieve suffering. All blood is red.”
Adhering to such high values has not been easy, and is not for everyone. Staff here have not been paid for two months, since banks no longer function and sending Ministry of Health cash from Tripoli to rebel territory is a non-starter.
Perhaps one-third of the foreign hospital staff in Nalut left Libya as part of the exodus of hundreds of thousands of migrant workers – skilled and unskilled, who have built Libya and make it work – who fled Libya in the first weeks of violence.
And as the conflict and isolation has increased, with no end in sight, some wish they had gotten farther from harms way.
“Our country said we must leave, but if your place is safe you stay,” says Lorna Improgo, a nurse from the Philippines who has worked in Libya since 1991. The medical director in Nalut promised that if the situation deteriorated, he would guarantee their evacuation to Tunisia, 20 miles away as the crow flies.
“We hold onto this assurance only,” says Ms. Improgo. “He told us: ‘But now if you leave, then the hospital will close. We can’t work without you.’ ”
And after so many years working in Libya, the Filipina nurse – one of 10 at this hospital – can’t complement enough the Libyans she knows. “They are good people, very very good,” she says of those she has worked with for three decades. “We are in the middle – we treat both sides.”
“I want a peaceful Libya,” says another Bangladeshi nurse, Sahetaj Khanom, who wears an aquamarine hospital gown and hair cover as her shift begins. “But nobody knows when it is finished, this war.”
Which is why some are wondering how their quiet, pre-uprising posting to the relatively obscure town of Nalut has turned into what, on some days, now appears to be a combat deployment. A Katyusha rocket fired by pro-Qaddafi forces last Thursday landed inside the hospital compound, less than 50 yards from staff housing – one of half-a-dozen that landed that evening.
“I was afraid too much!” recalls Bangladeshi nurse Usha Barai of the blast that burst in her windows. “Suddenly, ‘Boom, boom!’ I fell down and I cried.”
Space has since been made for living in the reinforced basement of the hospital itself, with one door listing the “Filipina Group” and others. Many have moved from their unprotected apartments where they maintain vegetable gardens and usually spend their free time.
But the conflict has been inescapable. “Our life is very painful,” says Ms. Barai. “We love people, but it is very hard. In front of my eyes, I have seen a lot of people die. I want to go. My family is also crying.”
At least she does not have her family with her, as does one Pakistani anesthetist, who moved into the basement with his wife, 3-year-old child, and 3-month-old baby. Lack of cash has kept them from leaving.
“The people of Nalut are very cooperative and they help us,” he says. About the conflict, he adds: “We are waiting for the result.”
Concern Qaddafi may target staff
The Nalut hospital is not alone in feeling the pressure of the Libyan war. The besieged rebel enclave of Misurata, east of Tripoli, has withstood the same frequent shelling from pro-Qaddafi forces that rains upon the city. In Zintan, 70 miles east of Nalut and still in the rebel-held western mountains, this reporter saw fresh Katyusha strikes last week in the hospital parking lot.
And that is not the only danger for foreigners in this rebel town. Russian-born Ukrainian lab technician Zhenya, who has lived in Libya 11 years and is Muslim, has made three trips to Tripoli since the uprising began, but now the hardened front lines make such a journey impossible.
“The people are fine with me here, we are like brothers and sisters,” says Zhenya of her decision to stay. “Some leave. But me, no. It doesn’t make sense … that when something goes wrong, I leave.”
Libyan and foreign staff alike are concerned about Qaddafi's wrath if their profile is raised higher. Most asked not to be fully named or photographed, though their professional work continues regardless no matter who controls this town. Pro-Qaddafi agents once worked to identify regime opponents here, as they did in cities across Libya.
“From the beginning of the war in Nalut, there were members of the Revolutionary Committee who took pictures and the names of protesters during demonstrations,” says Dr. Bhiey from Egypt. They were later arrested at checkpoints or harassed.
Duty-bound in solidarity with the people, despite the anxiety, this surgeon has no plans to leave.
“My wife was bathed in sweat; the sound was very, very loud,” says Bhiey about the Katyusha strike that shocked his Moroccan wife and their three children. “Now when [she] hears a mosquito, she is scared.”
Sign up for our daily World Editor's Picks newsletter. Our best stories, in your inbox.