As the violence in Libya escalates by the day, the International Rescue Committee (IRC) is warning that attacks on health care and civilian infrastructure are not only adding to the conflict’s ever increasing death toll, but also jeopardising the country’s already fragile COVID-19 response.

At least 28 people were injured and five killed when their homes were hit on Monday, and the organisation is extremely concerned that civilian neighbourhoods appear to be coming under deliberate attack.

Additionally, two field hospitals were shelled on Wednesday injuring five paramedics, while the Al Khadra Hospital in Tripoli was hit three times in the space of just five days earlier in April - putting out of action one of the few hospitals that had been designated to care for suspected COVID-19 cases.

A paramedic was killed when the ambulance he was traveling in was hit 10 days ago, and in just the past week, four other hospitals had to suspend operations as a result of the hostilities - leaving the response stripped of 18,000 consultations that are desperately needed to save lives in this pandemic.

With the country’s health system already so fragile, the IRC is deeply concerned that these attacks on hospitals and other health infrastructure are being carried out in violation of international humanitarian law and are also taking an unacceptable toll on the country’s ability to respond effectively to COVID-19, leaving thousands of vulnerable people at risk if they contract the disease.

According to the latest UN data, 80 per cent of migrants and refugees report not having access to health care, with discrimination and fear of arrest further allienating them from accessing basic services and making them even more invisible as the country fights COVID-19.

“We urgently need a ceasefire. Not only to protect civilians from the fighting, but also to help contain the spread of COVID-19. Recent estimates suggest that only 6% of health facilities are fully equipped in Libya as it is, but many more are now out of action due to the sharp uptick in fighting, meaning this figure is likely far lower in reality,” said Tom Garofalo - Country Director for the IRC in Libya.

“There were thousands of people at risk in Libya even before this pandemic. The country hosts over 700,000 migrants, refugees and asylum seekers - and they are among the most vulnerable in Libyan society. The majority live in densely populated towns and cities where they fear for their lives on a daily basis. They are under the constant threat of robbery, abduction and abuse - one of the main reasons that over 80 per cent report being unable to access health care.

“Most came to Libya in search of jobs and safety, but the conflict has forced thousands to risk their lives in an attempt to reach safety in Europe. At least 3,200 - including children - have been intercepted at sea and brought back to Libya so far this year, but their fate when they reach Libya’s shores again is unclear. Some return to their communities, but others are taken to vastly overcrowded detention centres where they have extremely limited access to health care and are at increased risk of contracting the virus. Neither option is safe.

“Libyans, refugees and migrants alike must be given a chance to protect themselves during this pandemic. People must be able to access health care, doctors must be able to safely get to work. More medical supplies must be brought into the country to boost the response, and health facilities must not be a target. The only way to achieve this is with an end to the hostilities and these calls must no longer fall on deaf ears. In line with the calls of the UN Secretary-General for a global halt to hostilities, all parties to the Libya conflict must agree to a lasting ceasefire and a return to the UN-led peace process. And those responsible for violations of international humanitarian law must be held accountable.”