Bowsher Gemma, Bogue Patrick, Patel Preeti, Boyle Peter, Sullivan Richard
1Conflict and Health Research Group, King's College London, London, UK.
King's Centre for Global Health and Health Partnerships, Suite 2.13 Weston Education Centre, Cutcombe Road, London, SE5 9RJ UK.
Confl Health. 2018 Jul 9;12:29. doi: 10.1186/s13031-018-0162-0. eCollection 2018.
The conflict environment in Libya is characterized by continued pervasive insecurity amidst the widespread availability of small arms and light weapons (SALW). After the First Civil War, armed brigades took the law into their own hands and the resulting violence terminated a short-lived post-conflict period that has relapsed into a Second Civil War. The Libyan government has struggled to assert authority over armed groups and these brigades, refusing to disarm have contributed directly the initiation of a second conflict; some are motivated by self-defense, status, criminality, vindication or political aims. Once, a bastion of public health in the Middle East and North Africa (MENA), the country now faces a substantial and unprecedented challenge: to rebuild a devastated health system amidst the burden of armed violence and the proliferation of small and light weapons (SALW) especially firearms of various kinds. The health system in Libya is compromised; healthcare professionals have little time to record or document such cases given the immediate clinical needs of the patient. This corresponding decreased capacity to deal with an increasing demand on services caused by SALW-related morbidity compounds the challenge of data collection and indicates that external support and advocacy are required. A public health strategy towards effective SALW armed violence reduction and injury prevention requires the interdisciplinary advocacy of practitioners across the fields of justice, security, development, health and education. Through surveillance of firearms and injuries in the post-conflict environment we can better evaluate and respond to the burden of armed violence in Libya. In order to reduce armed a reconceptualisation of arms reduction campaigns must occur. Notable emerging evidence recommends the inclusion of community-based interventions and development programs which address local motivations for firearms ownership alongside improved international coordination. This renewed approach holds importance for recovery, development and securing the transition to peace. The high prevalence of firearm ownership, weak institutions, nascent security forces, porous borders, inadequate weapons stockpiles, combined with high military spending, compounds public weaponisation as a health crisis for the entire MENA region.
利比亚的冲突环境特点是,在小武器和轻武器广泛存在的情况下,不安全状况持续普遍存在。第一次内战结束后,武装旅自行其是,由此产生的暴力行为终结了短暂的冲突后时期,国家又陷入了第二次内战。利比亚政府一直难以对武装组织和这些旅行使权威,这些拒绝解除武装的旅直接导致了第二次冲突的爆发;有些是出于自卫、地位、犯罪、报复或政治目的。这个国家曾经是中东和北非地区的公共卫生堡垒,如今却面临着一个巨大且前所未有的挑战:在武装暴力的负担以及各种小武器和轻武器(尤其是各类枪支)扩散的情况下,重建遭到破坏的卫生系统。利比亚的卫生系统受到损害;鉴于患者的紧急临床需求,医疗保健专业人员几乎没有时间记录或存档此类病例。这种应对与小武器和轻武器相关发病率导致的服务需求不断增加的能力相应下降,加剧了数据收集的挑战,并表明需要外部支持和宣传。一项旨在有效减少小武器和轻武器武装暴力及预防伤害的公共卫生战略,需要司法、安全、发展、卫生和教育等领域的从业者进行跨学科宣传。通过对冲突后环境中的枪支和伤害情况进行监测,我们可以更好地评估和应对利比亚武装暴力的负担。为了减少武装暴力,必须重新构想减少武装的行动。新出现的显著证据建议纳入基于社区的干预措施和发展项目,这些措施要解决当地人拥有枪支的动机问题,同时改善国际协调。这种新方法对于恢复、发展以及确保向和平过渡至关重要。枪支拥有率高、机构薄弱、安全部队新生、边境管控不严、武器库存不足,再加上军事开支高昂,这些因素共同导致公共武器化成为整个中东和北非地区的健康危机。