Small and light arms violence reduction as a public health measure: the case of Libya

Abstract

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.

Trends and patterns of deaths, injuries and intentional disabilities within the Libyan armed conflict: 2012-2017

“…The country faces serious and unprecedented challenges. No single policy can be addressed in a complex and relapsing conflict environment such as Libya [43,44]. Hence, the country should be alerted to deal with such ongoing consequences particularly within the health care settings.…”

Trends in Suicides and Homicides in 21st Century America

“…We know that social determinants of health such as poverty, level of education, neighborhood-built environment, neighborhood poverty level, and education and economic policies are distal factors that predispose to violence [ 80 ]. While firearms are not the cause of homicide, access to firearms is a force multiplier [ 81 ]. If access to firearms were restricted, even when violence occurs, they are likely to be less fatal [ 82 ].…”

Quality of life at 3 and 6 months in military personnel with a history of thoracic trauma suffered in combat

“…In Colombia, the number of casualties resulting from armed conflicts between 1958 and July 2018 was 262.197, and 46.813 of those victims were part of armed groups (armed forces and outside of the law), and 215.005 were civilians 2 . For this reason, armed conflicts are a public health concern with high economic and social costs, affecting both military population and civilians 3 . Military members who survive combat wounds may manifest a wide spectrum of clinical disorders secondary to physical long-term effects associated with direct organ damage, or psychological alterations, such as post-traumatic stress disorder, which negatively impact health-related quality of life (HRQL) 4,5 .…”