“While the hospital compound was safe, we could easily hear gunfire and bombings…we were scared… for the last one month, we did not have access to cooking gas and had to use electric heaters to cook food…and in just eight months, I could not earn enough to recover the expense [of my loans].”  –Princy, a nurse from Kerala’s Ernakulam district working at the Tripoli Medical Centre hospital. (Source: The Hindu)During conflict situations, violence can transform health workers’ professional and personal livelihoods. They often suffer threats that are physical, financial, and emotional.

Indian health officials are grappling with this issue now as they determine how to assist Indian nurses trapped in regions of Libya engulfed in intermittent fighting.

Earlier this month, Kerala Chief Minister Oomen Chandy and Federal Foreign Minister Sushma Swaraj organized evacuations for thousands of Indian nurses who worked at Libyan hospitals in Tripoli and Benghazi.

The Indian government has issued a plea for banks to waive interest on loans to health workers caught in conflict zones.

Nonetheless, only 10% of Indian health workers in Libya expressed interest in evacuating. Both international and local health workers choosing to remain in Tripoli and Benghazi have been caught in the escalating fighting among rival militia groups, most devastatingly demonstrated by the kidnapping and gang rape of a Filipino nurse last month.

Shelling in civilian areas has also posed enormous threats to health facilities and staff in Tripoli’s Al Afya hospital, which was severely damaged by militia shells aimed at the Tripoli International Airport only three kilometers away.

In this context, it is essential that the global community take immediate steps for ensuring the safety of health workers in Libya, and hold perpetrators accountable for these clear violations of international law.

In addition to immediate threats to personal security, violence in Libya has also posed life-changing financial strains on health workers. In the midst of intensifying violence and fleeing staff, remaining nurses report that salaries have not been paid for months at local clinics. This poses an enormous financial burden not only for the immediate welfare of health workers and their families, but for their future abilities to repay the sizeable loans often taken out to finance their travel and work in Libya.

Although the Indian government has issued a plea for banks to waive interest on loans to health workers caught in these conflict zones, we must do more to prioritize the financial security of these workers.

Ensuring the security and welfare of health workers in conflict requires comprehensive measures for ensuring their physical, financial, and emotional well-being. The risks war and violence pose to frontline health workers is not one-dimensional, so policies designed to safeguard their well-being ought not to be, either.