Two years ago I expressed my individual feeling in a small article that was posted on Ibnosina website (www.ibnosina.org); I titled it as "Let us prepare for 2007". Most likely, it was read by very few people.

I came cross it today and read it to remind my self of what I wrote. If you are interested the following link takes you to the article from that was published more than a year ago.
(http://www.ibnosinahealth.org/modules/AMS/article.php?storyid=31)

In any case after reading it I decided to express my feeling today. In one sentence, when I wrote this article, the hot topic among Libyan health professionals as well as the public at large was the treatment abroad.

Unless I am out of touch because of distance or illness, I am not sure that we have solved this issue yet. Our boarders with Tunisia are still quit busy with medical tourists who either sold their belongings or borrowed money to go for treatment in Zarzis, Sfax and Sousse and all the way to Tunis. The same goes if you visit Tripoli international air port. The planes to Jordan, Egypt and Europe have fair amount of Libyan medical tourists too. I call them medical tourists for the lack of a better term.

Some have suggested to me that these patients are not very smart. They are leaving excellent care in Libya to spend their money on a commercial one abroad.

I certainly do not agree with this opinion. Excellent, average or poor care is outside the topic for this treatise. It is the trust in the Libyan public health system is what seems to be driving people to seek medical care abroad. It seems that such a trust is way below any measures. At least that is my opinion and I am happy to see that I am wrong.

Along with the problem of continuing seeking treatment abroad by Libyan citizens, I see that there are other issues are currently being added to the discussion agenda in the country such as whether it is necessary to have a secretariat of health or not.

This question is too big for my hat but I may predict that the elimination of the secretariat of health will worsen the problem. I say this for the following reasons:

1. Secretary of health has a huge responsibility coordinating many needs for the entire country. Such responsibility can not be done by the individuals in their own municipal jurisdictions. National disease prevention and control centers, vaccination, infection control, medical personnel supply and many others can be done only at the national level.

2. The health laws that deal with delivery of health care, ethical issues, medical errors are initiated and modified on a national level rather than a municipal level.

3. At this point I see such discussion is really taking the country backwards. Other health professionals are functioning beyond the infrastructure issues and we are discussing how we are going to function for the rest of the year. This appears to be placing the health officials in Libya at a point of mental paralysis. They simply can not think long-term with this issue at hand.

4. I see the health services in Libya and their complex problems to be beyond the abilities and vision of one person. I think we need a task force that is working full time with credible charges, budget, authority, time table and accountability.

5. The bottom-line is the need for redesign and implementation of a health system with very long-term goals. A health service that is transparent and have a clear target that is the health of all citizens. Regarding the name no problem. You may call it Department, administration, Secretariat or authority or whatever as long as it takes good care of our citizens.

About the author
The author is a Transplant Surgeon at Ohio State University. Columbus, Ohio, USA. He contributed this article to The Tripoli Post. He can be reached at: elkhammas.1[at]osu[dot]edu