The vicious war being waged in Libya is making it almost impossible to deal with the COVID-19 pandemic in the country, bringing great misery in the infamous detention centers, where hundreds of migrants, asylum-seekers and refugees endure arbitrary and indefinite detention in dire living conditions. 

Despite calls for a ceasefire to allow for proper preparedness and response planning to put in place, fighting intensified in and around Tripoli, with more indiscriminate shelling and deadly attacks on residential areas and health facilities. 

From what I have seen while managing Médecins Sans Frontières/Doctors Without Borders (MSF) operations in the country, the pandemic – or, rather, the response to it – has made the daily struggles of Libyan civilians worse, and exacerbated the misery of migrants stranded in the country. 

Already juggling with security constraints caused by the escalating conflict, we had to scale down our operations as airports and borders closed, hampering our ability to receive medical supplies and an influx of experienced international staff, to renew the visa of those already here while forced to evacuate others at risk of developing severe forms of the disease. 

Prior to the COVID-19 pandemic, the political constraints, security challenges and the paucity of international staff on the ground, mainly concentrated in Tripoli, meaning that humanitarian programs to assist and protect migrants in Libya, even when properly funded, had already failed to deliver. 

For some 1,500 people currently held in the detention centers nominally under the authority of the Libyan agency fighting illegal migration (DCIM), there is utter despair. The halt of United Nations High Commissioner for Refugees (UNHCR) evacuation flights and International Organization of Migration (IOM) repatriation services in the wake of pandemic-related travel restrictions extinguish their only hope of a way out of a cycle of abuse and violence. 

It is common knowledge that overcrowded detention facilities with poor sanitation and ventilation encourage the spread of disease – as shown with previous tuberculosis outbreaks. Where to isolate? How to access adequate and timely healthcare? Key questions, which the pandemic makes more pressing, have remained unanswered or, at best, addressed on a piecemeal basis. 

In the weeks following the first cases of coronavirus in the country, the resulting price increase and shortage of basic food items combined with curfews caused mounting concerns over food provision in the detention centers where we provide medical and psychosocial assistance. 

Despite this recent deterioration, the food security program led by the UN food agency, WFP, has not yet intervened with direct food aid in detention centers, believing to do so would infringe its opposition to arbitrary detention. 

This encapsulates a general trend among international humanitarian actors who have adopted a very principled approach to detention. More than ever, this is not the time to abandon people held in Libya's detention centers to their fate. 

For more than three years, we have seen how important it is to ensure a physical, regular presence in the detention centers not only to improve the living conditions and conduct medical consultations but to reach out to the men, women and children locked up with no end in sight, speaking up on their behalf and exposing the inhumanity of their situation. 

Yet, most migrants and refugees in Libya are not held in DCIM detention centers. The vast majority, including those released or who managed to make their way out of detention centers in recent months, live in the main Libyan cities. There, they are exposed to threats of arbitrary arrest and detention, robbery, kidnapping, abuses and worse. 

While the early establishment of preventive measures such as curfews, lockdowns and closure of borders have likely contributed in containing the spread of COVID-19 in Libya, it has further disrupted an already fragile economy. 

Above all, it has significantly eroded opportunities for migrants to get access to daily work and other income-generating activities. Combined with the rise in food prices, as Libya imports the vast majority of its dietary needs as well as other essential goods such as hygiene products, this is leading to desperate situations: Migrants, often former patients in detention centers, now left without food and unable to pay their rent in Tripoli. 

Support provided by international aid agencies to migrants and refugees in urban settings outside of detention centers mainly consists in a one-off relief package, including cash assistance, and ad-hoc distributions that are subject to cancellation due to security and access challenges in a city at war. 

Migrants and refugees are pushed underground, out of sight and out of reach. Most initiatives to set up shelters supervised by international organizations, for instance in Janzour, have so far been unsuccessful as negotiations between humanitarian actors and the Libyan authorities dragged on with no tangible outcome. 

Such places where vulnerable migrants and refugees could find a minimum level of safety and decent living conditions while seeking more durable solutions, like evacuation, are more needed than ever. In fact, although limited, evacuations organized by the UNHCR were the only effective protection measure benefiting a fraction of the stranded refugees. They are left with no other alternative but attempt a dangerous sea crossing. 

The situation requires a radical change, which at the very least, means making the protection of migrants and refugees trapped in Libya an international priority. COVID-19 is a real and actual threat, but the response can't be worse than the disease. 

This is particularly true for stranded migrants, further exposed to violence in the new context created by the pandemic and with even fewer solutions to flee. The issue needs to become a real topic of negotiations to unlock the deadly stalemate, notably by restarting and scaling up humanitarian evacuation mechanisms.

Sacha Petiot is MSF head of mission in Libya.  

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