* Children are among Misrata’s casualties
* Poor records mean number of wounded unknown
By Nick Carey
MISRATA, Libya, July 18 (Reuters) - When 12-year-old Mohammed Bielshak left the house with his brother Ali on March 20, it was to give water from their well to thirsty rebels nearby who were fighting forces loyal to Muammar Gaddafi.
“All we wanted to do was help the revolutionaries,” Mohammed said.
While they were out in the street, they were hit by a rocket-propelled grenade. Ali, 14, sustained shrapnel wounds in the leg and stomach and now walks with crutches. Mohammed lost his right arm just below the elbow and his left thumb and was blinded in his left eye. His right leg was fractured and has had reconstructive surgery on his left leg.
NATO began a bombing campaign March 19 to protect civilians from the Libyan government, which was suppressing an uprising against Gaddafi’s 41-year rule.
Gaddafi’s government has denied that it has deliberately targeted civilians and says it is waging a war against armed criminals and al Qaeda militants. But Mohammed is in no doubt about who fired the grenade that day in Misrata.
“It was Gaddafi’s militia,” he said, unprompted, as he winced during his regular treatment at the Al Jazeera Physiotherapy Centre. “They fired the RPG at us.”
The rebels here have pushed Gaddafi loyalists out of the city and to a front line around 36 km (22 miles) west of Libya’s third largest city. They are now 10 km (six miles) east of Zlitan, the largest city between them and the capital Tripoli.
Mohammed is just one of the thousands of casualties of the fighting in and around Misrata since the start of the uprising. As a great many wounded have been sent abroad for treatment — Mohammed, for instance, was treated in Turkey for two months before returning home — the true price of Misrata’s freedom from Gaddafi’s rule is as yet unknown, not least because data is hard to come by.
But there is little doubt among some of those providing care to children like Mohammed that when the injured start coming home in larger numbers, the city will struggle to provide them with the treatment they need.
Doctor Al Hadi Almouda, who heads the Al Jazeera clinic, says that staff there are currently treating 160 people.
“When more of the injured return home, I don’t think we will have the facilities or the staff to treat them,” Almouda said. “Nobody knows when they will return or exactly how many of them will come, but they will need treatment for a long time.”
“It’s going to be a big problem for us,” he added.
Getting hold of data in Misrata is not easy, in part because of the chaos of the early days of the fighting.
For this article, staff at the Al Hekma promised casualty numbers several times, in particular for children. But that data did not materialize.
Instead, a doctor at the International Medical Corps field hospital near the front line provided the latest official figures for the city since the uprising began in mid-February – with the caveat that the data may be incomplete. As of July 16, 813 people in Misrata had been killed, 7,848 had been injured and 781 were missing.
How many of them are children like Mohammed is also hard to ascertain.
“Unfortunately, there is little reliable data available,” said Demetrios Mognei, a doctor at the IMC field hospital.
Mognei says that part of the problem is that record keeping at Al Hekma until late March was haphazard because the hospital was inundated with casualties and doctors had little experience with war wounds. He estimates that amputations made up around 15 percent of cases in the early days, compared to around 2 percent now.
“The doctors here did not have the time, the experience, the supplies or the equipment,” Mognei said. “That is why the number of amputations was so high.”
Mognei said that when polytrauma, or multiple wounds, occurred, it was more expedient to remove a limb while trying to treat a patient’s more serious wounds.
Thanks in particular to experienced Libyan doctors working in the United States, Canada and Germany who have returned home to help out, Mognei said the number of amputations has been brought down to their present levels.
“Those doctors are more flexible when it comes to approaching cases and preventing amputations,” he said.
It is not just the physical damage that Misrata will be dealing with for years, but also the trauma that accompanies the wounds of war.
While Dr Almouda administers physiotherapy to Mohammed at the clinic, he attempts to lift up the bandage on the boy’s left leg to show the extensive, red scarring left after the reconstructive surgery he received in Turkey.
Mohammed keeps pushing his hand away, becoming increasingly frustrated.
“Enough! Enough” he eventually shouts, more in anger than in pain.
Upon leaving the clinic he insists on getting out of his wheelchair, then slides down the front steps on his backside and gets into his father’s car unaided.
He is taken to a school nearby where a group of women — who call themselves the Association of Our Generation for Unity — engage him with a Playstation. The group provides games and a place for injured children to socialize. But this day is just for Mohammed, who has steadfastly refused to come here.
“We find trouble getting many of the kids to come here,” said Marwa Karami, 19, a medical student who set up this programme with her sister Salim, 22. “They want to stay at home and don’t want to go out among people.”
Salim, an economics student, said the war has been hardest on the children of Misrata.
“Adults like me find it difficult because we have only ever seen war on television,” she said. “Not on our streets. Imagine how hard it is for the children.”
At a new physiotherapy centre set up by the University of Misrata’s Faculty of Medical Technology, the centre’s head Agila Erfaida says that injured women have also been traumatized.”
“It is easier for the men who are fighting this war because to be wounded fighting Gaddafi is a badge of honour,” he said. “But women do not expect to be shot when they are unarmed and find it much more difficult to deal with.”
It is clinics like this and Al Jazeera that will have to shoulder the burden when Misrata’s injured return, though it is hard to say how many of them there will be.
“It is only when the war is over that we will find out just how big the problem is here,” the IMC’s Mognei said. “It is only then that we will know what price the people of Misrata have paid.”
Editing by Giles Elgood