Abderrahaman Mohamed Lehbib, pediatrician in the Tindouf camps
Dr. Abderrahaman Mohamed Lehbib is the only Sahrawi pediatrician working in the Tindouf refugee camps. At 71 years old, he does not think about retirement, but rather about continuing to fulfill the debt he contracted with his people 50 years ago, when they were expelled from Western Sahara.
In his consultation at the Smara Hospital, located in the Sahrawi refugee camp in Tindouf (Algeria), Dr. Abderrahaman Mohamed Lehbib smiles when asked why he chose to be a pediatrician. «I didn’t decide. “I was going to be an engineer, but at that time medicine was the most important need.” He, like many colleagues of his generation, set out to cover the most needy and sensitive sectors of the newly built refugee camp 50 years ago. The vocation was something secondary. In those years, the memory of their land, Western Sahara, was recent and the Sahrawis had not long ago crossed the border with Algeria to settle in their tents and flee the war against Morocco, forced to abandon that home that half a century later only the elderly know.
Mohamed participated in the war for two months. Then he moved to another front: the health of his people. Since then, he incurred debt. He would study to continue serving his country, which was beginning to bury its guerrillas. «While I was studying, others fell martyrs. At least you had to pay for it with something, right?” he asks. He graduated in Medicine in Cuba in 1982 and worked as a general practitioner in the camps until he obtained specialization in Pediatrics in 1996.
Mohamed Lehbib remembers the first years of his profession. “At that time there was no schedule,” he recalls. Those were the most delicate times for both the doctor and his patients: «There was no one to advise you, neither as a general practitioner nor as a specialist. “We had to attend to all the cases.” He says that a good part of the people continued with the very latent Bedouin spirit and did not go to hospitals until the patient was already in a serious condition. “The patient arrived to you practically when he was already knocked out,” he says. For the doctor, these were difficult times, but he managed to open a path that continues today. «We made all the effort we had to make. I think it was successful and many lives have been saved,” he reflects.
At 71 years old, he is the only Sahrawi pediatrician in the camps. It is not due to a lack of doctors, but of professional opportunities in this place, which causes many professionals to emigrate to Europe, mainly to Spain, in search of better living conditions.
Together with the Cuban Brigade, they must address the health problems of a population of more than 65,000 minors all year round, according to data from the last official census completed in 2018 by the United Nations High Commissioner for Refugees (UNHCR). Added to these are some sporadic medical missions that alleviate that workload a little.
With these resources, pediatricians face diseases such as anemia, one of the most persistent in the camps. In 2023, the indicators revealed that 54.9% of children under five years of age suffer from it. Malnutrition and respiratory diseases are other challenges that Mohamed encounters every day, as he himself acknowledges. «Here the basic basket does not cover the monthly demand that families have. And they’ve been doing it for fifty-odd years as an emergency service. We have been refugees for half a century. We do not have to continue receiving emergency aid, but that problem has not yet been resolved,” denounces the pediatrician.
An emergency that in recent years has resembled a bottomless pit. In November 2023, the Sahrawi Red Crescent warned that the basic basket received by 133,672 people was reduced by 30%. Its president, Mohamed Sidahmed, warned a couple of months later that malnutrition was becoming chronic in children under five years of age and reported that “a third of children were malnourished” and that 73.9% of pregnant or breastfeeding women suffered from anemia.
These are alarming data for a population that is very vulnerable to food insecurity. The Joint Assessment Mission 2022, promoted by the World Food Program (WFP) and UNHCR, recognized that 90% of the Sahrawis do not have weapons in the face of the lack of food. If we talk about dependency the figure is even higher. The study revealed that in June 2023, 94% of surveyed households depended on WFP support for basic food.
But not everything is negative. In recent years, a successful vaccination campaign has been developed that protected 97% of the population under 30 days of age from diseases such as tuberculosis.
The daily consultation
The data lands in a waiting room where mothers with their children are seen entering and leaving Mohamed’s office, who does not have a single minute of respite throughout the morning. But compared to the above, this is bearable. “At most, currently I don’t exceed thirty-something patients, at most 40. Before it was up to 100.” Even so, talking about attention to all cases makes no sense. «What’s up! It’s impossible. We can’t, we try, but when you go beyond 30 patients a day it reaches a point where they are poorly cared for,” he says.
Salka Mahdi enters the office with her children, Mahdi and Salam Salek, aged four and two. The doctor examines the older man on the stretcher. He thinks it is hepatitis. You will need to have an analysis done to confirm this and obtain a complete liver profile. With the second, Mohamed asks the mother to help him calm her down so he can listen to her. Salam Salek cries while Mahdi laughs and claps like an imp on the other side of the room because of the bad situation her sister is going through. Mohamed sweetens his voice to calm her down. It seems like he has nothing.
The doctor opens his office on Mondays, Tuesdays and Wednesdays in Smara, while on Thursdays he participates in activities and meetings at the Ministry of Health, located in Rabuni, the administrative capital of the camps. On the first Saturday and Sunday of each month he goes to El Aaiún, the following to Auserd, then to Boujdour and, finally, to Dakhla, the wilaya further away from the rest of the camps. He reserves Fridays to rest, although sometimes he takes the car that same morning to save a day and serve more people the weekend he has to go to Dakhla.
He prefers to open as soon as possible, at nine in the morning at the latest. The time spent in the consultation is set by the patients themselves. «I work until there is no one. Maybe when I leave someone will come, but with the patients here I will never leave without leaving one untreated,” he says decisively. And so all year round, except when he travels to other countries to participate in conferences.
The lack of specific materials and medicines is another of the challenges facing the Sahrawi health system, in which all its branches suffer from this dryness of resources. Others are yet to be developed, such as neonatology. To this day there is still no professional specialized in this area, which falls to Mohamed. This whole situation makes the tasks of professionals difficult, from issuing diagnoses to things as simple as when Mohamed has to do a urine test on a baby, but they don’t have the bag to collect the sample.
In a context like this, complications do not alter him. «From the experience we have suffered in the first years, complications are something you assume, what really affects is when you have cases with solutions and you do not have the means to give them them. “That is the most shocking thing we found,” he acknowledges.
At his age he has to make efforts, especially after the heart attack he suffered and the tension problems he suffers, which has reduced his resistance. “I also had cataract surgery and I can’t work that long, but before I could be here until six in the afternoon,” he says.
He is not aware that there is a possible replacement, but he does not think much about it and even less about retiring. For him, above any retirement regulations is his law, that of the Sahrawis. «Our law of the revolution is that there is no retirement until after the triumph. As long as I can do something, I will continue doing it,” he promises.
—But don’t you get tired?
—And if I were tired, what would I do? If you were in my position and you saw reality, perceived it with your eyes, would you withdraw? More years have passed than I have left in my life. I never think I’m tired.
That’s the payment.
