Libya is a country of nearly 6.5 million people, and the availability of emergency medical care can be summed up this way: It is almost nonexistent.
It is for that reason that a leading emergency physician from Massachusetts General Hospital, Dr. Thomas Burke, chief of the Boston hospital’s Division of Global Health and Human Rights, found himself in Benghazi, Libya, on Tuesday. Burke was preparing to begin a 10-year cooperative effort between Mass. General and Benghazi Medical Center to develop an emergency care infrastructure, when tragedy struck.
Just hours before Burke was scheduled to meet with John Christopher Stevens, the US ambassador to Libya, the US consulate was attacked. Stevens and three other Americans were killed, including Glen Doherty, a Winchester native and former Navy SEAL working for a private security company.
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Burke’s colleagues had spoken with Stevens just 45 minutes before the attack, and Burke was on the phone with an embassy attaché when the shelling began.
“He yelled, ‘Oh my God, Oh [expletive],’ and then he hung up,” said Burke, who was in a hotel about a mile from the consulate when the attack began. “Then we heard these deep blasts. We didn’t know what was going on. Nobody knew if the whole city was being attacked.”
Burke is well known in the field of global medicine, specializing in maternal, newborn, and child health, and has done considerable work training and educating health care workers in sub-Saharan Africa, said Roy Ahn, associate director of Burke’s division. “He’s very passionate about serving the poor and the vulnerable and the disenfranchised,” Ahn said. “That thread is pretty consistent throughout his career.”
Burke has seen his share of horrors across the world, but he described the situation in Libya under the 42-year-reign of Moammar Khadafy as horrific.
The Benghazi Medical Center was built nearly 30 years ago, but did not open until 2009, “in keeping with Khadafy’s policy of controlling eastern Libya by severely restricting resources,” according to Burke.
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“At the hospitals, the physicians have no management experience because Khadafy controlled everything,” Burke said from London on Thursday, where he was preparing to board a flight after initially evacuating to Istanbul.
“They have never made a budget, don’t have any structure, and don’t know how to do it,” Burke said. “It’s astonishing because we’re so used to the basic infrastructure, but they don’t know how to do it.”
In addition to helping develop a pre-hospital care system and an emergency department, Burke said Mass. General is focusing on putting together a management and leadership training program for hospital staff.
When the revolution in Libya began in February 2011 — leading to the overthrow and killing of Khadafy — Burke said that Benghazi Medical Center developed its emergency department in “a hasty 20 minutes” as the injured streamed in.
Burke said Stevens was elated that Mass. General was working with the Benghazi hospital, and was “really happy and upbeat” when Burke’s colleagues spoke with him just before the attack. Stevens was scheduled to visit the hospital and meet with Burke the next morning.
“Everybody in Benghazi really loved [Stevens], and the leaders of the hospital knew him well and had him for dinner in their homes,” Burke said.
Laila Bugaighis, chief medical officer of Benghazi Medical Center, issued a statement condemning the attacks, but said she did not believe Stevens was specifically targeted.
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“What happened in Benghazi . . . is shamefully horrible, but should not be misinterpreted. There is never an excuse to barbaric action,” she wrote. “Those who claim it was stirred by some silly movie that attacks the prophet of Islam are just trying to find an excuse for selfish violence.
“Those who think the American consulate was targeted are also mistaken,” Bugaighis said. “Benghazi will never forget what the American government did for us, and their humanitarian stand with the Libyan people is something that can only inspire gratitude.”
Billy Baker can be reached at billybaker@globe.com. Follow him on Twitter @billy_baker.