Thousands of fighters have lost limbs in Libya conflict

With the use of more powerful weapons of war in Libya, more soldiers are ending up seriously wounded and maimed.

Libyan medics treat a wounded man at a hospital in Tripoli on August 27, 2011, as fighting was underway on various fronts in the Libyan capital and its suburbs.

Misurata, LIBYA // On a rare break from non-stop operations at his hospital, Ashraf Khalil, an orthopaedic surgeon, caught a glimpse of the dark side of Libya's future.

Driving near the beach, Dr Khalil watched off-duty fighters enjoying a swim in the sea - and was appalled by the number who had lost one or more limbs in the battle to oust Col Muammar Qaddafi and his regime. "So many of our men have been terribly deformed by this war," he said.

The death toll is estimated to be anywhere from a few thousand to tens of thousands, but one fact is indisputable: maimed and injured Libyans will number in the thousands. "We have no facilities for prosthetic limbs or even enough wheelchairs," said Dr Khalil, 30.

Basic medical supplies are now streaming into Libyan hospitals in abundance but the more expensive equipment to help the disabled to live fuller lives - each prosthetic limb must be tailored to its recipient and sometimes surgically attached - will be longer in coming.

More than 60 doctors, occasionally helped by medical staff visiting from abroad, have been working non-stop in the emergency ward of Mujamma Aliadat hospital in Misurata since the uprising began in February.

At first, the injuries were simple bullet wounds. "A small hole in and a small hole on the other side," said Dr Khalil. Often, they could patch them up without a major medical emergency.

But as was shown when 73 fighters were rushed to the hospital last Thursday from the front lines near Bani Walid and Sirte, the injuries have become much worse as both sides began using anti-aircraft guns, rockets, landmines and mortars.

The most common injuries now are amputations and "open fractures", which are bones literally shattered and sometimes jutting out of the body from high-velocity wounds.

Dr Khalil said he has conducted 30 amputations and about 50 other surgical operations on open fractures.

Amplify that by the 60 doctors in the ward and you get somewhere near 4,800 life-altering injuries at one emergency ward in Libya, although with Misurata at the centre of some of the fiercest fighting there may have been more injuries here than elsewhere.

David Cameron, the UK prime minister, highlighted the issue on a visit to Tripoli this month.

He promised to provide 50 beds at specialist hospitals to fit prosthetic limbs and provide rehabilitation - but at the new Libyan government's expense.

International aid organisations and charities have begun fund-raising for equipment but preparing a nation for tens of thousands of disabled people will be a large undertaking.

From offering psychiatric help to creating new transport systems and making streets and buildings wheelchair accessible, the needs of the nation's wounded are manifold.

"This is the next phase - the rehabilitation of the injured people from this war," said Soadde Messoudi, communications coordinator in Libya for the International Committee of the Red Cross (ICRC).

The organisation was bringing in equipment to help to keep up with the demand for prosthetic limbs and other rehabilitation needs.

Perhaps nowhere in the region has shown the need for preparation in dealing with thousands of injured people than Iraq, where eight years of conflict have wrought havoc on the civilian population caught in the crossfire.

Many children have become orphans and the hospitals cannot produce enough prosthetic limbs to treat everyone in need.

For Dr Khalil, the difficult days are not close to being over. His brother, who was transporting ammunition to members of a rebel fighter brigade, had the skin torn from his arm by a rocket, and required a skin graft.

While Tripoli and Benghazi have begun their path to normal life, the emergency ward in Misurata is still an endless rotation of surgery, amputations and suturing.

Doctors live inside dormitories at the hospital, taking only the occasional break for a few hours of sleep, a meal and a fresh pair of scrubs.

"We never thought we'd see anything like this in our whole lives," said Dr Khalil. "I've seen things here that I couldn't imagine before - children finding a landmine, even women jumping from buildings. They couldn't take the fear of Qaddafi or the loss of their sons."