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BENGHAZI, Libya (Reuters) - A team of foreign doctors has arrived the war-torn Libyan city of Benghazi to carry out heart surgery on at least 30 young children during a month-long flying visit to a country where healthcare is in tatters.
The treatment is almost impossible for Libyan families to obtain due to the collapse of the health system and an economic crisis that makes sending patients abroad unaffordable.
The doctors have been visiting eastern Libya since 2012, but did not go to Benghazi for two years because of fighting that has destroyed parts of the city and is still raging in one downtown neighbourhood.
This time they hope to operate on 30-40 children, though the final number will depend on the complexity of children's' defects. Most are under three years old. Some could die within weeks without the treatment.
Khaled al-Fellah's 19-month old daughter Zahra was among the first to receive the surgery.
"Her heart problem was discovered the day of her birth ... We received basic treatment to maintain the condition as there were no possibilities (for medical care)," he said.
"The diagnosis was wrong many times. When the diagnosis was correct a surgery had to be performed. We should have had this surgery 10 months ago."
The team is led by William Novick, an American doctor who set up a foundation that has treated children with heart disease in more than 30 developing countries. They train local staff as they work.
Initially the trips to Libya were paid for by Libyan public funds, but these dried up and they now depend on private donations.
For the past three years rival alliances have been battling for power in Libya, setting up competing governments in Tripoli and the east. Benghazi, where forces loyal to Khalifa Haftar have been fighting Islamists and other opponents, has seen some of the heaviest violence.
A U.N.-backed government has been trying to establish itself in Tripoli since last March, but Haftar and the eastern government have rejected it. Across the country, public services have continued a slow decline.
The health sector, which was heavily dependent on foreign staff before Libya's 2011 revolution, has been crippled by their departure in the turmoil that followed. Medical supplies and equipment are in short supply, and many hospitals are shut or barely functional.
Conditions at the Benghazi Medical Centre have got worse, Novick said.
"The staff is gone. The maintenance of the hospital is low," he said. "I've found that the situation has very much deteriorated since 2012."
Reida El Oakley, the health minister for the eastern government, said a private clinic in Tripoli is the only medical facility in the country that offers heart operations.
The 28,000 Libyan dinar ($20,000) cost is prohibitive for Libyans who "go bankrupt to treat their children" but struggle to withdraw even a few hundred dinars from the bank because of a liquidity crisis.
Trips by Novick's teams have been delayed because of funding shortages. Lives have been lost because of a lack of treatment, said Oakley.
"We have more than 300 kids waiting for open heart surgery, maybe 400," he said. "(The doctors) need to be here full time.
Additional reporting and writing by Aidan Lewis; Editing by Robin Pomeroy