In a remote area in Libya, southwest of Tripoli near the border with Tunisia, rebel forces have regained control of the Nafusa mountains after months of heavy fighting against forces loyal to Moammar Gadhafi.
Many residents of the region fled across that border during the battles, but a small group of foreign doctors and nurses stayed behind to help tend the wounded in the town of Nalut.
During fighting on the outskirts of Nalut one day last month, Grad rockets had been raining down for two hours when the first casualty was rushed into the ER.
"That was [a] gunshot in the chest descending to the abdomen. It did a laceration, or wound, in the liver," a doctor explained.
Crowded around the operating table were nurses from Ukraine and the Philippines, a Pashtun anesthetist from Pakistan, and two surgeons — one from Egypt, the other from North Korea.
An International Staff
Jomma Metawa says it's a familiar scene at this hospital. He was running the lab back in 2005 and came back a few weeks ago to Nalut, his hometown, when he heard about the staff shortage.
"We are few, yes, because all Libyan people [are] not here. All the Libyan nurses went to Tunisia," Metawa says.
Others joined the rebels' ranks, like Naji, the man brought to the ER that day.
He worked at the hospital as a lab technician before the revolt against Gadhafi's regime. Then he traded his scrubs for the rebels' khakis.
Naji was marching with the rebels toward a village besieged by Gadhafi's troops when he was shot. It took the international crew three hours of surgery to save his life.
Before the conflict, Libyans and foreigners equally staffed the Nalut hospital, the second largest in the region. Now, three-quarters of the local staff have gone, and the hospital is mostly run by foreigners.
Staying To Help In Libya
Cecilia Castillo, a lab technician from the Philippines, says the decision to leave is more difficult for them.
"Because once we've crossed the border, we can't come back," she says. "And besides, they need us here."
She has been working in Nalut for seven years. She spent 12 years before that in Misrata. She says Libyans are her people, too, and she wants to keep helping.
Ali Gernaz , the hospital's acting director, is Libyan. He says the foreigners stay out of a keen sense of duty and loyalty.
"Can you believe? They're cleaning!" Gernaz says. "We have one physiotherapist, a specialist ... she cleans the room. She's a doctor, but she cleans the room, really. She likes to help us, because now there's a shortage in everything in Nalut hospital."
Nalut was one of the first towns in this mountainous region to attempt to liberate itself from Gadhafi's rule. That was back in February; Gadhafi's forces started to shower Nalut with Grad rockets shortly after that.
The remaining staff had to move into the hospital's basement.
Around the kitchen table, Usha Barai, a nurse from Bangladesh, and Castillo, the lab technician from the Philippines, fix coffee from a dwindling supply.
Chatting with the Pakistani doctor on duty that morning, Barai wonders when life will get back to normal.
"Not in near future, I don't think so," the doctor says.
Then Barai asks when they're going to get paid.
Local authorities fled Nalut when the rebellion began; they left empty coffers behind. No one at the hospital has been paid since.
Care For Family Members?
Opposition leaders have arranged to provide food and other essentials to the staff. Lorna Improgo comes out of the weekly handout with two bags of rice, tomatoes, cooking oil and lime cakes.
"We are lucky we have food," she says, "but we don't have salary. How is that lucky? It's not lucky!"
A young lab technician from Nalut passing by jokingly asks what use the money would be anyway. All the shops in Nalut are closed.
"No! We work here because of our family," Improgo answers. "Not for ourselves. We know that the hospital will take care of us, but our family, who will take care of them?"
Improgo used to send up to two-thirds of her salary to her son, a college student in the Philippines. Now he's only one semester away from graduation, but scrambles to pay tuition. The $1,500 Improgo was to wire him over the spring would have covered most of it.
Improgo says she believes she'll be paid in full at some point, but only if she sticks around.