When rebel fighters returned from the front line to Nalut in Libya's Nafusa mountains last month, Nurden Abosowa, 12, discovered new toys. Parked outside his uncle's house was a pick-up truck with a machine gun bolted to the back – one of thousands of weapons that littered the country.
Nurden and two friends climbed up on to the truck, imagining they were rebel fighters shooting at Gaddafi's soldiers. Then they hit the jackpot. Inside was a pile of unused 14mm anti-aircraft bullets. Excited, they examined their find. Nurden decided to get the gunpowder out of his bullet. Unable to prise it open with his hands, he began to strike it against a rock. A loud explosion brought adults in the surrounding houses rushing out.
In agony and bleeding heavily from his abdomen, where a section of stomach and intestines had been blown away, and from his lacerated hand, where pieces of hot metal were now lodged, he was rushed to the remote town's hospital, a place that until recently would have been ill-prepared to cope with such a case.
Before the uprising that led to Gaddafi's demise, he would have faced a life-threatening two-hour drive across the border into Tunisia, but Nalut hospital has changed dramatically. Merlin, the British medical emergency relief charity – which The Independent on Sunday is supporting for this year's Christmas appeal – has been bringing in new staff and training existing personnel since April.
While the conflict is over, the flow of casualties has continued. Today Nurden looks well. His hand and stomach are bruised and scarred but, a month after his accident, he can move his hand, is walking nimbly and is wearing football shoes – a sign that he has begun to play again. He grins sheepishly as he recalls the accident. "I didn't know anything was going to happen," he admits. "We thought the bullets were safe." He has come to Nalut hospital to see Joanna Woodrow, the physiotherapist whose help over the last month has ensured his hand is moving again, with no lasting nerve damage. The 40-year-old from Yeovil, Somerset, was brought over from the UK by Merlin to help with the immediate crisis and to train nurses and doctors how to use physiotherapy. "The war is over, but now we're facing a new tragedy," Ms Woodrow said. "We fear we're going to see lots of kids, because there are so many weapons around and they are curious."
At the height of the fighting, Nalut became a ghost town: most of the population fled across the border to Tunisia. On the roads in and out of Nalut the detritus of war is everywhere. Abandoned tanks lie by the roadside along with arsenals of discarded weapons. In built-up areas, spent bullet cases are as common as cigarette butts littering the ground. The deadliest armaments left behind are the unseen mines scattered about the landscape. The full extent of the lethal debris is as yet unmapped in Nafusa region so nobody knows when they might inadvertently take their last step.
Mohammed Essa was in his fourth year of medical training in Libya when the war broke out. At first he worked with the rebels, co-ordinating information. He now he works as a logistician for Merlin. He said the risks were increasing as people slowly returned to their farms in the valley. "The places where people were fighting, that's where people have their farms, so there are lots of unexploded rockets, shells and mines there. The children go to the farms to play because there's space, and that's when it happens."
There are no national figures for the number of children injured since the conflict ended last month, but in Nalut, a small mountain town, home to just 25,000, one has died and at least five children have sustained serious injuries. In the nearby towns of Zintan and Zintan East, there have been 12 such accidents, injuring 33 people – mostly children – and killing two.
Last month, Sarag Adin, 51, and his wife Naema Masaud, 43, had just returned home with their six children to Takut village after sheltering from the fighting in Tunisia. Their house had been occupied by Gaddafi forces and was riddled with bullets, but they finally felt safe. Then four weeks ago, while Naema was resting inside the house, she heard an enormous explosion. When she went outside she found her youngest son, Zakaria, 11, lying motionless in their garden.
"He was just frozen and there was blood everywhere," she recalls, blinking back tears. "His hand was blown off, and his left eye and groin were all hit. We had never seen any weapons, but there must have been a land mine we didn't see. Our eldest son fought with the rebels, and we were afraid for him, but we never expected this: the unexpected son died."
They took Zakaria to Nalut hospital but, with no specialist doctors, all the staff could do was stabilise him and send him by ambulance to Tunisia. By the time he arrived, he had been bleeding from a femoral artery for hours. The next day he died.
Libya is not a poor country, but under Gaddafi the health system – particularly in smaller towns – had been neglected. Outwardly, the hospitals look good, but inside they are under-staffed by often poorly trained medical workers from overseas. Many doctors and nurses come from countries such as North Korea, whose dictators struck deals with Gaddafi that included the transfer of medical staff.
Dr Mohammed Gnam, the medical director of the Nalut region, says that outside big cities such as Tripoli and Benghazi, Libyan doctors are scarce – and specialist doctors of any nationality even more so. "Doctors are concentrated in big cities because their opinion is that they can't get experience outside them. People do not trust the whole medical system.
"Most who can will go to Tunisia or Egypt rather then being treated here. There's a shortage of medical equipment, a shortage of specialists and a bad administrative system which means it was going downhill long before the war. Corruption was also a problem; the money wasn't reaching hospitals."
Initially, Merlin responded to the crisis overflowing into Tunisia. As the Libyan people's needs changed, so did Merlin's response. Since September, it has been supporting health facilities across the Nafusa region, improving paramedic and ambulance services, providing health workers and using mobile health teams throughout the region. It has hired doctors, nurses and midwives from neighbouring Tunisia to reopen 16 clinics, and is training them in medical education techniques to pass on their expertise.
The sobering reality is that until the thousands of weapons and unexploded devices littering the country are safely removed, their emergency help will still be required.
How your donation can help to change lives
The Independent on Sunday Christmas Appeal is for the international health charity Merlin, whose medical experts are saving lives in some of the toughest places on earth. Treating people injured during the conflict in Libya, training midwives in Afghanistan, and feeding malnourished children in Kenya, Merlin takes countries from emergency to recovery. A specialist in emergency medical response, Merlin delivers aid in 16 countries, rebuilding health systems that have been devastated by conflict or natural disaster. Just £10 can feed 45 children with life-saving PlumyNut in Kenya; £25 can buy a surgical kit to treat casualties in Libya; £75 can treat one HIV patient for a year in South Sudan.
To make a donation visit: www.merlin.org.uk/independent-on-sunday-appeal or call 0800 035 6035 (24 hour, seven days a week - donation line).