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LPDC Bolsters COVID-19 Ring of Care in Lebanon

At its emergence in early 2020, the COVID-19 virus knew no borders, respected no ethnicity, and knew no social barriers. It began, in many ways, as the world’s most democratic of pandemics. Rich and poor alike were locked down in fear of what was to come. Only towards the end of the year did a divergence appear between the global rich and poor. As the calendar clicked over to 2021, it was clear that the world’s disenfranchised would become increasingly vulnerable to the ravages of the virus.

COVID-19 has disproportionately affected racial and ethnic minorities. Underfunding among refugees and forcibly displaced populations are prolonging the pandemic. Yet, ironically, the battle to control the coronavirus is vastly underfunded in those nations that need support most.

In Lebanon, compound economic and social crises have stretched the state beyond recognized limits. Lack of medications, fuel, electricity, water have combined with a lengthy absence of political leadership to form a toxic vacuum. 

Maintaining support for Palestinian refugees is vital for maintaining peace and stability in a highly uncertain environment.

Into this void, the Lebanese Palestinian Dialogue Committee (LPDC), jointly with the UNDP and supported by Germany’s GIZ, have established working partnerships with agencies including the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), the World Health Organization (WHO), the National Committee on COVID-19, the Disaster Risk Management Unit at the Presidency of the Council of Ministers, and the Palestinian Embassy in Beirut. 

Together, they will support and complement the efforts of the Lebanese Government to mitigate the health, social and economic risks associated with COVID-19; and, in particular, improve the preparedness and response to the coronavirus pandemic for the Palestine refugee population in Lebanon.

The LPDC takes a robust view of the pandemic. 

“We acknowledge that this virus is not a short-term challenge”, says Abdulhadi Chalak, the LPDC’s COVID-19 Response Coordinator. “What faces us are a significant number of variables affecting both the pandemic’s trends and our consecutive response”. 

While the working group initially focused on infection control and prevention, followed by PCR testing, contact tracing and then a shift towards vaccination, this year has been about building capacity for COVID19 treatment – especially for severe to critical cases.

A recent study by the LPDC predicts that an estimated 40,000 people living in camps will contract the virus within the next three to six months.

Of these, 36,000 will require some form of healthcare. While an estimated 12,400 will be asymptomatic or have mild symptoms, around 6,800 people will be severe or critical cases requiring hospitalization, and 3,600 among them will require intensive care. These final numbers are beyond the capacity of camp-based medical facilities.

2021’s addition of over forty intensive care beds and sixty in-patient beds within four key hospitals – Al-Hamshari; Human Call Hospital; New Safad; and El Buss – significantly boosts critical care for Palestinians and, indeed, are accessible to non-Palestinians living in the camps.

Mustafa Abo Atieh, Director General of the Human Call Hospital in Ein El Hilweh Camp, recalls how, in 2020, “we would simply test and refer patients. We could not treat infected patients ourselves, and there was minimal treatment capacity around us in Saida”.

Now though, with six specialized units provided by the LPDC, he reports, “we’re able to treat people from our community within the community”.

The selection of LPDC intervention locations was based on infrastructure availability and the readiness of potential partners and beneficiaries. Balancing between spread and depth, the project delivers a nationwide ring of care by covering the three most significant Palestinian refugee clusters across Lebanon, namely Beddawi (near Tripoli, north Lebanon, Ein El-Hilweh (near Saida, south Lebanon) and Tyre, also in south Lebanon. 

Speaking from with the newly inaugurated COVID ICU ward at the Palestinian Red Crescent Society’s (PRCS) Al-Hamshari Hospital in said, its Director Dr Riyadh Abol’Enen says, “At the beginning of the outbreak, we combined our ICU and pediatric wards to create an emergency COVID ward”. 

It wasn’t the ideal solution, however. The lack of negative pressure led to many of his medical staff becoming infected. Unable to work, it reduced the hospital’s capacity to respond. 

“Our new ward was expressly designed as a COVID ward. It means we can offer optimal care to our COVID patients while protecting our staff at the same time”.

Already, he notes, “the ward is running at almost full capacity”. He adds, “The virus isn’t something that’s going to disappear quickly. We need to remain vigilant and ready to respond to peaks in infection. We must not misunderstand any dips in the infection rate as a sign that the virus has been defeated – this is no time for complacency”.

His staff, who worked tirelessly and at great risk to their safety during the pandemic’s first year, continue to support him and Al-Hamshari’s patients equally as tirelessly but in conditions of heightened health security.

“Each patient has their own respiratory equipment, ventilation, their own syringe, and negative pressure ventilation above their beds”, comments ICU nurse Samir Al Bakri. “This helps us treat with patients as we move hand-in-hand to reach a new phase”. 

Importantly, legacy post-COVID is built into each unit’s design. “All interventions were made with an eye on long-term sustainability whereby a COVID19 ICU can be repurposed to serve as a catheterization laboratory or a regular ICU”, Abdulhadi Chalak points out. 

In addition to wards, plans are in place to increase capacity for PCR testing. With 17,600 PCR test kits delivered to the PRCS already, a new PCR testing machine has been given to New Safad Hospital. Test results are being communicated to the Ministry of Public Health’s platform as part of national follow up.

For the LPDC’s Chalak, “The most important part of the project on top of investment in rehabilitation and medical equipment, is the long-term investment in human capital – namely the frontliners and their supporting staff. With them, we’re focusing on capacity building and training. Additionally, we’re working with beneficiaries on the organizational level to support their long-term sustainability and improve their performance”.

The outbreak continues to penetrate the Palestinian community in Lebanon stubbornly. The Human Call’s Mustafa Abo Atieh points towards a “low vaccine uptake and the fact that people are paying less attention to COVID prevention good practise than earlier in the pandemic” as reasons for the virus’ relentlessness.

With the progressive nature of the pandemic response, future plans incorporate major efforts to promote and support vaccination through awareness, registration and lobbying for vaccine provisions.

The targeted group is the camps and gatherings population, including Palestinian refugees, Lebanese and other nationalities, without any discrimination, as per UNDP’s principle of ‘Leaving No One Behind’.

The LPDC knows this isn’t an emergency that will soon be over, and it continues to invest in building the capacity of the Palestinian community with long-term goals.