Lebanon: One year after the battle, medical needs remain high in Arsal

17 Aug 18

Abdelhameed (75) from Arsal in Lebanon and Abdellatif (56) from al-Qusayr in Syria might not know each other, but what they have in common is more than just the similarity between their names. Abdelhameed and Abdellatif have both lost everything to war, Abdelhameed to the Lebanese civil war years ago and Abdellatif to the war in Syria, which forced him to flee. Likewise, they have both been diagnosed with chronic illnesses and neither would be able to afford medical care without the assistance of MSF’s medical team in Arsal.

MSF began working in Arsal, on the Lebanese border with Syria, in 2012 and has been continuously providing free medical care for vulnerable communities of both Syrian refugees and local Lebanese residents ever since. MSF’s Bekaa project coordinator Sergio Bianchi explains why MSF first began working in Arsal.

Arsal was strongly affected by the Syrian crisis. Not only does it host a high number of refugees but the residents of Arsal suffered from instability with armed groups present in the area for years. During this period, access to the town was limited which had a huge impact on the living conditions in the town, the delivery of international humanitarian assistance and the access of Arsal’s residents to basic services. MSF started providing primary healthcare services and mother and child care, free of charge, in order to ensure the availability of these services through these tough times in Arsal.”

It was no easy feat for MSF to continue providing medical services in Arsal over the years. Our teams faced numerous challenges, mainly related to security but also due to the lack of other aid organisations in the town. The battle of Arsal in summer 2017 pushed armed groups from the area completely and brought relative stability to the town. As a result, MSF was able to step up its response in Arsal, developing outreach activities in the community as well as reinforcing the team with expert international staff.

Yet, despite the improvement in the security situation in Arsal over the past year, the humanitarian situation has not improved virtually at all. Humanitarian agencies remain largely absent whilst medical and humanitarian needs amongst both the Syrian and Lebanese residents remain extremely high.

Despite the relative stability, there are few organisations in this town providing primary health care. Specialized secondary health care services are just not accessible to the community as only two field hospitals, both with limited capacity, are present in Arsal,” continues Bianchi.

Our teams all struggle to refer patients, especially neonates and those needing specialised chronic diseases care or psychiatric services. For instance, it could take two to three hours to refer a baby that needs an incubator from our clinic. This is because most patients need to be sent outside Arsal, to Zahle, Beirut, or even Saida. Furthermore, some of our patients do not have the papers that allow them to travel.”

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One such patient was Ahmed, just 57 days old. He arrived at MSF’s clinic in a critical condition and was diagnosed with sepsis. He needed an urgent referral to another hospital for tests and treatment, but his doctor was forced to call around for hours before one an hospital would accept him.

Likewise, pregnant women struggle to access safe delivery services as well as affordable ante-natal and post-natal care. MSF’s maternity clinic assists women with 80 normal deliveries each month.

I delivered my first baby in MSF’s clinic,” says Gharam, who is five months pregnant. “I’m currently receiving ante-natal care and will deliver my second baby here too. The care I received was good, and the services are free. I can’t afford delivering in another centre.”

Back in the chronic diseases clinic, Abdelhameed, who suffers with diabetes, awaits his consultation. The door to the doctor’s room opens, Abdullatif picks up his belongings and his medication to head home. He really understands the importance of committing to medication and follow-up visits because his diabetes deteriorated when he first fled to Lebanon from Syria. “We lived through a difficult security situation in Arsal where it was hard to travel. Still, we could come to this clinic. It never closed,” says Abdellatif.

Abdelhameed’s sits down with the doctor; he recently needed emergency surgery. He had to be hospitalized in Zahle, and even with the contribution from the social security fund he had to pay $1000 US dollars to cover the costs.

 “The fact is that the health needs of people in Arsal are not being met by the services offered in Arsal today. This gap is especially serious at the secondary health care level. More assistance is needed in Arsal in order to meet the needs of both the Syrian and Lebanese populations who are in urgent need of quality, affordable care,” ends Bianchi.

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