In this interview, Dr. Mona Osman, Director of Primary Health Care Center at the Department of Family Medicine at AUBMC, discusses the interventions implemented by the AUB community to support internally displaced persons (IDPs) in collective shelters, in collaboration with the Ministry of Public Health.
As part of this initiative, activities have been conducted in partnership with multiple departments at AUBMC, including Obstetrics & Gynecology, Internal Medicine (Division of Endocrinology and Metabolism), and Psychiatry.
Additionally, several faculties are contributing to these efforts, including the Faculty of Medicine, Faculty of Health Sciences, Hariri School of Nursing, and Faculty of Agriculture and Food Sciences. AUB-led initiatives such as the Neighborhood Initiative, Center for Civic Engagement & Community Services, Office of Student Affairs, Resident Staff Organization, and volunteer groups and student societies (AUBMcares, Medical Student Society, Nursing Student Society, Premedical Student Society, FHS Student Society, Food & Agriculture Student Society, and AUB Diabetes) are also actively involved.
Addressing Varied Medical Needs in Shelters
Dr. Osman shares, “From the very first week, we mobilized ourselves to examine individuals in shelters, provide them with adequate management and necessary medications.” The Family Medicine Department is striving to address both basic and advanced medical needs across seven shelters in Ras Beirut.
To date, over 1,000 individuals have benefited from these services, which include offering medical care to individuals suffering from acute and chronic conditions, providing them with the required medications and referring those who need further evaluation to the primary health care center in the Department of Family Medicine. The Division of Endocrinology and Metabolism, alongside AUB Diabetes, has also conducted specialized visits to some shelters to offer management and education for those living with diabetes mellitus.”
“Our work extends beyond simple interventions; we also provide options for advanced care at the hospital,” explains Dr. Osman. For example, for women requiring further evaluation in a more private setting or tests, the Department of Obstetrics and Gynecology is redirecting patients to AUBMC for free consultations on Saturdays.
Another significant initiative led by the department is the immunization program for displaced children, many of whom left their homes without their vaccination cards. This will be done as part of the National Immunization Campaign of the Ministry of Public Health. In collaboration with the Hariri School of Nursing, we started collecting data on vaccination from the different shelters. Upcoming activities will focus on assessing malnutrition in children, conducting environmental assessments, and providing health education for persons in temporary shelters.
Common Health Issues Observed
The most prevalent health conditions reported by the AUBMC medical staff on the field include acute respiratory infections, otitis, tonsillitis, bronchitis, gastroenteritis, and musculoskeletal problems (such as joint, back, and neck pain). Febrile illnesses, allergies, reproductive health infections, urinary tract infections, and skin problems (like dermatitis) are also prevalent.
The crowdedness and challenges facing proper hygiene practices in shelters might increase the risk of infections especially with the beginning of the cold season. Exacerbations of chronic conditions such as asthma, COPD, uncontrolled diabetes, and hypertension, are also a major concern, especially given that patients with chronic diseases require continuous access to their medications, follow-up testing and adequate nutrition.
The Psychological Impact on the Community
Given the occurrence of psychological distress amongst children and adults in the community – the Department of Psychiatry has begun offering psychological first aid in some shelters, with plans to extend these services further.
‘Continuous psychological assessments are particularly crucial for children.’ explains Dr. Osman.
In the initial days of the conflict, many in the community experienced significant stress, which affected their nutrition and sleep patterns. An impact assessment on the mental health of children and adults is essential in order to prepare for the post-war recovery phase.
Learning from Past Experiences
Dr. Osman emphasizes the learnings achieved from past experiences and crises to improve interventions during this war. She reflects on the 2006 war, as well as the lessons learned from mobile clinics established for Syrian refugees in 2014-2016, during which the AUB community implemented similar initiatives in shelters.
“We have experience with the necessary documentation, interventions, and assessments in displacement/mobile clinics,” she notes. However, she stresses the need for improved coordination and reporting among different stakeholders to avoid duplication of services and streamline the delivery of efficient healthcare to IDPs.
The digitization of health records and a unique ID system on a national level would be immensely beneficial for efficient, effective, and safe delivery of healthcare services. This is very important in normal conditions and more so during displacement and emergency situations. The Sejjeli program at the AUB Global Health Institute provides an example of digital health that was launched during previous refugee influxes. “Having clear files for each patient would provide comprehensive information about their health condition, the medications they are taking if any and would therefore result in better care” concludes Dr. Osman.
The efforts of the medical community in this war cannot go unnoticed – AUBMC medical staff and healthcare workers are continuously on the front lines of crisis in Lebanon. They have learned to be flexible, agile, and efficient in the most difficult of situations, acting as a backbone to the Lebanese people. As we continue to be faced with one crisis after the other, the urgent need for relief and coordination on a nationally organised effort is felt more than ever.
Tala Nassif
Tala Nassif holds a BA in Economics from the American University of Beirut and an MSc in Development Studies – Labour, Activism, and Global Commodity Chains – from SOAS University of London. Specialized in international development and economic empowerment, Tala currently serves as a Senior Research Assistant at the Asfari Institute for Civil Society and Citizenship at AUB.