Main pic: informal refugee settlement in the Bekaa Valley in Lebanon. © Medair/Diana Gorter. Inset: Dr Susan Brown.
THE sun rises over the Bekaa Valley, and as in so many homes across the globe, babies cry, older kids and adults rub their sleepy eyes and get ready for the day.
However, these families are some of 1.5 million Syrian refugees in Lebanon. In the challenges of a “Corona-chaos” world, try to imagine “home isolating” or “social distancing” when your home is a one or two room tent -shared with 10 other people.
This is the reality for the Syrian refugees who live within 6175 refugee settlements in the Bekaa.
I am a Coleraine GP working in Lebanon with the Christian humanitarian organisation, Medair. Within this country which hosts more refugees per capita than any other in the world,
Medair is working alongside Syrian communities and low-income Lebanese families. Our aim is to help provide safer places for them to live, improved health care and community support.
Since I joined Medair here in February I have been helping to co-ordinate our preparation and response to the COVID-19 crisis. Lebanon too has found itself in a whirlwind of the unknown and panic.
NUMBERS STEADILY RISING
Coronavirus finally breached the country’s attempted defences on 28th February and we have watched the numbers steadily rise to 133 people confirmed to have the virus at time of writing. It’s a very different role from what I anticipated, but finding strength, purpose and peace through a strong faith in God, I am finding it challenging but also a privilege to be part of an amazing team.
It has been a week when things have escalated dramatically worldwide.
I find myself alongside other humanitarian Non-Governmental Organisations workers in meetings with the World Health Organisation, Ministry of Public Health and UN.
Working hard to minimise my “imposter syndrome”, I realise that most people are just doing their best to get a grasp of what is going on and the best way to deal with it while navigating a dangerously fragile economy - the cost of health and protection supplies has gone up by 100 times in the space of one week!
We have moved into the “Critical Programming” stage. This allows most staff to work from home with exception of emergency or life-saving work. And yet, we are also preparing to ramp up for “COVID only” work. This includes holding awareness raising sessions, manning ambulance helplines, providing transport and caring for those who are ill- both with Corona virus and without. Despite our current Medair job descriptions, many of us are first and foremost doctors, nurses and midwives. There is much debate about what “Isolation” could possibly look like in a refugee settlement. “Complicated” is a massive understatement.
A focus group was held with some of the Syrian refugees and the responses were fascinating, although at times concerning. Many reported that they would not attend hospital for diagnosis or treatment fearing expulsion from the country. Some of the camp members are incredibly proactive and forward thinking while others refuse to accept advice and continue their cultural practices of visiting the sick and practice unhelpful traditional “cures”.
Although there is no official confirmation yet, we are working on the assumption that COVID-19 is probably already in the Valley and possibly in the unprepared camps. But, without doubt, the most contagious diseases on the rise are fear and panic. Combating rumours and replacing them with facts has been one of my biggest battles so far.
The UN High Commissioner for Refugees recently wrote that “the coronavirus is a test of our systems, values and humanity”.
DIGNITY INTEGRITY ACCOUNTABILITY COMPASSION FAITH HOPE
These are Medair’s six core values. As a global community we can get sucked into referring to “cases” and “high risk populations”, forgetting that these are people with stories and loved ones. I’ve been struck that it has never been more important to keep Medair’s values in clear sight. Last week, at a meeting, there was uproar because one of the country’s first critical coronavirus “cases” had previously had a diagnosis of cancer. “Why was this not shared with the public?” angry attendees demanded. “It would have relieved so much public anxiety if they had known he was ill already”. When the noise finally died down, the speaker quietly responded, “We did not share this information, because the man’s family did not know he had this cancer.”
Gulp. Dignity. Integrity. Accountability.
But then, in hope-filled contrast, I had the opportunity to speak with almost every member of staff in our team. The purpose was to ask about what they’d be willing or feel able to do if we go into "corona-only" humanitarian actions in the camps. I was also just concerned to see how they were holding up in the stress.
INSPIRED TO TEARS
I came away, so encouraged and inspired almost to tears by these incredible people who, despite their fears are finding courage and kindness. My favourite conversation was with a Lebanese member of our Monitoring and Evaluation team (a role that normally involves lot of statistics and numbers) -
Sous: “ Dr Susan, I will do anything. I will do it all."
Me: "Thank you so much, that is really amazing…but Sous, the first two options on this list are roles providing health care for patients with coronavirus if they end up in isolation."
Sous: "Oh...ok…. But will you teach me how to help?"
Me: “....of course”
Sous: “Then I will do it all!”
Compassion. Faith. Hope.
It is such a privilege to work with wonderfully courageous teammates like Sous and for people who have been living in survival mode for years. When our international staff were given the opportunity to return to their homelands because of the likelihood of Lebanon’s airport and borders closing in the next few days, it didn’t really feel like we needed the choice. For each of us, leaving was not an option.
For me, the biggest challenge is not whether or not I will get coronavirus. As a GP back home I would still be “front line”, but, rather, concern about being separated from loved ones, who also may become unwell. And yet, in the middle of so much unknown, as a Christian, my firm belief and hope is that safest place for my family and me to be is exactly where God has us for this moment. Whatever may come.
If you would like to financially support Medair’s response to Coronavirus please visit: https://www.medair.org/emergency/coronavirus/
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