| voorstelling project | dankbrief werkkamp 2008 |

The Rehabilitation of Al-Shifa’a Clinic
Previously Destroyed During
Nahr el Bared Crisis 2007

1. Project’s Background and Situation

The fighting in Nahr el Bared camp broke out on Sunday the 20th of May 2007 in the early morning after the Lebanese security forces raided a suspected Fattah Al-Islam safe-house in Tripoli.
The displacement of the camp civilians began on Tuesday 22nd of May during a temporary cessation of hostilities between the Lebanese Army and Fatah Al-Islam militants. Thousands of individuals fled the camp seeking safer refuge, leaving their homes and all their belongings behind. This massive displacement of civilians continued every time a cessation of hostilities took place.
According to UNRWA, around 31,441 persons (6,199 families) were displaced. Of those, 26182 persons (5045 families) sought refuge in Baddawi Camp. The majority of those IDPs were hosted by the families in Baddawi; the remaining sought shelter in schools and other displacement centers (KGs, warehouses, mosques, clubs) in Baddawi or its surroundings. Other IDPs were dispersed in Tripoli, Beirut, Saida, Tyre, and Beqaa, mainly in other Palestinian camps at the homes of relatives, whose economic condition barely helps them support their own families. The displaced refugees suffered from very poor living conditions, mainly those in the schools and the displacement centers, since such locations are not adapted for living. (Figures as of August 2007)
On September 2, 2007, the Lebanese army announced the end of the hostilities and its complete control over NBC. Shortly after, Experts from UNRWA and Khatib and Alami (contractor assigned by the Lebanese Government to rebuild the camp) and a number of NGOs were allowed to enter, what is now referred to as the New Camp, to begin the emergency return operations; entrance to the old camp is still restricted up to this date. Demining experts handled clearing UXOs while UNRWA began clearing the rubbles and Khatib and Alami assessed the status of the buildings. UNRWA then established a temporary plot (plot23) in the southern side of the camp where pre-fabricated housing units were built. These units were poorly constructed and are not suitable for living especially with the winter season coming in Lebanon. About 120 families currently inhabit these units. UNRWA also rented a number of unfinished buildings and performed some minor works on them to render them habitable. 10 buildings were rented up to this date, yet, the conditions of these buildings are as worse as the housing units.

2. Current Health Situation:

The increased return of the camp inhibitions coupled with the lack of houses and the over-crowdedness, is creating miscellaneous health problems. Add to that the lack of resources to tackle these issues, the end result of which would be a rather complicated health crisis. Even thought there are a number of local and international NGO working to meet the increasing needs of the camp occupants, the latter remains to be insufficient. The some associations worked in the health sector, some of them are PRCS, UNRWA, UNICEF, the National Association for Social Medical Care and Vocational Training (NASMCVT), and Al-Shifaa through their main operational Clinics and Health Centers, however many gaps exists that hinders the proper function and the coordination mechanism, the gaps in coordination are limiting the ability of health workers to be able to reach all who are in need.

3. Al-Shifaa Historical overview

Al-Shifaa’s work started in 1970 changing names repeatedly, the first of which was”Mostawsaf Al-Sha’bi”, and then it was changed to “Al-Jama’ya Al-khayriya li Al-Riaa’ya Al-Shabiya”. But as of 1995 the name was changed to “Jama’ya Al-Shifaa Al-Tebbuyeh Al-Ejtima’ya”. Well-known as Al-Shifaa, they work through two clinics one located in Nahr el Bared and the other in Baddawi. At the beginning the scope of work was primitive, where they used to offer medical services through volunteer doctors and medication through whatever in-kind donations and free samples we reserve from various pharmacies and donors. But, with the economical problems, the increase in population and depilated living condition Al-Shifaa was forced to extend the scope of its services as indicated below. However, during the NBC crisis (Nahr el Bared Camp) Al-Shifaa center was 1st partially destroyed but still resumed it work till the end of June, after which it was completely demolished.

4. Pre-NBC Crisis:

4.1 Services:

Prior to the Nahr el Bared Crisis our centers used to offer the following services:

• Consultation covering almost all specialties
• Referrals for more complicated cases to neighboring hospitals for symbolic fees.
• Pre-natal, post natal as well as neo-natal services
• Laboratory services
• Dental services
• Guidance and counseling center offering health education and awareness
• Emergency services covering first aid, and minor injuries

4.2 Staff:

The staff comprised of a group of people who are working either on paid or voluntary bases as follows:

• Three general practitioners
• Twenty five specialty doctors
• Two nurses
• One technician
• One volunteer administrator
• Several volunteers performing miscellaneous work

5. Post-NBC Crisis:

Both centers, in Nahr el Bared and in Badawai, were still operational even after the fighting started:

Baddawi Camp Clinic:

Following the displacement from Nahr el Bared to Baddawi Camp, a significant humanitarian crisis was created. To help alleviate the crisis and cope with the situation, Al-Shifaa center in Baddawi took the following steps to make it more functional as an emergency center:

• Increasing working hours (8 a.m. until late at night)
• Extending the staff according to the work-load, by taking up volunteer nurses, doctors, assistances and administrators
• Approaching relevant medical parties to accommodate the increasing demand of medications

The previous procedures in the Baddawi clinic enabled the center to accommodate up to 160 patients daily.

Nahr el Bared Clinic

The center in Nahr el Bared was in the begging of the war partially destroyed and they continued their relief work and emergency under bombing being the only working health clinic until the end of June 2007. After war it was completely destroyed but by filling their responsibility with the returned families as a 24 hours medical center they continued the operations. Since the return of the families, Al-Shifaa offered basic emergency services and consultations, distributed free medicines, and served as shelter for the displaced families offering food and water with the help of IRC (International Red Cross) and still with an average of 25 patients per day.

As mentioned above, the equipments are very primitive, the funds and donations are diminishing, and the venue hardly confines with the conditions needed to run a health facility, for it lacks proper hygiene and organized mechanism of work. The following is a brief description of the center’s current situation:

5.1 Services:

• Emergency (24 hours)
• Consultation (General Practitioner)
• Dressings & Changes
• Medicines (Free)
• Diapers distribution
• Milk distribution
• Clothes distribution

5.2 Volunteers:

No. Full Name Position

1. Dr. Tawfiq Assad Dr. General Medicine
2. Dr. Ahmad Yasin Al-Hajj Dr. General Medicine
3. Mr. Milad Samir Salami Staff Nurse
4. Mr. Ahmad Yousef Al-Tayar Nurse
5. Miss. Eva Ghinem Nurse & Secretary
6. Mr. Emad Awdi General Director
7. Mr. Ahmad Ibrahim Suleiman Cleaner

5.3 Equipments:

A lack on equipments and medical instruments is found in Al-Shifaa Center in Nahr el Bared.

6. Special Considerations:

It’s noteworthy to mention that even though there are many local and international organizations currently working in Naher Al-Bared, but none of which offer a 24-hours emergency services (except for PRCS & Al-Shifaa). And as mentioned previously all the workers in the center are volunteers, which demonstrate their strong community ties and the enormous support that they are receiving.

In the recently Plan of Nahr el Bared Rebuilding, February 2, 2008, it is proposed to rebuild the Al-Shifaa Medical Center Hospital as it can before. The estimated and approved dates are to begin in April 2008 to be finished October 2010.