Lebanon Capacity Building, One Year Later

By Bethany Morehouse

Sitting at a table with a glass of freshly squeezed orange juice at Fares Café in Tyre, a historical city in southern Lebanon, it is difficult to imagine that just one year ago the rocky beach here was covered with debris from the conflict that erupted between Israel and Hezbollah in July 2006.

PHOTO: IMC A baby receives a vaccination at an IMC clinic in Bent Jbail, southern Lebanon.

With the Mediterranean lapping fewer than twenty feet away and a clear view of the ancient columns at Al Mina, one might easily confuse International Medical Corps’ southern base for an expatriate staff’s Rest and Relaxation destination.

But at this time last year, IMC was launching a massive emergency response aimed at not only alleviating the immediate suffering of displaced civilians, but also helping repair the country’s devastated health care system.

Before the 34-day war that began July 12, 2006, Lebanon boasted one of the highest gross domestic products in the Middle East and demonstrated economic strength in the tourism, agriculture, and banking sectors. Recurrent civil strife and Israeli incursions, though, have weakened both the financial and institutional capacity of the government, limiting the Ministry of Public Health’s ability to adequately meet the needs of the population.

To adapt, private for-profit services dominated the healthcare system, leaving rural and resource-deprived communities with limited access to affordable primary health care services. The public health programs that survived focused on curative care and neglected preventive care and public health promotion.

Populations in the south most affected by the conflict lost not only their homes, but also their livelihoods. Young people in particular have suffered from the psychological distress of war. In an effort to help children cope, IMC has transformed spaces in schools and municipal buildings throughout southern Lebanon into safe play spaces. In many communities, these are the only recreational areas available. Here, children can participate in activities including art projects, dancing, drama and sports.

“Children feel free to be themselves here,” says IMC psychologist Carol Tabbal, who regularly monitors and evaluates the child-friendly spaces program. “The children are less despondent and happier than they were when they first arrived. The process of natural healing is taking place.

PHOTO: IMC IMC staffs unload furniture as part of an effort to rebuild a clinic in the border town of Kfar Kila that suffered major damage in the war.

For kids like 10-year-old Hussein, the program is helping them put the pain of war behind them. “I was unhappy when I returned home after the war because my house was not beautiful,” he says. “I was scared, scared to sleep alone. Now I play, I ride my bike. I feel happy.”

When IMC deployed a rapid response team to Lebanon to provide emergency humanitarian assistance, its aim was delivering IMC’s signature developmental relief package: addressing immediate needs while emphasizing longer term development by building capacity. By helping local organizations and ministries develop and manage effective health programs, IMC can ensure true local ownership and sustained change.

To expand overall access to care, as well as prevention activities, IMC has partnered with local organizations and civil society groups that existed prior to the war. With help from the Ministry of Social Affairs (MOSA) and others, IMC has supported clinics and community centers in more than 100 villages in nine districts throughout Lebanon, reaching over 500,000 beneficiaries.

IMC continues to conduct Health Educator Training of Trainers (TOT) workshops and Seminars for Knowledge that promote quality health care services and serve as skills refreshment courses for nurses and doctors working in IMC-supported clinics. In May, 102 nurses from 48 such clinics successfully completed the TOT program and 100 physicians participated in Seminars for Knowledge. These trainings, conducted each month in a different district, tackle two of the issues endemic to Lebanon’s health delivery system: low prioritization of public health prevention and low retention of skilled health providers. By supporting health personnel, IMC in conjunction with the MOSA and Ministry of Public Health can better equip health providers with essential skills to manage and deliver services while indirectly ensuring continuity of care.

Beyond the walls of these health facilities, IMC actively engages local communities to reduce poverty and unemployment, empower youth, and accelerate social transformation. Seven community development centers offer remedial and job skills courses that target women, youth, and other vulnerable populations. These range from language skills workshops, handicrafts/sewing training, and literacy/computer training, to basic first aid courses. Establishing such centers is a compelling alternative to conventional development approaches as they promote a participatory, holistic method that leads to positive, concrete changes.

As IMC moves forward to meet the needs of vulnerable and underserved populations throughout Lebanon, it faces a unique opportunity to reverse the health delivery system’s existing weaknesses, while harnessing the country’s tremendous human capacity. Working both for and through local communities, IMC will continue to enhance access to affordable health care services, encourage retention of qualified health providers, and reinforce existing strengths in the community. Through this holistic approach to health and wellbeing, IMC will empower Lebanese communities to navigate the development process and be fully equipped to adapt to future crises.

READ MORE:

Remembering the War in Lebanon, an Interview with Dr. Haider Sahib

IMC Receives UNICEF Grant to Revamp Education in Lebanon