LEBANON: Illness must not rid life of its value

Wednesday, August 30, 2017 — Leila sits on her couch in her modest room with a table at her side. On it there is everything she might need: a glass of water, a bowl full of medication, a TV remote control and breakfast leftovers. She prefers to keep these things close by because she has difficulty moving. She spends her days waiting to hear a knock on her door and for a visitor to come and keep her company, or for one of her children to return from work or from the search for work.

For the past few months she has had new friends whose regular visits she waits for impatiently. They are the Médecins Sans Frontières / Doctors Without Borders (MSF) nursing team in Burj el-Barajneh refugee camp, in south Beirut.

Leila is a Palestinian widow. She’s 56, but her illness has taken a toll and made her look older. She lives in Burj el-Barajneh, one of the oldest Palestinian Refugee camps in Lebanon, a densely packed warren of apartment blocks and self-built housing in the southern suburbs of Beirut city. Leila has been suffering from diabetes for years and normally sends one of her children to the UN agency for Palestinian refugees UNRWA centre to get her medication. However, it had been a while since she was checked by a specialist. This led to the deterioration of her health, especially causing problems for her feet and eyes, due to the serious complications of diabetes. Every time she had a health problem, she was taken to the hospital, but she never received the necessary healthcare in a continuous manner.

Today, Mahmoud, an MSF nurse, is following up on her condition. “Leila was suffering from irregular glucose levels. It was starting to cause serious complications,” he says. “After assessing her case, she was enrolled in MSF’s home-based chronic diseases care programme in Burj el-Barajneh refugee camp.

“In the first weeks, the nursing team visited her almost every day, and the doctor accompanied as needed, until we stabilised Leila's condition.”

“I was taking the drugs my relatives were bringing me, but I did not know much about my illness and about the diet to follow,” Leila said, describing her health situation before the MSF nursing team started to visit her.

The home-based chronic diseases care programme targets patients who have difficulty with movement which prevents them from seeking important regular medical check-ups. MSF launched the programme in Burj el-Barajneh in May 2016. It currently provides this service for almost 170 camp residents.

Through the home-based chronic diseases care programme in Burj el-Barajneh, MSF aims to ensure access to medical services for the neediest groups, especially those with chronic diseases. Diabetes, hypertension and heart disease are among the leading causes of death in low and middle-income countries such as Lebanon. They are even more dangerous with age and in the absence of necessary healthcare.

The programme is based on periodic visits carried out by the medical team to the homes of elderly patients to follow-up and treat chronic conditions, such as diabetes and heart disease. For people who have lost their loved ones, lived in displacement camps and experienced unemployment, disease, destitution and loneliness, for those who have been left alone in life, the medical staff have become like family. As Amna Banat, 84, says, smiling, “When they come to see me, I feel cured.”

Regular follow-ups carried out by the medical team contribute to a remarkable improvement in the health of patients. In addition to the necessary medical examinations, the patient’s medical team provides them with guidance on how to take care of themselves, how to take the medication and insulin injections, and the diet to be followed to control their illnesses, as well as information on other health-related topics.

“They bring me medicine, so they spare me an extra concern. I do not have to borrow money to get it. They come two or three times a week to follow-up on my case. They know more about me than what I know about myself. I feel very happy when they come to visit me,” says Amira, 80, a Lebanese woman who was married to a Palestinian. With the exception of the MSF team, few people knock on Amira’s door to check on her. She lost her husband years ago and suffers from partial paralysis that keeps her bed-ridden.

As for the challenges facing the programme staff, the most prominent one is building trust with patients, a process which may take a long time. “Despite the challenges, our biggest reward is seeing a smile on the patients’ faces when they see us,” says Rashid, a nurse working for the project. “It is proof of their trust and feeling of safety. This is how we measure our success.”

In Burj el-Barajneh camp, MSF runs a health centre providing reproductive and mental health services for individuals and groups. The organization’s community-based activities also include health awareness sessions and group psychosocial support for the elderly, as well as for other groups in the community.

In the Burj el-Barajneh Palestinian camp to the south of Beirut, an MSF team provides home-based care to almost 170 elderly and bed-ridden patients living with chronic diseases. The service brings not only medical benefits for the patients, but often also allows a brief moment of human warmth in otherwise very lonely lives. “When they visit me I feel better. They visit me two or three times a week. I tell them that I’m out of my medication and they get it for me,” says Amina Banat. Photographer: Bruno De Cock
Amina Hamadi, 78, has diabetes and was suffering from loneliness and depression. Her physical illness and immobility had greatly affected her – especially as she believed people were tired of helping her. Today, Amina is smiling. In collaboration with our mental health support team we have lessened Amina’s depression. Photographer: Bruno De Cock
Burj el-Barajneh refugee camp in southern Beirut. Photographer: Bruno De Cock
MSF nurse Amal is helping Amira Al-Hassiri, 80. She has been bedridden for seven years and suffers from diabetes and high blood pressure. “They always visit me and measure my diabetes level and blood pressure. God bless them,” says Amira. Photographer: Bruno De Cock
“When they visit me I feel better. They visit me two or three times a week. I tell them that I’m out of my medication and they get it for me,” says Amina Banat. Photographer: Bruno De Cock
MSF also offers mental health support (individual and group sessions) and health education services to a group of 30 people in a home for the elderly in the camp. Photographer: MSF