Lebanon: UNRWA health department: Nahr El Bared crisis; Developments and actions undertaken 29 May 2007

Situation Report
Originally published
Medical Care

Following the truce that was declared between the Lebanese Army and Fateh Al-Islam in Nahr el-Bared on Tuesday the 22nd of May, UNRWA's convoy carrying medical supplies, water, hygiene kits, electric generator to run the water plants and baby food was allowed to enter into N/Bared Camp. Unfortunately the convoy stopped in the middle of the camp due to intensive shelling. The Agency water tanker was severely damaged and left unattended. The medications were dropped in a mosque on the main road. The supplies were confiscated later by Fateh Al-Islam. In the meantime, several thousands fled the camp southward to Beddawi camp, Tripoli Town and surrounding villages. These IDPs were accommodated in schools, clubs or with relatives. Several hundreds families left towards other areas and are accommodated with relatives and friends.

Four medical officers, three assistant pharmacists, two doorkeepers, two clerks and two cleaners were hired to assist with management of patients in Beddawi clinic. An additional Medical officer was hired today, the 29th of May due to the high workload. One of the Mobile Dental units was modified to serve as general clinic and it is visiting IDP locations, offering the required assistance. One Medical Officer was assigned to supervise the health services in the area. He is liaising with authorities, NGOs and other UNRWA staff.

On Tuesday the 22nd of May, medical supplies, mainly for treatment of chronic diseases, were sent to Beddawi clinic. The same night a team started the distribution and continued to work for two consecutive nights until after midnight.

On the 21st of May, 13 casualties were evacuated from N/Bared camp to Safad PRCS (Palestinian Red Crescent Society) hospital in Beddawi Camp. Two other casualties were admitted to private hospitals. On the 22nd of May, more casualties were transported to Safad hospital.

On Wednesday the 23rd the Clinic at Beddawi Camp started operating in two shifts, until nine pm. Additional staff was recruited. On the 28th of May the mobile team started visiting the displaced people outside Beddawi camp.

A contract has been signed with a private pharmacy in Beddawi camp with the aim of supplying patients with life-saving medications that are not available within the agency medical supply catalogue and which they used to pay for.

The Agency has contracts with two hospitals in North Lebanon for secondary care, namely Safad, PRCS hospital and Akkar hospital. The first hospital has decided to spare the beds for the casualties and the second has become inaccessible for poor security of the area and for the fact that the families left the camp southwards, while the hospital is located eight Km north of N//Bared camp. For these reasons the Agency is in the process of finalizing an agreement with al-Islami Welfare Hospital in Tripoli to admit refugee patients. The agreement will cover in-patient medical and surgical cases in addition to kidney dialysis.

Radiology services in North Lebanon are usually provided to the refugees from a radiology unit located in N/Bared camp, now not accessible anymore. Therefore a contract will be signed with Safad hospital in Beddawi. More sophisticated X-rays examinations can be made at the Centre Hospitalier du Nord, with which we already have a contract for outpatient services.

The Minister of Public Health and the Prime Minister has clearly declared that all casualties will be treated at the expenses of the Ministry of Public Health. However, we are confronted with the refusal of some hospitals to comply in some instances. UNRWA will cover the expenses, should the hospital refuse to do so.

Medical supplies and a gas-operating refrigerator were sent today, the 29th of May to Beddawi Camp.

Chlorination of water is done regularly and the environmental health staff is monitoring water quality. Every person is supplied with around 95 litres of water. A separate report on the Environmental Health services is under preparation.

The health centers in North Lebanon and in other areas have been asked to collect data on displaced and resident patients separately to maintain adequate disease surveillance. Communicable diseases will be reported over the phone on daily basis. Fortunately the health situation is under control so far.

Environmental Health

Water supply from N/Bared public local water wells was cut since Sunday 20/5.

The remaining inhabitants of N/Bared Camp rely on local household water wells with questionable water quality and on the bottled water that can be brought to the camp from time to time by NGO's.

UNRWA water tanker was severely hit while was entering water to the camp first week of the fighting. The tanker is still in the camp.

Water reservoirs in N/Bared camp as well as water mains and control rooms are expected to be severely damaged; for some of these, serious damage has been confirmed.

Garbage is being collected in different sectors in Beddawi camp except for some individuals' initiative who volunteered to take some garbage away from the congested camp sectors.

Beddawi camp water supply is adequate so far in spite of the influx of displaced. The Agency is supplying an average of 95 liters per capita per day through the camp water wells operated by UNRWA sanitation staff for about 18 hours/day.

So far, a sewage tanker and a refuse compactor trucks have been redeployed from other Areas to North Lebanon to cope with the current situation. Almost all sanitation vehicles and tools serving North Lebanon camps were stuck in N/Bared camp.

A watsan cluster has been assembled under UNRWA umbrella. So far 3 meetings have been held at Lebanon Field Office. Detailed intervention plans are being set with the participating NGOs.

It is planned to send to North Lebanon a bobcat from Tyre Area and other 3 dumpers for refuse collection and other support activities. This equipment will be relocated from Saida, Tyre and Central Lebanon Areas.

Additional sanitation laborers, water plant operators and other staff are being recruited to cope with the crises.

A water and sanitation coordinator has been assigned for North Lebanon.

Report prepared by: Dr Jamil Yousef