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Lebanon

Status: Current response

Lebanon is grappling with a devastating economic crisis that has badly weakened its already fragile healthcare system. Hundreds of medical staff have been laid off, and there are acute nationwide shortages of basic medicines and medical supplies, including PPE.

In addition to this crisis, a huge explosion in Beirut’s port on on 4th August  2020 destroyed much of the capital city, tragically killing over 200 people and injuring over 6,000. Six of Beirut’s hospitals were damaged, of which three were completely destroyed, including specialised COVID-19 treatment facilities.

UK Emergency Medical Team (UK EMT) sent an assessment team to assess the damage and identify priority medical needs. They found that the immediate trauma response had been impressively handled by the Lebanese health services. However, medical facilities urgently needed support to tackle the rising number of COVID-19 cases.

Following a formal request to the UK EMT from WHO Lebanon to assist with the COVID-19 outbreak, UK EMT deployed a team of specialists in intensive care (ICU), infection prevention and control (IPC), water, sanitation and hygiene (WASH), logistics and humanitarian coordination.

“More recently we’ve been working on clinical case management. So working alongside the nursing teams and the doctors to improve the level of care in the emergency departments and the wards, and also in the intensive care units.” Ram Vadi - Team Lead, UK EMT

How we’re helping

The UK EMT is now supporting six public hospitals across the country: Baabda and Daher El Bachek government hospitals in Beirut, as well as government hospitals in the cities of Bouar, Tripoli, Halba and Saida (Sidon).

The team is focusing its support on COVID-19 intensive care units, COVID wards and emergency departments. They’re working with hospital staff to increase their skills, capacity and confidence in managing coronavirus cases, and to help improve patient and staff safety.

Key activities include:

sharing clinical best practice on COVID-19 case management

helping hospitals implement WHO-recommended IPC and WASH measures across emergency departments, COVID-19 wards and ICUs

supporting frontline staff develop positive coping mechanisms to handle the fear and stress of working with COVID-19

providing resources and training to help community groups tackle COVID-19 misinformation and reduce stigma.

6

public hospitals supported

44

WASH and IPC training sessions

56

case management trainings

The response so far

WASH and IPC

UK EMT IPC specialists have been helping hospital staff to implement WHO-recommended IPC and WASH measures, to reduce the risk of transmission of the virus to staff and patients. This includes redesigning patient flow inside emergency departments, keeping positive, negative and suspected COVID-19 patients separate.

Team members have so far delivered 44 training sessions on WASH and IPC. These have covered topics including:

  • screening and management of COVID-19 patients in emergency departments
  • WASH, IPC and proper use of personal protective equipment (PPE)
  • IPC awareness for non-medical staff, such as cleaners, security guards and administrators.

Case management 

UK EMT has deployed medical doctors and ICU nurses with extensive expertise in managing COVID-19, to support Lebanese hospital staff improve their skills and knowledge of treating critical COVID-19 patients.

The team are sharing clinical best practice and providing training and hands-on coaching in specialist ICU skills for COVID-19, such as proning techniques, ventilation escalation and continuous positive airway pressure (CPAP). They have so far delivered 59 training sessions.

The UK EMT has also delivered four online learning events in partnership with the Center for Research in Emergency and Disaster Medicine (CRIMEDIM). The webinars linked ICU and critical care specialists at Saida Hospital with Italian doctors experienced in managing COVID-19.

RCCE

A core part of the UK EMT’s work is risk communication and community engagement (RCCE). This involves supporting communities tackle COVID-19 by building collaborations between different local and international stakeholders, and reducing fear-driven behaviour.

In partnership with Saida Hospital, UNICEF and the Union of NGOs in Saida, the UK EMT launched a public awareness campaign: ‘Live Your Life while Fighting Coronavirus’. Its aim is to raise awareness of the virus and to help reduce the stigmatisation of those infected with COVID-19 across Saida province, including refugees from Ein El Hilweh, the largest Palestinian refugee camp in Lebanon.

What’s next

The UK EMT’s response will continue into 2021. The team is working to ensure the changes that have been implemented are sustainable, and can be maintained by local teams into the future.

Carousel photos: 1) ICU Nurse Rowena Williams with ICU lead at Saida Hospital. (Walton, August 2020). 2) The UK-Med Assessment Team visits Geitaoui Hospital, Beirut. (Ritzau-Reid, August 2020). 3) John Irvine, critical care nurse in intensive care, delivers a training session to staff in Lebanon. (Ritzau-Reid, August 2020). 4) ICU Nurse Rowena Williams presents at Baabda Hospital, Beirut. (Walton, August 2020). 5) UK EMT nurse Jay Matthews accompanies an ICU nurse on his rounds at Saida Governmental Hospital COVID ICU. 6) UK EMT team members run a simulation training for staff at Bouar Governmental Hospital, practicing flow and screening of suspected and positive COVID patients at the Emergency Department (nurse Katy Drillsma-Millgrom, logistician Rocco Massad and Dr Ram Vadi). 7) UK EMT team members run a simulation training for staff at Bouar Governmental Hospital, practicing flow and screening of suspected and positive COVID patients at the Emergency Department (Dr Ram Vadi as patient). 8) UK EMT nurses Jay Matthews and Rowena Williams provide training on proning of COVID patients for nursing staff at Baabda Governmental Hospital.

We’re grateful to the Foreign, Commonwealth & Development Office (FCDO) for UK Aid funding from the British people to fund this important response.