Profiles of Health Workers in Gaza, the West Bank and Lebanon

April 8, 2011 ANERA
Gaza, Health, Health Education, Hospital Infrastructure, In-Kind Medical and Relief, Lebanon, Mother and Child, West Bank
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New nurses' station ANERA installed at the Beit Jala Hospital, West Bank. New nurses' station ANERA installed at the Beit Jala Hospital, West Bank.

April 8, World Health Day, is an opportunity to celebrate the people who have devoted themselves to helping others live healthier lives. Below are six individuals who work with ANERA on health-related projects in Lebanon, the West Bank and Gaza.

 Nadia Dalloul, pharmacist, Lebanon

“Ever since I was a child, I wanted to be a pharmacist. I wanted to help keep everyone around me healthy. When I finished high school, I applied for pharmacy studies at college. But at the time, civil war made it difficult to study on a regular basis. Often the school was closed for days or weeks. It wasn’t safe to go back and forth because of the shooting and violence.

Nadia Dalloul, pharmacist on ANERA's staff in Beirut, does public health outreach on the rational use of medicines.

Nadia Dalloul

So I decided to switch schools to be somewhere safe. I went to Massachusetts College of Pharmacy for three years. But I have to say that as soon as I graduated I came home. Why? Because there is no place I want to live except here in my own country where I can contribute something valuable. In Beirut, I have my family and friends around me and that is so important to me.

After I got my degree, I came home and started my own business, Community Pharmacy. I’ve been working here as a pharmacist for 25 years! And, I still love what I am doing. My key focus has always been on the well-being of my customers, my patients. That means not only distributing medicines but also promoting a healthy lifestyle. I think I’m among the few pharmacists who really takes time with each patient who comes in to fill a prescription or ask advice. I spend at least 15 minutes chatting and talking about what to eat and what to do. I always see my patient as a human being, more than just a customer.

“Ever since I was a child, I wanted to be a pharmacist. I wanted to help keep everyone around me healthy.”

One of my priority concerns is to stop the flow of fake medicines and also to curb the irrational use of medicines too. In Lebanon, it is too easy to get fake medicines or abuse medical prescriptions and over-the-counter drugs. There need to be good rules and instructions on how to take medicines and how to watch out for potentially harmful side effects.

It is not enough to have a good medication. It must be the right medication in the right dose at the right time. I have seen patients who buy the same medication over and over without consulting to make sure that it’s right and I have seen doctors overprescribing medicines. Many people think medicine is magic and sometimes the positive response feels like magic but you can’t always be sure of the right result if you overdo it.

This is a real concern for me and I welcome ANERA’s effort to raise awareness through the Rational Use of Medicine program. Working with ANERA made me realize I am not alone. By joining forces I can put my experience and knowledge to good use in helping to monitor the quality of donated medicines we distribute and to help educate people about the rational use of these medications.

I am convinced that we can make lives better. That’s a fact. And, that’s the principle that I live by. If I can make a difference, if I can find a solution and help people improve their lives, I will always try”

Nisreen Afifi, Health Educator, Gaza

Palestinian health educator Nisreen Afifi speaking about health at an ANERA-sponsored event in Gaza.

Nisreen Afifi speaking about public health at an ANERA-sponsored event in Gaza.

“My father always wanted one of his children to pursue a career in health so he was delighted when I chose this field that I love. I’m the eldest of five children but I’m the only one who has chosen health as a career. It comes in handy too! The women in the building where I live are always seeking advice. Their questions are general and I can answer most of them. I also read a lot to stay up to date with health trends.

After graduating from Al-Azhar University’s College of Pharmacy, I worked in private pharmacies and the WHO warehouse where I learned a lot about medications and perceptions. Many women from poor neighborhoods used to visit me at the pharmacy where I work. They felt comfortable asking me for help and I felt my value then because I could provide good advice.

“I can see my work is benefiting others.”

My work now, training mothers who receive food parcels through ANERA’s project, expands my ability to help my community. The USAID-funded project will help 6,000 families, 1,200 of them with pregnant or nursing mothers. The parcels contain basic necessities, like olive oil, macaroni, lemon juice, blankets and shampoo. Distributing the parcels provides us an opportunity to organize sessions to offer valuable health tips, from nutrition to baby care.

I was a bit nervous the first time I conducted one of the awareness sessions but the women were so appreciative. Today, I can easily stand in front of a group of 40 mothers and share experiences and the information I have to offer, especially about healthy diets for pregnant and nursing mothers. It is not always easy. The women often follow traditions handed down through generations and are reluctant to change their habits. So they have to trust me and know that I have their best interests at heart.

What really breaks my heart is the deteriorating state of our health sector because of all the pressures and siege imposed on Gaza. So it is a great feeling for me to know that I and my colleagues are doing something to help ease the misery and perhaps light a candle in the darkness.

I can see my work is benefiting others. The mothers I work with all love their children and want to make a better life for them, so they are very eager to learn and put in practice what I teach them. It’s very rewarding for me to see how much they trust me and how much they gain from what we do.”

Firas Abou Aloul, emergency responder, Ein El Hilweh Camp, Lebanon

Listen to an interview with Firas >>

“My interest in health care grew as I grew. My father was a nurse and when I was a child he used to take me with him to the clinic. I used to explore while he worked and I found it a very interesting and intriguing environment. So I studied nursing too.

Firas Abou Aloul, emergency responder in Ein El Helweh Palestinian refugee camp, Lebanon

Firas Abou Aloul

I’m 29 years old now and I work in community health. I have been involved in teaching medical and healthcare skills to youth and adults in different refugee camps in Lebanon, namely in Ein El Helweh camp, in Saida. Earlier in my career as a nurse, I only worked with patients who had already been admitted to hospitals and clinics. My work at that time was somehow dictated by patients and doctors.

Now, in community health, I am able to work more with outpatients and those that are not able to reach the hospitals or clinics for various reasons.

Since I started working in the camps, I noticed the challenging life conditions of the communities. Poverty, lack of education and housing, proper access to health care and health awareness are a daily struggle for the people. Chronic diseases are spreading in the camps, even among the young.

Emergency services are also missing. You may see an ambulance with a driver, but without a medical team or equipment. I recall one case of a woman who suffered cardiac arrest and there was no emergency team was available. It took two hours for any sort of emergency service to reach her. By then, she had died.

Cases like that, made me realize the importance of having trained emergency personnel in the camp. It took us four years to develop this service and thanks to the support of local and international donors, we have now a first aid emergency team and a well equipped ambulance for the people of Ein El Helweh.

“Changing behavior takes time, but now we realize we actually can make a difference.”

I became active in ANERA’s Creative Health Campaign (CHC) four years ago after participating in a training workshop where I represented Human Call Association of Ein el Helweh camp. My relationship with ANERA developed as we discovered mutual interests regarding health care. The CHC campaign was dealing with key health topics not yet addressed by others, like smoking, rational use of medicine, nutrition and exercise, and breastfeeding. I also realized the importance of CHC’s unconventional methods by teaching and engaging everyone in seeking healthier lifestyles.

Changing behavior takes time, but now we realize we actually can make a difference. Attitudes are starting to change. We have smoke free areas and more young mothers are aware of the importance of breastfeeding and the healthy nutrition of their children.

It reinforces my commitment to my community. You know, when it comes to the general population and every person living in Lebanon, I believe we are all responsible. Everyone must play their role, even if different people have a different level of duty. Every citizen must be responsible for his or her family, just as much as a municipality must be responsible for the area that it is expected to care for.”

 Ali Al Ramhi, Doctor, West Bank

Dr. Ali Al Ramhi at the Beit Jala Hospital in the West Bank, where ANERA made major renovations to the building infrastructure.

Dr. Ali Al Ramhi

“When you entered the hospital, you couldn’t figure out where to go. It was hard to tell whether you were entering a hospital or a jail.” A cardiologist by training, Dr. Ali Al Ramhi has worked at Beit Jala Government Hospital for 15 years. He currently serves as hospital director and has horror stories about working there.

Dr. Ali lists some of the challenges he and his medical staff faced. “The hospital had no water well and there were often water shortages, especially in the summer.” The elevators broke down on a regular basis, making it difficult for patients and staff to get to different departments quickly. Worse still, when the elevators were out of order, Dr Ali said his doctors had to postpone or even cancel surgeries because they couldn’t get patients to the operating theaters. “You can’t ask a severely ill patient to take the stairs.”

Medical equipment and materials that should have been stored safely out of the way were stacked wherever there was space, leading to messy hospital departments. Overall, the hospital suffered from severely deteriorated facilities, broken A/C and heating systems, bad lighting, a lack of signage, and a general air of despondency.

Dr. Ali also describes the deteriorated central laboratory which, normally is off limits to non-staff. However, he often found patients and visitors wandering around the laboratory looking for test results. In addition, it was crowded with various equipment and machines, making it hard for staff to find space to work. These problems combined to reduce the efficiency of the laboratory.

Dr. Ali explains says these were just a few of the obstacles that negatively affected his staff’s ability to work. His tone changes as he describes what happened this past year after ANERA renovated nearly 80% of the hospital. The appearance, space, hygiene factors, lighting, sanitation facilities and quality of services were all much improved after the USAID-funded project transformed the hospital. “You can clearly see the difference, and we now officially have a proper hospital entrance!”

It’s not just the entrance that is different. The central laboratory now has a proper entrance with a reception window for patients and visitors to get the help they need without interfering in the lab itself. Staffers say they now feel more comfortable working with better lighting, more space and privacy. Dr. Ali points out how much the lab’s turnover rate increased. “The laboratory used to complete 15,000 medical tests a month; however, now they now conduct 25,000 medical tests.”

“People now compare our hospital to other hospitals outside the West Bank!”

To address the other problems, ANERA installed new elevators and built a water cistern and two new storage facilities. Dr. Ali also marvels at the improvements in the Emergency Unit, which used to treat only 80 to 90 patients a day. Additional patients were transferred to other government or expensive private hospitals as far away as Ramallah, Hebron and Jericho. After ANERA’s renovation work, the Emergency Unit now can treat between 120 and 160 patients.

Renovation of the X-Ray and Internal Medicine and Heart Disease Departments increased hygiene, provided better lighting and sanitation facilities and new A/C units. New curtains around patients’ beds give them much-needed privacy.

Hospital workers tell Dr. Ali how much happier they are now that the work flow is more organized and there is enough space and privacy for them to work without feeling cramped.

Patients also stop are pleased. Dr. Ali says one patient told him, “Beit Jala Hospital is like a five star hotel now, especially the new IC Unit.”

Dr. Ali smiles with pride, “People now compare our hospital to other hospitals outside the West Bank!”

Mostafa El-Ghosein, warehouse manager and pharmacist, Gaza

Mostafa El-Ghosein, manager of ANERA's in-kind medicine donation program in Gaza.

Mostafa El-Ghosein

“The more one helps people, the more people will help him,” this is my belief on both personal and professional levels. My role models are my older brother and sister. They are 10 years older than me and went to medical school in Egypt. I think I chose pharmacy studies to follow in their footsteps because I admire them so much. I wanted to be in the health sector so I could help more people too. For me, a pharmacist’s work is all about helping cure diseases and alleviating pain.

I studied in Philippines 20 years ago and then managed a pharmaceutical warehouse in South Africa. It was so rewarding. I have learned so much about other cultures and learned other languages. It helped me develop a global approach to life.

“Quality of service is the key because we are dealing with the health of my people.”

Back in Gaza in 2002, I was reading an advertisement in the newspaper and saw ANERA was looking for someone to manage its medical in-kind program. I thought it was a way to combine my skills and experience as a pharmacist and manager. My highest priority is to ensure that all procedures are legal and follow all rules and regulations. Quality of service is the key because we are dealing with the health of my people.

It gives me great satisfaction to know that through my work, clinics and hospitals are benefiting from the medicines they might not otherwise have. Thanks to ANERA’s distribution of donated medicines, poor patients can have access to medication almost free of charge. I know how hard it is for some families to pay for medicine, especially those with chronic diseases like high blood pressure and diabetes.

Gaza has great shortages of medical supplies. Thankfully, through my work, I can help our community. After all, we don’t live alone. For me, success is not selfish. It is all about helping others.

I have four wonderful children and I want to be a good role model for them too. I can’t force them into health work or any other studies. I can only advise them. They have the right to choose their own futures but I believe they will pursue something that will also benefit our community.”

Mejdoline Jom’a, nurse, West Bank

Mejdoline Jom'a, head nurse at Jericho Hospital, walks through the wing ANERA renovated with USAID funds

Mejdoline Jom’a (right), head nurse at Jericho Hospital

Walking around Jericho Government Hospital’s* newly painted rooms and hallways, with their cool, fresh colors, Head Nurse Mejdolinen Jom’a smiles at the patients. She comforts them and reassures them that they are in good hands. The patients smile back at her and express their gratitude and relief. And that, she says, makes all her personal sacrifices worth it.

“I remember when I first left my home in Jenin and headed to Jordan to get my bachelor’s degree in nursing. I was nervous about leaving my family but excited because I was going to study what I loved.” Four years later, Nurse Mejdoline returned to the West Bank with her degree but had to leave her family again when she moved to Ramallah to practice nursing at a local hospital. After 12 years there, she was transferred to Jericho Hospital. She has been working there as head nurse for the past 11 years.

Mejdoline acknowledges it wasn’t always an easy place to work. Hospital Director Dr. Nasser Anani describes some of the major challenges they faced. “Since the hospital was constructed 11 years ago, we were forced to work without a functioning air conditioning system, a gruesome situation when you live in Jericho’s extremely high temperatures. It made the patients very uncomfortable and hampered the staff’s productivity.” As the building aged, there were more problems like leaky pipes and drainage systems and a lack of hot and cold water. Dr Anani adds, “The ceiling boards started to fall apart, mainly because of the leaking water and sewage.” The leaks spread throughout the hospital, including the Dialysis Unit, Emergency Unit and Central Kitchen. “Waste water from the hospital flowed into a nearby valley and this created a bio-hazardous environment right next to the hospital. We received many warnings from the municipality but there was not much we could do then.”

Nurse Mejdoline describes the Kidney Dialysis Unit, a cramped room only 10 square meters in size. “The room is very stuffy and dark, and on top of that, the leaks leave an awful stench. The space is not nearly sufficient for the number of patients the hospital treats.” Dr. Nasser elaborates, “We consider our dialysis patients the most sensitive, since they come for treatment every few days and stay for four to five hours at a time. This badly structured room affects them physically and psychologically.”

Soon that will all change. With USAID funding, ANERA is building a new addition to the hospital to house a new 500-square-meter Kidney Dialysis Unit. One patient’s husband who accompanies his wife for her dialysis treatment says they are excited and relieved about the prospect of a new clean place for treatment.

In addition to painting and tiling, ANERA is focusing on renovating the sewage, water and drainage systems, installing A/C units, electrical works, and replacing the contaminated underground water tank with a new concrete tank. Some hospital sections have been renovated while work is still ongoing in other sections.

Nurse Mejdoline is also excited about the new accommodations for hospital staff. “The hospital lacks accommodation for on-call doctors and other staff living outside Jericho. But soon, I’ll be able to live in the new staff accommodations and will be available whenever my patients need me.” Dr. Nasser echoes Mejdoline’s joy over the healthier work environment and adds his belief that it will quickly translate into higher productivity and better health care for patients too.

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