Sovereign Military Hospitaller
Order of St John of Jerusalem of
Rhodes and of Malta

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Liban: brief overview of the general situation on the humanitarian level. 2nd report

Liban: brief overview of the general situation on the humanitarian level. 2nd report
26/07/2006

Situation Report from the President of the Lebanon Association of the Order of Malta H.E. Marwan Sehnaoui:

As the military operations develop, the emergency problems Lebanon faces build up accordingly.

Since 22nd / 23rd July, important factors were added to the disruption of ground communications as relay antennas for communications became war targets and trucks with containers became potential targets, being arbitrarily destroyed.

From Beirut, the United Nations Undersecretary General for Humanitarian Affairs, Jan Egeland, announced his concern for Lebanon’s “major humanitarian crisis….” He estimated that around 500,000 to 1 million people in Lebanon are in need of international humanitarian assistance. He also found it necessary to ask for over 100 million dollars in foreign aid to cover the initial three months after the conflict.

The country’s EMERGENCY crisis grows more acute by the day.

The number of displaced fleeing from the different combat regions is now over 500,000 (we estimate the number to be around 700,000+) of whom 50% are children (according to UNICEF). Amongst those displaced, more than 110,000 are living in the barest conditions. They have been piled up in schools located in Beirut, Mount Lebanon and the North, which have been transformed into Centres For Displaced Persons.

These temporary Centres are in no way equipped to accommodate such large numbers of refugees or cope with such a dramatic situation. The circumstances of the refugees are critical and the fear of swift proliferation of epidemic diseases is extremely high.

In order of importance, URGENT solutions have to be implemented to meet the following needs and problems:

1. The hygiene conditions of the places where the displaced are accommodated.

In most cases, the Centres have taken in a considerably larger number of displaced than the available premises can deal with; the hygienic conditions are catastrophic; it is necessary to ensure water and hygiene products, family kits, adapt the supply and storing of water, ensure the decontamination of sanitary spaces and locals and the sanitisation of dirty water.

2. Availability of drinkable water and in some cases domestic water especially to ensure, in this hot summer season, newborns and babies’ bath water.

3. Milk for newborns and babies;

4. Medical drug supplies;

5. Mattresses, sheets and blankets;

6. Food products to supply the Centres.

The distress of those trapped in combat zones, or bordering these zones, becomes more and more complicated. Access to supply aid has become increasingly perilous.

The day before yesterday we had to deploy huge efforts to be able to (exceptionally) deliver medical supplies to the village of Reich in South Lebanon (borderline village, close to Maroon el Raps and Bint Jbeil where combats are now taking place. At least 8000 displaced originating from nearby villages have found refuge at Rmeich; that number does not take into account Rmeich’s original population).

The Sovereign Order of Malta Centres located or bordering combat zones are extremely active (except the Centre in Siddikine which was under shellfire until the day before yesterday).

As for the shortage of basic products (food, fuel for generators and electricity, pharmaceuticals, etc.), the terrified population’s reaction towards this unexpected war and the psychosis it has engendered accelerates the shortage process and disrupts distribution.

The shortage of crude oil derivative products has become quite imminent.

Regarding medical drugs, the President of the Syndicate of Medical Supplies Importers announced that “… since the beginning of the blockade, Lebanese especially those suffering from chronic cardiac and diabetics diseases and blood tension have rushed towards pharmacies. There has also been a rush on milk for newborns, ventolin and tranquillisers….”

To avoid the dramatic consequences of a shortage situation, humanitarian corridors allowing the safe passage of humanitarian aid and basic products must be urgently negotiated. These humanitarian corridors should also include the safe passage of humanitarian aid within the territory.

The extent of the destruction portrays in a more obvious manner the forthcoming problems the country and NGOs will face once a ceasefire is seriously installed. These problems are associated with the reintegration of the displaced and the reconstruction process. To this is added the fact that the coming school year will no doubt be disrupted, because the displaced are mostly installed in schools.

Managing the emergency: Information collected from our Centres (in the field, across Lebanon) and from the two most concerned Ministries (Ministry of Public Health and Ministry of Social Affairs) reveals the immense difficulty in finding adequate solutions to organise the following:

– Regrouping and accommodating the displaced (essentially accommodated in empty schools as we are in a holiday period) ;

– Implementing basic hygiene conditions;

– Supplying food and basic products of primary necessity;

– Providing medical care and pharmaceuticals.

Hospitals: currently, they are fully operational. However, hospitals receiving war wounded will soon lack hygienic products, tranquilisers and sedatives. Hospitals suffer from the hazards and difficult transfer conditions of both the wounded and patients in need of hospitalization away from war zones where communication lines have been disrupted.

The Order of Malta has essentially focused its intervention on medical care and pharmaceuticals provided within the area of services provided by the Order of Malta Health Centres (exception – the Centre of Roum – Jezzine, where, in addition to medical services, the Order is in the process of taking in charge nearly all of the problems faced by 200 families , that is, about 1000 displaced persons in the region).

Action: the Order of Malta has adopted the following operative mode:

1. Ensuring the dispatch of pharmaceuticals (Ref.: attached index of urgent pharmaceuticals in great shortage).

The process of convoying the pharmaceuticals lots to war zones represents an important problem. We are resolving this issue step by step as we go.

2. Providing medical care and pharmaceuticals to different ‘displaced Centres’ within the boundaries of the zone of the Order of Malta Health Centre.

3. Building a small emergency stock of pharmaceutical products to be prepared for any shortage situation. At the same time, exploring ways of distributing pharmaceutical donations provided by other Associations or government organisations.

4. The Ministry of Public Health has also approved the principle, if needed, upon which the Order of Malta is entitled to receive and convey to the NGOs the donations of pharmaceuticals destined for them.

Meantime, we are purchasing pharmaceuticals available on the local market as, due to the understandable war psychosis, suppliers’ stocks are decreasing at a drastic speed.

Equally, we are in the process of forming an emergency mobile team of volunteers who are friends of the Order of Malta. This emergency team will intervene in ‘displaced Centres’ located outside the zones of intervention of the Order of Malta Health Centres.

This situation requires the urgent disposal of important funds not foreseen in our budgets and reserves (estimate of one month’s expenses for the activities of the Order of Malta: US $ 80,000, – 100,000).

This report covers a concise overview of the humanitarian situation in Lebanon.

BRIEF OVERVIEW OF THE OPERATIONAL SITUATION OF THE ORDER OF MALTA CENTRES (TUESDAY 25TH JULY 2006).

1. SOUTH LEBANON :

a. Yaroun – Rmeich

(bordering Israeli frontier – as well as Rmeich located at ± 5 to 6 Km from Yaroun – the village has been evacuated under direct threat as it is neighbouring the current confrontation zone of Maroun el Ras and Bint Jbeil.)

Since the start of the hostilities, the village of Yaroun has been completely evacuated as it was under direct threat.

All Christian inhabitants and a large fraction of Shiites have found refuge in the neighbouring village of Rmeich (Christian) where more than 8000 displaced persons from the neary villages of Aita el Chaab, Aitaroun, Maroun el Ras and Bint Jbeil have found shelter.

As Yaroun’s accessibility is judged suicidal, the doctor responsible for the Centre of Yaroun, Dr. Raed el Alam (a cardiologist, originally from Rmeich) with whom we have had, up until today, regular phone contact, has set up a transmitter under the flag of the Order of Malta at Rmeich. He can provide most of the medical services but says there is a dramatic lack of medical supplies and pharmaceuticals due to the displaced, who are rapidly increasing number.

Despite sporadic border shelling, Rmeich is not yet under direct threat. Nevertheless, as the means of transportation are extremely difficult, there is a shortage of food and pharmaceutical products.

Through the Red Cross, the Ministry of Social Affairs was able to deliver 300 food rations; Caritas has delivered 1000 bread rations.

Last Sunday, in coordination with the Red Cross convoy, the Order of Malta was able to deliver pharmaceutical products.

The Minister of Health was pleasantly surprised by this exceptional delivery (due to combats taking place in the neighbouring villages of Rmeich – Maroun el Ras and Bint Jbeil. But it is possible that this contact with Rmeich be the last before the situation stabilises).

In conclusion, we can state that Rmeich faces a situation of total distress, lacking pharmaceuticals (especially for chronic diseases), milk for newborns and babies, bread, drinkable water. And is also the difficulty faced when the wounded, or patients in need of hospitalization, have to be transferred to hospitals.

b. Marjeyoun

(Adjacent but not bordering the Israeli frontier)

Like Rmeich, Marjeyoun has so far escaped direct bombardment; nevertheless most of the roads leading to it and its neighbouring sectors are under shellfire.

Sister Hélène Habib (from the Congregation of the Sacred Heart), trapped in Beirut at the beginning of the hostilities, has returned to Marjeyoun with stocks of pharmaceuticals given by the Order. She has reassumed the operation of the Health Centre which was run in her absence by Sister Emilie.

The Health Centre delivers medical care services to displaced persons presently installed in neighbouring villages either under shellfire or threat (Kfarkéla, Khiam).

As the Order of Malta succeeded in transporting Sister Hélène and a batch of pharmaceuticals to Marjeyoun, the Ministry of Public Health has asked the Order to ensure the routing and dispatch of pharmaceutical products to the Government Hospital of Marjeyoun and the Kfarkéla Medical Centre. This mission was completed successfully.

Sister Hélène is coordinating her actions and services with the management of the Government Hospital of Marjeyoun.

c. Siddikine

(30 Km from Tyre, by Cana – exclusively Shiite population – zone intermittently under shellfire. The village has suffered direct bombing on many occasions. The most recent was on 23rd July.)

As a result of the bombardment of the village, the Health Centre is not accessible; the personnel, like the inhabitants, have been forced to re-locate to safer areas.

Communications are practically impossible. Nevertheless we were able to get in touch with the person responsible for the Health Centre, Mrs. Nohad Balhas, whom we encouraged, if possible, to regroup her team and resume activities, even if the Health Centre has to relocate to another, safer village, because of the military operations.

d. Roum – caza de Jezzine

(Bordering combat zone in South Lebanon)

The area of Jezzine is presently receiving ± 5235 displaced persons, mainly accommodated in the local schools.

Because of its position, neighbouring direct confrontation zones, the Health Centre is fully operational.

Besides delivering medical care services, the Health Centre is taking charge of the most basic needs of ± 1000 displaced persons (180 families) installed in neighbouring schools.

It is important to note that children constitute the largest fraction of the displaced persons in the region. Of the 1000 displaced being looked after by the Order of Malta Health Centre in Roum, we count:

– 12 newborns from 0 to 6 months;

– 14 newborns between 6 months to 1 year;

– 150 children under the age of 5;

– 400 children under the age of 8.

Food and basic hygiene aid:

Since they have been accommodated in the region, the displaced families have received a delivery of food – bread, rice, sugar, salt and oil – from the Bahia el Hariri Foundation and the Secours Populaire But the Order can not guarantee its continuance. While we monitor the evolution of the situation, the Order of Malta Health Centre of Roum is providing the displaced with their most basic needs in terms of food and hygiene products.

Medical care services:

Almost all of the medical care services, pharmaceuticals and provision of milk for newborns are provided by the Order of Malta Health Centre located in Roum

2. BEKAA :

a. Barqa :

(bordering the area of Baalbeck, a war zone)

The Health Centre is fully operational.

On 17th July, it started providing medical care services to the displaced who had found refuge in their home villages in the Baalbeck area.

The flow of these displaced persons is difficult to estimate as they are scattered all around neighbouring villages. Nevertheless, the Health Centre’s team has noted a significant increase in the Centre’s activity.

Generally, the Health Centre of Barqa registers an average of 60 patients per day. Currently, it is registering up to 150 patients a day.

3. GREATER BEIRUT:

a. Ain el Remmaneh :

(Located administratively in Beirut’s southern suburbs and bordering the targeted square of the war taking place in the southern suburbs.)

Located a few hundred metres away from the targeted zones, the Order of Malta Health Centre is operational. It is providing medical care services and pharmaceutical products to two Displaced Persons Centres located within the intervention area of the Order of Malta Health Centre; the Displaced Persons Centres are located respectively in the Madame Aoun School (± 400 displaced) and the Public School of Furn el Chebbak (± 268 displaced).

Displaced Centre – Madame Aoun School:

The ± 400 displaced include 31 children below the age of 5, and 5 newborns.

Besides providing comprehensive medical care and hygiene services, children under the age of 5, including newborns, take their daily baths at the Order’s Health Centre.

Displaced Centre – Furn el Chebbak Public School:

The 268 displaced include 7 children aged between 1 and 2 years and 9 newborn.

The Health Centre of Ain el Remmaneh, supported by a volunteer doctor, provides medical care services and pharmaceuticals for the displaced persons.

Besides medical care services, the Health Centre of Ain el Remmaneh ensures, when possible, clothes, mattresses and pillows.

4. NORTH LEBANON :

a. Khaldieh :

The Health Centre is fully operational.

It provides pharmaceuticals to the displaced installed in the Toni Franjieh Public Complementary School, located within its intervention area, Zghorta;

The 217 displaced include 104 children – 10 under the age of 2.

The medical care services are provided by the official doctor of the caza of Zghorta.

Besides providing pharmaceuticals, the Health Centre located in Khaldieh is also distributing clothes.

It is important to note that a large number of displaced persons are sheltered in local inhabitants’ homes. It is difficult to estimate their precise number, but management of the Order of Malta Health Centre of Khaldieh estimates it at ± 200.

This summarises very briefly the operational situation of the Order of Malta Health Centres which are fully engaged in the present war.

As for the other Order of Malta Health Centres

North of Beirut:

Health Centre of Zouk Mikhael;

West Bekaa:

Health Centre of Kefraya

North Lebanon:

Health Centre of Kobayat

They continue to operate at full capacity in their respective regions; they are already taking measures and precautions to be able to cope with a flow of displaced persons or any other unpredictable development that could occur in their regions.

This summarises the situation to date.