On the road with the Mobile Medical Unit in Lebanon

The MMU project was established as “mobile health for Syrian refugees and Lebanese affected by conflict” in 2015 and has then continued to expand since. Demand has only increased. Today, it includes a total of four mobile clinics, each located in the regions of Akkar (north), Baalbek-Hermel (northeast), Nabatieh, and Tyre (south). The Baalbek-Hermel MMU base is located in Ras Baalbek, in the Beqaa Valley about 120 kilometers from Beirut. Hemmed in by two snow-capped mountain ranges that separate the region from the Mediterranean coast to the west and Syria to the east, the Beqaa Valley runs through most of Lebanon. We are moving around the very north of the country, close to the Syrian border.

Many of the Lebanese who live here suffer from desperate poverty. In addition, the region hosts about 339,000 Syrian refugees, most of them in informal camps. Electricity from the state is only provided one to two hours at a maximum. Most people here can neither afford diesel for their private generators, nor the fuel to drive to a doctor’s practice or a hospital in the larger cities of Baalbek or Zahlé, some 40 kilometers away. The only medical care available for most comes from non-governmental organizations, such as the Mobile Medical Unit.

In the mobile clinic, nurses Lamise and Sleiman treat the first patients together with pediatrician Dr. Hadi and field assistant Mariane. Field coordinator Elias, who heads the project in Baalbek-Hermel, kindly keeps the crowd in check and listens in on individual patients to see how they are doing. He is well-connected here and knows most people personally. Since he does this not only in Nabih Osmane, but in the entire region, his two phones never stop ringing.

Elias introduces me to 14-year-old Ali Hassan and his mother Asmahan. They have been coming to the mobile clinic since the project began in Baalbek-Hermel two and a half years ago. Today, they came to have Ali‘s cold symptoms checked. He has the flu. But not only that: Ali has a mental disability and is hyperactive. He excitedly moves around the parking lot, barely staying in one place for a minute. Shyly, he shakes my hand to say hello but quickly turns away, clearly uncomfortable with strangers. Ali also suffers from diabetes and epileptic seizures.mHis mother, Asmahan, says that for over four months now he has been unable to get the medication he urgently needs. Because of his illnesses, Ali cannot attend a regular school. Until a few months ago, he went to a special center for children with disabilities, but due to rising prices, the family can no longer afford the tuition of 900,000 liras. By comparison, the legal minimum wage in Lebanon, which many nurses, teachers and public sector workers earn, is still around 675,000 liras. On this day, that only converts to about 33 USD a month. Thus, one month of education and care for Ali would cost his family a salary of one and a half months. “Since he doesn’t get his medicine anymore, he often gets sick and when he has a fever, he gets epileptic seizures more rapidly,” the mother reports. Now the shy boy with the friendly smile sits at home most of the time and gets bored. “He is often hyperactive, suddenly runs out into the street and between cars.

In the mobile clinic, Mariane, the team’s field assistant, is examining 10-year-old Manal, daughter of a Syrian family in the Beqaa Valley that survives only from the support of non-governmental organizations. Manal has a lisp and needs speech therapy. “Unfortunately, we don‘t have time to give her therapy here. But I can refer her to a speech therapist for that,” Mariane says.

For Mariane, 23, working at the mobile clinic is her dream job. She is the newest member of the team and has only been there for just under six months. She is the only one among her fellow students who found a job just two months after graduation. Almost all her friends are currently unemployed; most of them are trying to leave Lebanon somehow. Not an option for Mariane: “Leaving my home, family and friends is not worth it to me.” The field assistant wants to continue working with children in Lebanon. Her dream: to open her own practice or even clinic here sometime in the future. “I see that there is a great need for this. I want to give back to my community.” Many of her friends have already left the country. Almost every household in Lebanon today has at least one empty bedroom where a brother, cousin, daughter, or grandchild once slept and who left the country in recent years for better opportunities. As this has been the case for many of Marian’s friends, these departures have left her with deep emotional wounds. “But fortunately, I have made new friends here at the mobile clinic,” she says, pointing at nurses Lamise and Sleiman. The team gets along so well that they even spend time together after work.

“We go hiking, camping and barbecuing together; we’re like family. It feels like we’ve known each other for ten years, not just five months.” The fact that the work in the MMU creates strong bonds between the team comes as no surprise to me. Every day, the group cares for more than 100 patients in a very confined practice. An enormous achievement.