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By Venetia Rainey

Mqaiteaa, Lebanon: It was a miserable, cold February morning, and the rain lashed at the tarpaulin roofs of the makeshift tents that make up the informal settlement of Mqaiteaa in Akkar, north Lebanon. But despite the terrible weather, a small group of Syrian refugees had gathered outside a Mobile Medical Unit, and some were even smiling.

“I have been here about two years,” said Mohammad Mustafa Selyom, the shawish – leader – of the camp, with a shake of his head. “Today is the first time we have had medical services made available to us.”

“Before, whenever we needed anything, we had to get it ourselves.”

This meant not only paying for the cost of medical assistance themselves, but also actually getting to a hospital or primary health clinic – a huge ask for refugees already struggling to feed and shelter themselves, especially for those who live in large, remote areas such as Akkar.

The solution has been the introduction of Mobile Medical Clinics, funded by UNICEF and run along with Relief International, which involves a team of people and a miniature pharmacy travelling around areas where refugee communities are cut off from the usual services.

“Here in Akkar, it’s a vulnerable area,” explained Rose Badawi, Health and Nutrition Coordinator for Relief International. “You have a lack of access to primary health care as it’s hard to reach. That’s why the MMU is very important.”

In Mqaiteaa, a settlement where tents jostle with rows and rows of greenhouses, the MMU has set up by sectioning one of the tents into three rooms: a private one for the midwife to see both expecting and lactating mothers, another private one for the general practitioner to see patients, and a waiting room where scared-looking kids and crying babies have their arms measured to check for malnutrition.

As screaming and laughing children run around in the mud that cakes everything outside, weary-faced mothers and fathers line up for their turn with the doctor or nurse.

Along one wall sit boxes and boxes of drugs – antibiotics, deworming tablets, delicing medicine, painkillers – all with meticulously kept checklists on their lids.
At a table near the door, assistant Rosie Mitri is busy persuading a seven-month-old baby to stop flailing for a moment so she can measure the circumference of his upper arm, a simple and practical way to test for malnutrition. After a few seconds she manages to tighten the plastic strap and make a reading: Kinan tests positive for moderate malnutrition.

Lirad, his mother, said she had brought him to the doctor because he had had a cold for a week, but didn’t realize that could be caused by him being slightly malnourished. Clutching her smiling, drooling son, she said she was glad she now knew, and would give him whatever medicine the doctor prescribed.

“I have four boys and three girls,” she said, rubbing her eyes tiredly. “He [Kinan] is the youngest. and the oldest is 13. I have been in Lebanon for two years. Life is very difficult here. Luckily my other kids have not been sick yet.”

Behind her, Mitri brandished a small silver sachet. “This is a multivitamin and mineral sachet for children under five,” she said proudly. “We try to explain to every mother the importance of giving a child all the vitamins it needs at this age. It’s one sachet per day for each child and usually you spread it on the food.”

Most of the cases the MMU sees are easily treatable, such as scabies and lice, but can also be deadly, for example diarrhoea and respiratory tract infections.

“I would say that 99% of the cases we see we treat on the spot,” said Dr. Charbel Semaan, as he ducked out of his temporary office for a second. “It depends on the season, in winter we see a lot of respiratory tract infections.”

“Diarrhoea we see all year around though, because the WASH [Water, Sanitation and Hygiene] situation remains difficult in summer and winter,” he added.

For Lateif al-Hamoud, a 45-year-old woman who looks far older, the MMU brought much needed relief after weeks of no medical attention.

“I’m sick, I don’t know what it is. I have a fever and a headache,” she groaned, wiping her forehead. “God knows what caused it, the bad food, the bad water, the bad living conditions, God knows. Its terrible here. My house is very, very cold and we are really suffering.”

“I have been lying in bed unable to move,” she added, “but when I heard they were coming, I came from there straight away. The doctor was nice; he gave me some medicine and told me to take care of myself.”

The Medical Mobile Units and provision of free basic medication was made possible through the generous donation of UNICEF France National Committee.

©UNICEF/Lebanon-2015/ Haidar and Stephanie Laba

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