Standing Hand in Hand with Beirut

Background during and after the implementation of the project;

As the first anniversary of the deadly Beirut explosion approaches, life has only become more unbearable for millions of Lebanese people who have seen their living conditions deteriorate, forcing some of them to leave the country. The human cost of the economic and political crisis in Lebanon is causing one third of Lebanese children to go to bed hungry and most households are short on food. Rabih Torbay, CEO and President of Project HOPE, who visited Beirut less than 24 hours after the port explosion and whose family still resides in Lebanon, warns the country is running out of chances if no solutions are found:

"Almost one year ago, a giant blast sent a shock wave through Beirut, bringing death, destruction, and fear about a future that was already grim. Twelve months later, the whole country has been brought to its knees with more than half of the population living in poverty.

"Lebanon has become a living nightmare of surreal proportions. The country now has one of the lowest minimum wages in the world, standing at 675,000 Lebanese pounds, which is barely 30 dollars. This is two times less than the monthly minimum wage in the Central African Republic (USD63) and the Democratic Republic of the Congo (USD55).

"Today, a large majority of Lebanese are surviving by relying on their families living abroad to send money or bring them basic items like medicines, hygiene products, and even baby diapers. Soon, families will no longer be able to afford or even find medicines at all, as the government is slowly lifting the subsidies on key goods. People with chronic diseases such as diabetes or heart conditions are struggling to get their treatment, increasing the likelihood of health complications and death.

"Hospitals' shelves have been left empty, oxygen is lacking, power cuts are lasting longer, and doctors are leaving the country. Lebanon's health facilities are facing a catastrophe, and this will only get worse if cases of COVID-19 continue to increase. Besides, the country's humanitarian crisis could rapidly escalate as more than 4 million people, including one million refugees, are at immediate risk of losing access to safe water in Lebanon. Most water pumping will gradually cease across the country in the next four to six weeks.

"The possibility of Lebanon turning into a 'failed state' is becoming truer with each passing day. Lebanon needs international assistance more than ever. Yet, this will not be enough as long as solutions are not found within the country. Lebanon must break with its endemic political incapacity because the country is already running out of chances."

Naba’a Achievements; During the last period, The most highlighted achievements during the last period;

• Following the Beirut port explosion, our project to provide trauma care and psychosocial support. Till this day, it continues to provide immediate assistance through the procurement and distribution of medicines, medical supplies, disaster health kits and personal protective equipment. 
• We at Naba’a are doing all we can to help all affected communities during this extraordinary crisis. Our assistance efforts go to all: Lebanese, refugees and others who were affected without distinction. The devastating impact of the explosion is compounding the challenges currently faced by Lebanese and refugees and adding even more difficulties as families were struggling to survive with the economic crisis that was exacerbated by the impact of COVID-19.
• Naba’a provided cash assistance for 650 family distributed as 777 in Borj Hammoud and 58 in khandaa along with distributing disinfection / hygiene kits for 1050 families in Beirut and south. Where 150 families in Ein EL Helwi, El Buss, Burj Al shamali and Rachidie camps received hygiene kits in addition to 900 families in Beirut. As for food kits, 225 families in Mie and Mie area and Saida al Balad have provided with Food kits as well as 75 families in Ein El Helwe. Whereas, 435 families in Beirut have received food kits and distributed as 306 families in Khandaa in 900 in Borj Hammoud.
• Our humanitarian response to the tragic blast focuses on the most vulnerable in the community and on different major areas: shelter with emergency housing repairs and protection with mental health and psychosocial support.
• Nabaa’ participated in the rapid assessment for 1400 shelters. In addition to the Internal referral for 20 cases from Nabaa team who are working in Borj Hammoud area about other issues as gender Based violence, psychosocial, interventions, cash assistance, livelihood sector, education sector. 392 out of 751 are children, whereas 169 are youth and 190 are elderly taking into consideration 5 people with disability. Adding to this, 570 are Lebanese and 181 are foreigners.

• The division of the groups of children's sessions were according to age (6-14):

-Art therapy sessions for children aged 6 to 10 years

- Psychosocial support "sessions for children "She deals or “I deal with awareness sessions for girls and boys from 11 to 14 years old

- Psychosocial support sessions for all age groups

• 100 children were targeted, divided into groups according to social and psychological needs. The psychologist referred 30 new children for individual follow-up.

Case Study;

Case Code; R1

Summary of the background/history of the beneficiary and the problems suffered from:

After observing the beneficiary’s situation through her participation in awareness sessions, she began talking openly about her situation among the Psycho Social Support group members (group of girls aged 14-20), where she talked about the consequences of early marriage that she faced and suffered from, as she was forcibly ordered by her father to marry a man when she was 15 years old. This early marriage shortly led to family problems and complications including constant insults to her by the husband's parents, leading her to divorce few months after her marriage.

Moreover, after her divorce, she received insults from her own family who considers divorce as a shame and a social defect, where the mother told her, "You are just a divorced girl and so you are with us to serve us."

All that has been addressed and said to her had led to the emergence of high-risk psychological symptoms.

Psychological and Social Symptoms Observed:

- Community isolation (spends days without communicating or meeting with a family or friend)

- Feelings of permanent sadness (most of the time)

- Constant crying

- Fear of facing people

- Loss of self-confidence and loss of trust in people

- Sleep disorders (insomnia)

- Eating disorders

- Nail biting

- Hair cutting (self-torture for revenge)

- Harming her body by cutting off her wrists and arms

Data Collection Method:

Data is collected through the psycho-social support sessions and awareness sessions given, as well as follow-up via the telephone and home visit.

   Intervention and follow-up Methods:

Social intervention:

• Integrate in PSS activities with groups of participants of her age to improve her social life and work on her social skills to remove "isolation" symptom

Recommendations:

- Follow-up meetings with the psychologist through individual sessions on a weekly basis

- Continue participating in the sessions that she had begun as a recommendation by the social worker and at the request of the beneficiary herself (awareness sessions, art therapy sessions, social psychological support sessions).

Links:

• Naba'a website

Background during and after the implementation of the project;

Before the Beirut explosion, the following Nabaa’s Assessment showed 75% of the Lebanese were in need of assistance, 33% of the population became unemployed, and more then one million people were living below the poverty line. These numbers were likely to rise especially after Beirut explosion. In Addition Covid-19’s pandemic distracted the whole economic and social system. The Ministry of Health recorded more than 31,9917 cases and 3,616 deaths as of February 8, 2021.

Resulted from the previous assessment conducted by Nabaa directly after Beirut explosion, Lebanon needs a reliable crisis management strategy, people must be encouraged to take care of their physical and mental health, and new initiatives are necessary on several levels.

Nabaa started its intervention directly after the explosion where the resulted psychological symptoms were well managed through several appropriate services. Because the traumatic event triggers the symptoms and there is a chance that the symptoms will "turn on" again in the future, Nabaa’s intervention was extended for another short period of time.

After two months of intervention, followed by the previous intervention period, with children and parents in the Burj Hammoud area, Psychosocial Support activities (such as discharge activities and psychological follow up) led to positive outcomes in decrease of PTSD level among children (75%to 45%). Nabaa’s psychologists, social workers, parents and children evaluated the decrease of PTSD level.

If the trauma was left untreated, one may have experienced constant nightmares, insomnia, anxiety, depression, phobias, drug abuse, panic attacks, anger, irritability, or hopelessness. The individual may also begin to have physical symptoms such as gastrointestinal distress, fast heartbeat, or extreme fatigue.

Corona virus outbreak was the biggest challenge Nabaa faced due to the strict safety guidelines that were taken and followed while conducting home visits and following up with beneficiaries, as well in implementing activities with groups and municipalities to protect our employees and beneficiaries. Therefore, the sessions were provided remotely, especially after the general lock down.

Naba’a Achievements; During the last period, The most highlighted achievements during the last period;

• We at Naba’a are doing all we can to help all affected communities during this extraordinary crisis. Our assistance efforts go to all: Lebanese, refugees and others who were affected without distinction. The devastating impact of the explosion is compounding the challenges currently faced by Lebanese and refugees and adding even more difficulties as families were struggling to survive with the economic crisis that was exacerbated by the impact of COVID-19.
• Naba’a provided cash assistance for 283 family distributed as 225 in Borj Hammoud and 58 in khandaa along with distributing disinfection / hygiene kits for 1050 families in Beirut and south. Where 150 families in Ein EL Helwi, El Buss, Burj Al shamali and Rachidie camps received hygiene kits in addition to 900 families in Beirut. As for food kits, 225 families in Mie and Mie area and Saida al Balad have provided with Food kits as well as 75 families in Ein El Helwe. Whereas, 306 families in Beirut have received food kits and distributed as 306 families in Khandaa in 900 in Borj Hammoud.
• Our humanitarian response to the tragic blast focuses on the most vulnerable in the community and on different major areas: shelter with emergency housing repairs and protection with mental health and psychosocial support.
• A rehabilitation of 200 shelters with simple damages have been implemented in Borj Hammoud area where the total number of beneficiaries estimated as 751 individuals with regard to rehabilitation. Noteworthy that, Nabaa’ participated in the rapid assessment for 1400 shelters. In addition to the Internal referral for 20 cases from Nabaa team who are working in Borj Hammoud area about other issues as gender Based violence, psychosocial, interventions, cash assistance, livelihood sector, education sector. 392 out of 751 are children, whereas 169 are youth and 190 are elderly taking into consideration 5 people with disability. Adding to this, 570 are Lebanese and 181 are foreigners.

• The division of the groups of children's sessions were according to age (6-14):

-Art therapy sessions for children aged 6 to 10 years

- Psychosocial support "sessions for children "She deals or “I deal with awareness sessions for girls and boys from 11 to 14 years old

- Psychosocial support sessions for all age groups

• 100 children were targeted, divided into groups according to social and psychological needs. The psychologist referred 30 new children for individual follow-up.

Case Study;

The symbol is MA

Date of birth: 1982

Gender: Female

Nationality: Syrian

- Number of family members: 7 (two girls and three boys)

About her life :

The woman lives with her family of 7, two girls and three boys, and her husband in a small rented home. They used to live in Syria but after the war, they left Syria and flee to Lebanon. However, they did not find a decent life where some were bullying them, which made her feel stressed and tense. After they moved from one area to another, they finally settled in Burj Hammoud area, they remained in the area for months before the explosion broke out, as they were financially and psychologically affected. One of her children (10 years) didn’t face any psychological issues until the explosion occurred. After the explosion, he started having hearing problems, fearing everything, and urinary incontinence. This had a negative impact on the mother that led her to cry all day long.

They left the old house due to the destruction took place after Beirut’s blast and moved to a small house. The mother suffers from psychological problems, such as insomnia and eating disorders. Their psychological condition is not stable.

Economic situation:

The economic situation is execrable. They can’t afford purchasing the most basic needs for the children, including food, water, and house rent. Their situation is appalling, especially after Port of Beirut explosion. They also do not have any furniture in the house. They sleep on old mattresses on the floor, they do not have an electricity or internet connection because they cannot pay for these supplies, and the power only comes for two hours. So, during the daylight, the family members use a candle instead of power.

Health status:

The case lived under pressure due to the traumas that she had experienced. She also has two children who are suffering from urinary incontinence. This leads to an even worse economic situation. As she can’t meet the health needs of diapers or medicine.

Social status:

Social status is fine in the family. There are no problems between the mother and her spouse, or even with the neighbors. On the contrary, the neighbors like and defend them, especially when the landlord threatens to evict them. The neighbors didn’t allow such incident to happen, and talked to the owner to give them some time to pay rent.

The issues she suffers from:

Economic problems: expelling the family from the house - their inability to meet the needs of the house, such as food, drink, clothing, or even medicine.

Psychological problems, the most important of which are: insomnia, eating disorders, sadness, anxiety, fear, self-blame.

Intervention:

• Home visits to consolidate the relationship

• Transfer to cash assistance to pay the rent and was assisted with amount of $ 150

• Giving the family food assistance (food parcels – hygiene kits)

• Individual psychological support activities to alleviate the stress

• Psychological support activities to be shared with local community

-       Transfer the case to a psychologist in order to release stress

Recommendations:

-       Follow up on psychological support sessions and awareness sessions

-       Follow-up on psychosocial support activities

-       Follow up with a psychologist

-       Follow up on her children psychologically

-       Home visit

-       Transfer children to psychological support activities

Links:

• Naba'a website