Makarem el Akhlak clinic in Tripoli, Lebanon

With International Medical Corps’ Support, a Tripoli Clinic Transforms

By Hana Bourgi, Information and Reporting Officer, International Medical Corps Lebanon

After years of working as a medical representative in Beirut, Mr. Toufic decided to return to his hometown to give back to his community. Tripoli, a city in northern Lebanon, has long struggled with political instability and high poverty rates — challenges that have been compounded by the influx of nearly 252,000 Syrian refugees.

Mr. Toufic was hired to serve as the director of a primary health clinic run by the local non-governmental organization Makarem el Akhlak in Tripoli’s city center. He hired four doctors, one nurse and a part-time cleaner, and expected the patients to come pouring in — but they saw only about 100 a month. Those who came often complained about the lack and inefficiency of services.

“Despite the fact that I have a medical background, I was not aware of the correct structure and flow that should happen in a primary healthcare center,” Mr. Toufic said.

Mr. Toufic

Two years later, International Medical Corps was looking for a clinic to support in Tripoli to help make healthcare services available to underprivileged families, and found Mr. Toufic. They shared the same vision and started to work together, with funding from the U.S. Bureau of Population, Refugees and Migration (PRM), to improve the quality of services provided at Makarem el Akhlak.

The International Medical Corps team worked with Mr. Toufic to identify weaknesses and gaps in the clinic and actions to improve them.

“The first thing we [did was] meet and put [together] a work plan to improve the work at the clinic,” said Mr. Toufic.

Mr. Toufic, equipped with a checklist of goals, deadlines and focal points, met with his team regularly to make sure they were on-track with the work plan, while International Medical Corps held multiple training sessions for the clinic staff on such areas as infection prevention and control, non-communicable diseases and clinic management.

Mr. Toufic says that the support from International Medical Corps tremendously improved the day-to-day operations and quality of care provided at the clinic. First, the medical records are now well-organized in locked cabinets, helping to ensure patient privacy. Second, because more staff have been hired and the patient flow has been changed, people can be seen by a health professional more quickly. This includes a nurse who takes the full patient history and does the general examination before passing the patient onto the doctor — the number of which went from three to 16 after International Medical Corps began to help.

International Medical Corps’ support also allowed Makarem Al Akhlak to offer consultations at reduced fees — typically between $2 and $3 — and free prescribed medications for refugees and Lebanese host-community members. It covers 85 percent of the expenses of diagnostic tests for patients over 60 years old, pregnant women, children under five and those with disabilities. Vaccinations for children under five are free, and lower rates are given for antenatal care services. Family planning is also available at the clinic, including free-of-charge insertion of IUDs and injectable contraception, and reduced-rate sexual health services.

Today, Makarem Al Akhlak sees more than 1,000 patients a month — a 10-fold increase from when it first opened in 2012.

International Medical Corps also helped Makarem el Akhlak meet the standards required by the Ministry of Public Health, which enabled it to become a part of the ministry’s official network through which it can access free medication, financial support and training for staff.

The clinic also goes beyond providing medical services — it tries to detect health problems in the community it services and then solve them through awareness-raising about common medical problems, healthy habits and what services are available. Because of this, Mr. Toufic believes they are preventing outbreaks and lowering mortality rates, especially among children.

“[A] few months back, we noticed that the number of antenatal care visits was very low at our clinic,” Mr. Toufic said. “The midwife started doing informal interviews with women to understand the reasons behind not seeking antenatal care services and it turned to be low knowledge.

Therefore, and in coordination with International Medical Corps, we started doing awareness sessions about antenatal care and family planning at the clinic and we have noticed the increase in the number of pregnant women at our clinic.”

Makarem El Akhlak now has earned a good reputation among both host and refugee communities. This is evidenced by where the clinic’s patients come from. According to Mr. Toufic,

“People come from other districts to seek services at Makarem because of the quality of services it provides at low costs.”

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