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Lebanon : Expansion of the Neonatal and Intensive Care Unit, Kobayat Hospital

Expansion of the Neonatal and Intensive Care Unit, Kobayat Hospital, Lebanon

About the Hospital:
The Notre Dame de la Paix Hospital is a not-for-profit, private institution run by the Antonine Sisters. It is recognized by the state of Lebanon under the terms of Decree 476/1 (29/07/1998), and is governed by the laws and regulations of that country, as well as its own statutes.

The hospital follows the principles of Christian charity in its work and observes the Constitution of the Congregation of Antonine Sisters. Its mission is to care for every human being, in his or her entirety. Its ethics and conduct are determined by these Christian values: respect for the family, respect for life, respect for the dignity and freedom of the human person, assistance for the poor and needy.

History:
The Notre Dame de la Paix Hospital was built at Akkar, in Kobayat, during the Lebanese War. It met the need for a high-quality hospital in a poor region inhabited by some 150,000 people, far removed from all existing healthcare centres. It serves a region that includes Kobayat, Andkit, Chadra, Akroum, Fneidek, Michmich, Mashta Hassan, Mashta Hammoud, Akkar Atika, Sindiyaneh, Bireh, Wadi Khaled and neighbouring villages, 150 km from Beirut. It serves Muslim and Christian villages alike.
It is the product of a combined effort between doctors, local people, and the Antonine Sisters.
There are various administrative, clinical, investigative and nursing departments.
The hospital’s financial situation is precarious for several reasons:

1. The current economic crisis in Lebanon has had a severe effect on the poorest sectors of the population, including the hospital’s patients.

2. The hospital employs a permanent salaried staff, but the demands on their services are seasonal, since a large proportion of the population only returns to the region during the summer.

Hospital structure:
The hospital was established ten years ago. It has 150 beds and up-to-date medical equipment and supplies. There are three sections: administrative, medical, and nursing.

We now know that the northern region of Lebanon accounts for 25.82% of the country’s total birthrate. (UNICEF National Perinatal Survey, Lebanon, 1999-2000).
Previously, the Akkar district had no high-quality maternity or obstetric departments. Kobayat hospital provides a specialised service in this area that is of great value to the local community.

Its neonatal and intensive care unit employs excellent managerial, medical and nursing staff. The staff carry out their work with a human touch which is greatly appreciated by patients. That human touch sets the unit apart from similar services in other healthcare facilities in northern Lebanon. As a result, the maternity department alone often accounts for more than half the hospital’s activity (in terms of the number of beds occupied).

The neonatal and intensive care unit is widely recognized for the contribution it makes to the public good, in a region otherwise lacking in specialist facilities. The unit now accepts children up to the age of ten from the whole of North Lebanon. Its modest supply of equipment, however, is not equal to the demands that are made on it.

Unit management and current constraints

Impact of increases in the rate of demand:

Increases in the rate of demand have resulted in overloading and a shortage of beds (’surplus’ patients must be put into inappropriate beds, with all the risks to their lives that this can entail, and into wards outside the area where they are being treated).

Impact of existing equipment:

The unit’s high workload means that existing materials are wearing out fast. In some cases, equipment is ill-suited to the unit’s purposes (some monitors, for example, are not adapted for use on new-born babies). Furthermore, the unit has only a limited supply of the materials and equipment that are necessary for the treatment of certain specific, but common, cases (e.g. central monitoring stations, bedside patient monitors, HFO ventilators, syringe pumps, infusors, resuscitation incubators, oscillators, phototherapy tools).

The building in which the unit is housed needs renovating, and the unit is going to be extended into additional two wards that are currently used by paediatric services.

The unit will be divided into four parts:

1- At the entrance, a reception area giving access to the nurses’ office. It is to this area that parents will come to watch their children through panes of glass; it is also here that staff and visitors will disinfect their hands before approaching new-born babies.

2- The post-natal resuscitation area, comprising 4 resuscitation stations, each of which will include: a resuscitation incubator, a respirator, a monitor, an infusor, two syringe pumps, two oxygen sources, two vacuum sources and one medical air source. This area will also be provided with a sink and a large storage cupboard for equipment and supplies.

3- The neonatal and post-resuscitation area, comprising 4 stations, each of which will include: an incubator, a monitor, an infusor, a syringe pump, an oxygen source, a vacuum source, a sink and a large storage cupboard for equipment and supplies.

4- The child resuscitation area, comprising one resuscitation station only, containing: a bed, a respirator, a monitor, an infusor, a syringe pump, an oxygen source, vacuum sources, and a medical air source. This area will also be provided with a sink and a large storage cupboard for equipment and supplies.

5- The unit will also be equipped with a central computer monitoring station, connected to the bedside monitors, and with an office for the care team.

Publication : September 2008

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