Home Feature A checkup on the beating heart of healthcare

A checkup on the beating heart of healthcare

primary healthcare centers have been playing a greater role in society

by Thomas Schellen

The growing impoverishment among the population means the availability of affordable healthcare has become an essential aspect of meeting basic needs today. Primary healthcare centers have emerged as an option for Lebanese struggling to access now unaffordable public or private HOSPITAL CARE. Executive visited two major centers, the Karagheusian Primary Healthcare Center and the St. John the Baptist Community Health Center, to hear about their operations.

It is a crisp spring morning. Life is awakening on the streets of Bourj Hammoud. The sun strafes the rooftops of the countless low-rise apartment buildings that huddle cheek to jowl along alleys in the densely populated town, which is an integral part of the Beirut conurbation. While shops start opening along streets that are often barely wide enough for a small truck, life is already bustling at the Karagheusian Primary Healthcare Center (PHC), an unassuming complex of four buildings tucked away in a side street near the Beirut river.

The odd journalist and even a visiting delegation from an international funder organization coming here this morning (independently from each other) are immersed in a steady stream of visitors to the Karagheusian PHC. They are locals and resident refugees seeking relief from toothaches and eye problems, mothers looking to have their children vaccinated, persons in need of medications for their chronic ailments; they are the sick, weary and the suffering of many backgrounds and communities who have made Bourj Hammoud their home and live mostly in walking distance.

“We have a multi-disciplinary team of healthcare workers, both full-time staff and physicians who work with us half-time or part-time in such a way that 30 clinics in our 500 square-meter compound are ready to receive patients throughout the day, so that our center is able to welcome 700 patients per day. This is our philosophy: we are here to provide healthcare services for all. We believe that primary healthcare should be attainable, accessible, affordable, sustainable, and continuous for all, without discrimination,” says Serop Ohanian, the center’s director.

While I have splurged 200,000 Lebanese pounds or the equivalent of about $2, on a ten-minute taxi ride coming here this morning, and whereas nearby shops – advertising apparel such as $4 skirts, $5 belts, and $6 tops – visibly seek to cater to consumers with very modest purses, those with even tighter purse strings are served at the Karagheusian for a consultation fee ranging from an amount as symbolic as 30,000 Lebanese pounds to at most 200,000 Lebanese pounds for some advanced services. The fees for the standard PHC offerings represent a meaningful sacrifice to patients here and according to Ohanian are still a barrier to too many, even as in spring of 2023, 30,000 Lebanese pounds is just a few dimes for people who have access to livable amounts of veritable cash.

That the poor and needy are present in all types of societies is a historic truism. The flows of the ailing never cease in Lebanon and elsewhere, but the Lebanese residents’ needs for affordable healthcare have quadrupled when comparing present beneficiary numbers to those of 2019. More than reflecting the Covid-19 pandemic and the economic crisis, however, the rapid growth in needs commenced with the arrival of refugees from Syria around 2012. The number of beneficiaries at this PHC has exploded tenfold in the space of a decade, increasing from around 20,000 in 2013 to some 200,000 visits in 2022.

It is not in the least coincidental that the affordable provision of services at a long-standing charitable organization in Bourj Hamoud is done under a partnership of stakeholders, which includes the Ministry of Public Health, foreign donors and international NGOs, as well as the Karagheusian organization in its position as a local NGO.

According to Ohanian, the government’s growing enthusiasm for primary healthcare objectives such as disease prevention and health promotion in recent years has led to more and more synergies and partnerships between the public sector and local NGOs which have been delivering charitable works in Lebanon since the 1960s and 70s. “There is a commitment by the government to create synergies and there is a commitment from iNGOs to keep primary healthcare functioning as the best way possible,” he says.

Encased in this narrative of new synergies of social and charitable stakeholders, there is, however, a connotation of the persistent human inability to address predictable human needs without first having had to witness the impact of reiterated human decision errors. Explaining that the roots of the Karagheusian organization, which operates PHCs in Lebanon and Armenia, link back to both the early 20th century refugee experience of the Armenian people and to one Armenian family’s tragedy of losing a teenage son in the ‘Spanish flu’ pandemic, Ohanian says that “as an organization we have tasted the meaning of pandemic, and the meaning of refugees, and today, after 100 years, the history is unfortunately repeating itself. We are still seeing refugee crises and still seeing pandemics.”

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Thomas Schellen

Thomas Schellen is Executive's editor-at-large. He has been reporting on Middle Eastern business and economy for over 20 years. Send mail

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