Jordan has been a nation of refuge for people fleeing violence in neighboring countries. However, the influx of over 670,000 Syrian refugees which began in 2011 has placed the country’s national health system under significant strain. The International Rescue Committee (IRC) has worked with Syrian refugees in Jordan since 2012, and is one of the main primary healthcare providers delivering health services free of charge to Syrian refugees and vulnerable host community members.
Abdullah Mahmoud Al-Nsour has worked with IRC in Jordan since 2013. For the last two and a half years, he has been overseeing IRC’s primary healthcare and reproductive health program as a Community Health Program Manager. “My dream job has always been to support human dignity and protect human rights,” says Al-Nsour. His deep passion to serve others in need of humanitarian assistance, he says, is deeply embedded in his culture and in the community he comes from. His three sisters who work in UN agencies played a large role in shaping this passion.
This community health project in Jordan is a vital part of IRC's community health outreach strategy for addressing the gap in existing curative, preventive and promotive healthcare services for refugees and Jordanian communities. With support from the Johnson & Johnson Foundation, IRC is implementing the project with a Jordanian partner, Royal Health Awareness Society (RHAS). The project aims to integrate community health programming into the national health structure in Jordan, contributing both to humanitarian and development community efforts to respond to the refugee crisis as well as to strengthen national health systems and services.
Both the IRC and RHAS have significant experience implementing community-based and preventive health interventions in this context. In alignment with the Jordanian Ministry of Health (MOH), the project aims to establish a network of community health volunteers (CHVs) to expand basic health promotion and support to vulnerable households and communities, connecting them with IRC primary healthcare clinics, health services provided by other NGOs, and to the national public health system.
Al-Nsour oversees a team of five staff members and more than 180 CHVs, putting his background in computer information systems, human resources and project management to good use supporting communities in areas such as mental health, basic healthcare and quality health education. “Their basic needs start from having the correct information shared with them from a trusted source so that they can make informed decisions about the care and treatment they need,” he says.
Making sure children are supported is especially important to Al-Nsour. He recalls an early experience that was a turning point in his career within humanitarian health response. In 2015, while accompanying the IRC mobile clinic with the Jordanian MoH team providing polio vaccines for Syrian children living in informal tented settlements, he came across a seven-month old baby girl who looked very thin. Al-Nsour went back with an IRC doctor to check on her, and as he had feared, the baby was severely malnourished. They referred her immediately to the nearest hospital and then with IRC support to a private hospital, but sadly she did not survive. “I remember her name was Jawaher, which means jewelry, may her soul rest in peace. Her condition was very serious, but her mother had not realized her baby was sick. Her case reminds me of why I’m here.”
There are many success stories, he adds, that keep him going during tough times. “I remember one time a CHV talked about the head of a household who for a long time was not convinced about the importance of getting his children vaccinated. But then with multiple visits the CHV managed to change his mind and he took all his children to get their vaccines and started to convince his neighbors to do the same.”
Such changes in behavior to improve how individuals care for their own health is what the Community Health project is seeking to do. IRC trains CHVs who are an essential—and sometimes the only—link between communities and health systems. Without them, many would have no access to healthcare at all. CHVs address health education, basic healthcare and referral needs through formal and informal actions taken at the community level.
Confronting COVID-19 in Refugee Camps
Like in much of the world, the COVID-19 crisis changed everything even in the refugee camps in Jordan where conditions could hardly get worse. During the height of the COVID-19 pandemic, the national lockdown in Jordan and strict movement restrictions enforced by the government meant IRC staff and beneficiaries were unable to physically provide or access care at the clinics. In response, IRC Jordan developed a remote service delivery plan with support from Johnson & Johnson Foundation that allowed them to continue delivering life-saving and essential health services.
The switch from home visits to phone-based check-ins has been challenging for both health workers and the people they serve, says Al-Nsour. “Most challenges are around uncertainty, which causes stress and depression. We are uncertain about when the pandemic will end, whether the cases will go up again. Even after the pandemic is over, we will still need to work hard to get back to what we used to call normal.”
He wants the world to know that frontline health workers are helping others even though they have their own daily struggles and fights. “Some of them have overcome their circumstances and some are still in need of support,” he says. Besides his wife and three beautiful children, what motivates Al-Nsour is the feeling of responsibility to his team. “They see me as a role model. I need to lead them through this situation so they feel safe and confident. When they see me taking care of myself, which sometimes means I have to push myself to socialize despite the inner resistance to go out, and when they see me continue with my work, it helps inspire them to also keep going and helps make them stronger.”