From the coronavirus frontlines: Lebanon’s hotline volunteers work around the clock

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For 13 of the 15 years of Lebanon’s civil war, Maher al-Kharrat drove ambulances and treated the injured with the Lebanese Red Cross under the constant threat of being caught in crossfire. Now he is on the frontlines of a new battle – the one against the novel coronavirus.

“There is no fighting now, but we are still at war,” the 54-year-old told Al Arabiya English.

Kharrat is one of a team of around 50 volunteers who work around the clock to man the phones of the COVID-19 hotline at Rafik Hariri Hospital – Lebanon’s largest public hospital and the hub of the country’s coronavirus response.

Read more: Coronavirus: Lebanon sees highest single-day jump in COVID-19 cases

The basement call center in southern Beirut, housed in the headquarters of state-run telecoms company Ogero, receives an average of 100 calls per day, spiking to 500 on the busiest days.

Operators were trained on how to answer questions on the novel coronavirus, guide patients on quarantine procedures, follow up on suspected cases and coordinate with doctors and ambulance services to transport patients with severe symptoms to hospital.

When an operator receives a call, they can search key terms into the network’s COVID-19 database, updated regularly in coordination with medical staff at the hospital, to make sure the caller gets accurate advice and information.

For more coronavirus coverage, visit our dedicated section.

A boy helps his mother to put on a mask, during a countrywide lockdown to combat the spread of coronavirus disease (COVID-19) in Sidon, Lebanon April 28, 2020. (Reuters)
A boy helps his mother to put on a mask, during a countrywide lockdown to combat the spread of coronavirus disease (COVID-19) in Sidon, Lebanon April 28, 2020. (Reuters)

“This is essential for this disease that in one way or another came out of the blue,” said Dr. Firas Abiad, the hospital’s director. “People have a lot of anxieties about COVID-19, because we still don’t really know much about it.”

A huge responsibility

With the volunteers taking a new call around every five minutes, the work can be stressful, tiring and emotionally draining.

“When I get home I am exhausted,” said 22-year-old public health graduate Tracy Israel, who signed up to volunteer at the call center after struggling to find full-time employment.

“There’s this weight of a huge responsibility to make sure people get what they need and feel at ease.”

Read more: Lebanese women with foreign spouses denied coronavirus aid

Despite the efforts of the team to allay the fears of anxious callers by calmly and reassuringly giving detailed advice or guidance, there are times when they just cannot get through.

“People under stress can get aggressive, and sometimes they scream down the phones at us and make threats,” Kharrat said.

In late May, the Red Cross veteran suffered a heart attack and had to undergo surgery. But just four days later, he was back in his chair, answering calls and directing less experienced volunteers.

“I had to come back to help, I know many people out there are suffering,” he said.

Read more: Coronavirus: Lebanon introduces fines for not wearing face masks

Ola Bazzi, a 23-year-old volunteer who describes herself as naturally shy, was nervous about handling different personalities over the phone when she first joined the team in April, but said she has learned to empathize.

“The aggressive people make up a tiny minority of callers, but I understand them in one way or another – it’s a stressful time.”

In April, the Lebanese Health Ministry began conducting random coronavirus tests across the country to gain a better idea of the virus’ spread.

For the last two weeks, the Rafik Hariri Hospital hotline has been responsible for giving out the results to those who have been tested.

“This is when the pressure really started,” Bazzi said. “People call and expect the result straight away, even though we tell them the test takes 48 hours to be processed.”

Smart software

The call center is run by the National Council for Entrepreneurship and Innovation (NCEI), which provided software to forecast busy periods, analyze calls in real-time and provide recommended responses to common queries.

Read more: Coronavirus lockdown adds to Lebanon’s culture sector crisis

“This means that operators can always give the same answers to the same questions,” Maan Barazy, NCEI’s president said. “We don’t leave anything to chance.”

The specialized algorithm prompts operators to follow up with patients who have suspected symptoms, ensuring they can quickly get the care they need should their condition deteriorate. It also allows staff to trace everyone a patient has been in close contact with should they test positive for COVID-19.

When a patient needs to be admitted to hospital, their symptoms and medical history collected by operators at the call center are then shared with the staff at the hospital’s coronavirus unit.

“This way, the ER team knows exactly what to expect when the patient arrives,” Barazy said.

The system also helps monitor patients who have been discharged from the hospital that no longer need urgent care but are still contagious.

People wear face masks as they stand at the entrance of Rafik Hariri hospital, as Lebanon recorded its first death from the coronavirus, in Beirut, Lebanon March 10, 2020. (Reuters)
People wear face masks as they stand at the entrance of Rafik Hariri hospital, as Lebanon recorded its first death from the coronavirus, in Beirut, Lebanon March 10, 2020. (Reuters)

For Dr. Mahmoud Hassoun, who heads the hospital’s dedicated coronavirus unit, the smart software is where the call center really comes into its own.

“The algorithm does not make mistakes,” he said. “It’s a real added value for our hospital to help us curb the spread of the virus.”

The hospital at the heart of the battle

The Rafik Hariri University Hospital has become the reference center for the country’s COVID-19 response as it was the first hospital to receive coronavirus patients when the first case was confirmed on February 21.

The hospital has long suffered from chronic underfunding and under-resourcing and staff staged protests earlier this year to demand unpaid salaries and better living conditions.

Read more: Coronavirus puts spotlight on Lebanon’s ailing public healthcare system

For Abiad, the hospital’s response to the coronavirus crisis, including the creation of a dedicated call center has helped to change its reputation and public image.

“We have been able to build trust between us and the public and really address the needs of our patients.”

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