Ambassador Michele Bowe
What began as a contained and isolated outbreak of the Covid virus in Bethlehem, has now grown to infect over 25,000 people, concentrated in the Bethlehem and Hebron regions. This is the catchment area for Holy Family Hospital. These figure likely only capture a fraction of the numbers infected as the desperate economic situation forces those who have jobs to continue working, even with a sick household member. Sick people are not getting tested because of the road closures and the fear of breadwinners being quarantined without income.
In March, Covid found its way into Bethlehem resulting in an immediate and complete lockdown and curfew of the region. Manned checkpoints separated neighborhoods, the streets emptied, and no one dared to go outside. The exception was the doctors, nurses, midwives and staff of Holy Family Hospital. They bravely crossed through neighborhoods, sometimes escorting women in labor and made their way to work at the Hospital. Babies don’t stop for pandemics and our hardworking Hospital staff doesn’t stop caring for the Mothers and Babies of the greater Bethlehem region.
During the first three months of the shutdown, most economic activity stopped. Schools closed, businesses shuttered, and all non-essential medical services were stopped. Only 10% of the people were receiving salaries due to the heavy reliance on the pilgrimage and tourism sector. Families took care of each other and paychecks were stretched to cover necessities for extended family members. The Hospital staff came to work every day, suited up in their protective gear delivering 1,300 babies. To keep the patients and employees safe and healthy, the medical director split the employees up into teams and created 12-hour shifts. Any virus exposed teams would quarantine as a group to prevent a spread of the virus.
The Hospital is diligent about infection control and mitigation, as it is the only hospital in the region that can deliver and care for babies born before 32 weeks. The 18 bed NICU has been full to overflowing with babies as small as one pound. The staff has been putting in long hours at personal risk. Holy Family Hospital repurposed an operating theater into an isolation unit to deliver sick mothers staffed by a dedicated isolation team. These staff members volunteered for this hazardous isolation duty knowing they were helping their colleagues with fragile family members stay healthy.
This 3-month shutdown of Bethlehem, the Hospital clinics and the closure of the Hebron Road contained the spread of the virus but had a great economic impact on the Hospital.
Most families could no longer contribute at all toward their care or deliveries creating a large unplanned deficit of $600,000 in the Hospital budget. To maintain operations, the Hospital board voted to reduce employee salaries for three months by 18%. This was a difficult decision, but given the finite resources of the Hospital, an unavoidable one. In June, the Hospital board voted to reinstate full salaries because of the great economic hardship and the high-risk work conditions the staff face in today’s medical environment.
As the virus was contained in early May, some businesses began to reopen, but few came to spend money because of the economic situation. Bethlehem is no stranger to economic hardship. While it is the most Christian Governorate, in Palestine, it is also the poorest after Gaza. The presence of the Church creates regional stability through employment and economic stimulation, but livelihoods are dependent on pilgrims or day labor in Jerusalem. Families are accustomed to sharing their tables, rationing their water and electricity usage and waiting out the hardship. Monies saved for deliveries or medical care had to be diverted to buy food and a few hours of water and electricity each day. The hardship of this pandemic is unlike any past hardship experienced in the region.
In early June, the cases of Covid began to grow exponentially in Bethlehem and Hebron, from where the Hospital draws its patients. The crowded refugee camps, jam packed lines of laborers going into Jerusalem and crowded city centers created a surge of infected people. The Hospital was not able to stay free of the virus. A pre-symptomatic mother delivered her baby at the Hospital and when she became sick, her whole care team had to be tested and quarantined. Only one resident doctor tested positive and that team was able to come back to work. The head of Obstetrics was also exposed to Covid and had to isolate, but ultimately did not test positive.
During the month of September, the Hospital cared for a number of known Covid infected mothers and countless asymptomatic or pre-symptomatic others. Despite the best protocols and infection control procedures, staff members are falling sick and delivery room teams and other employees have been sent to quarantine. So far, ten staff members have fallen sick with Covid, complicating scheduling. Cases of infected patients are showing up at the hospital daily. Despite the high infection rates and tension, the Hospital remains well staffed and functioning. 460 babies were welcomed into the world at Holy Family Hospital in September by a very busy, but careful team of medical professionals.
The Ministry of Health is working hard to try to contain the spread of the virus. The fragile health system could collapse with this increased rate of cases. Today there are over 149 infected healthcare workers in the region. As Covid spreads, so does the poverty. As many as 90% of the people have not received a salary since mid-March and others have seen their salaries greatly reduced.
The Hospital budget is stressed because few patients can contribute toward their care and there is an increase in complicated deliveries and NICU admissions due to the impact of the virus and increased poverty. The NICU is running at or over capacity with more complicated and cost intensive cases than usual. The hospital remains busy with 12-19 births each day.
The protective gear required by staff has become hard to acquire and is increasingly expensive. Increased expenses coupled with the lack of patient contributions has created a projected deficit for the year of $600,000. Holy Family Hospital Foundation is working harder than ever before to find funding to keep the doors of our Hospital open during this crisis and beyond.
Bethlehem needs Holy Family Hospital now more than ever before to keep the mothers and babies safe and Holy Family Hospital needs you more than ever before to keep hope alive and to allow our staff to continue delivering lifesaving care for all without regard to creed or need at our modern day manger.