Features

A seasoned veteran’s “novel” experience

by MainGate Staff

Spring/Summer 2020

Rana Hajjeh (BS ’84, MD ’88) is director of Programme Management for the World Health Organization’s Eastern Mediterranean Region, an area comprised of 583 million people in 21 member states and Palestine (West Bank and Gaza Strip). She has been on the front lines of crisis response to some of recent history’s most serious public health emergencies, including Ebola, Cholera, SARS, MERS, and H1N1.

Hajjeh is based in the WHO’s regional office in Cairo. She recently returned from Iraq, where the WHO is providing technical support. “We work with the Ministry of Health in a variety of ways. Our main role is to provide technical assistance on how best to manage and control the pandemic, but we also supply large quantities of laboratory and medical supplies and equipment, and we have a large hub based in Dubai that has shipped tons of supplies to countries all over the world,” she says. The WHO distributes a wide range of information materials, some of which might be contrary to deep-seated beliefs. “Each country has a different context; for example, Iraq has a lot of religious sites and gatherings, and in the current context, these events can amplify the pandemic. We are working with religious leaders as well as public health officials. It’s not easy to convince people that during a pandemic, religious gatherings might harm rather than protect them. We leave it to countries to adopt and adapt our guidelines according to their own context and needs. Many factors need to be taken into account when making public health decisions including social factors, feasibility and acceptance of various interventions, and overall impact. Protecting health is our first priority, but there’s also a lot of concern about the potential to completely paralyze the global economy.”

Rana Hajjeh (BS ’84, MD ’88), Director of Programme Management for the World

Health Organization’s Eastern Mediterranean Region

Out of the 22 countries under Hajjeh’s purview, 12 are either directly in conflict or affected by neighboring conflict. Many have been in conflict for several years. This includes Syria, Yemen, Somalia, Sudan, and Afghanistan. “Countries that have been in an emergency status for a long time have very weak health systems,” she explains. We ensure that they have adequate support for early diagnosis and response, and we help them build capacity for better case management, including supporting hospitals. Iran was the epicenter of the coronavirus outbreak in the region, and even though they had strong health systems, they had an explosive outbreak due to a delay in identifying cases early on and putting in place interventions such as contact tracing and isolation.” Asked about measures such as business closures, social distancing, and limiting crowding to prevent the spread of COVID-19 in Egypt, Hajjeh smiled and said that these measures were recommended to the country but implementation and enforcement have not been consistent. She diplomatically indicated that political intricacies and obstacles are among the region’s many challenges.

The WHO designs policy based on the best data and scientific information available to date. Hajjeh explained that in 2005 the World Health Assembly approved International Health Regulations, which mandate that all countries share information about diseases that are declared pandemics or public health events of international concern. “We receive daily reports from countries, and we track how quickly the epidemic is progressing for the whole region. The WHO also works with countries to ensure that essential health services are available, such as immunizations for children, prenatal care for pregnant women, and medicines to treat chronic conditions.”

In terms of how her experience of COVID-19 is different from that of other outbreaks, Hajjeh says, “My family worried about me when I was working on Ebola in West Africa, but this is more challenging. It’s easier to protect yourself against a disease like Ebola, which is largely transmitted through body fluids, than it is to protect yourself against a respiratory virus. We’re all dealing with a lot of uncertainty with this novel virus—limited data-based evidence, no definitive effective interventions yet, like vaccines or treatment—and with a deadly global impact. I’ve never encountered an outbreak on this scale.”