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               Õ.È. 19185

          ÇáÈáÏÉ ÇáÞÏíãÉ -  ÇáÞÏÓ 91191

 

   The Four Homes of Mercy

        Of the Arab Orthodox

Invalids Home Charitable Society

Tel: 02-6282076  Fax: 02-6274871

              P. O. Box 19185

     Old CityJerusalem 91191

 e-mail: (homes4@bezeqint.net)

 web Site (fourhomesofmercy.com

 

Projects proposals submitted to all friends

 

Background

 

The Four Homes of Mercy is an independent, non-profit organization, which seeks, through the provision of specialist services to meet the needs of people of complex neurological disabilities resulting from damage to the brain or nervous system.  This is 100-bedded center that provide unique services to individuals of all ages.  The overall aim is to maintain patient abilities to enable them to enjoy as good a quality of life as possible.

 

The organization has been through radical reorganization and we are in the process of building a strong and an enthusiastic team to provide a high quality service for this group of disabled individuals.

 

Mission Statement

 

We believe that all disabled people should have the opportunity to enjoy an optimal quality of life, we work with other individuals and organizations to improve professional knowledge and skills and to raise awareness of disability issues.

 

The Four Homes of Mercy therefore seeks to:

·        Provide specialist clinical services which enable profoundly disabled people to enjoy as good a quality of life as possible within the elimination of their disability

 

·        Develop technological methods and social and recreational programmes which enable profoundly disabled people to be as independent as possible as well as the care of those who need rehabilitation and therapeutic care.

 

·        Undertake research in basic science, clinical management and epidemiologist relevant to profoundly disabled people.

 

·        Communicate with professionals and the public on improving the disabled and the profoundly disabled people

 

Services

 

We provide integrated clinical and non-clinical services through the following team:

1-    24 hours nursing care

2-    Full time rehabilitation consultant

3-    Part time pediatrician

4-    Part time neuro-psychiatrist

5-    Part time dentist

6-    Fully equipped physiotherapy department

7-    Fully equipped occupational therapy department

8-    Full time clinical psychologist

9-    Part time social recreational officer

10-Support services on site:

a.     Laundry

b.    Catering

c.     Domestic care

d.    Gardening

e.    Guard and driver services

 

 

Wards

 

We currently have ninety patients distributed through four wards:

 

·        Children’s ward: currently has 23 children ranging from the age of 3 years up to the age of 12 years

 

·        Teen age young disabled ward: currently has 18 young disabled residents ranging from the age of 13 years up to the age of 30 years

 

·        Adult male ward: currently has 26 patients up to the age of 90 years

 

·        Adult female ward currently has 28 patients up to the age of 94

 

We admit patients from the entire West Bank and Gaza and we are the only center in Palestine that provides services for this group of disabled people.  We even have patients from Jordan and Syria who remained here after the 1967 war.

 

Revenue from patients

Most of our patients come from extremely poor background and their families are unable to contribute anything towards the cost of their care.  The total contribution from patients and their families during the year 2005 did not exceed 3.10% of the total cost of running the Homes.  We rely hugely for our survival on donations and projects funded from local and international organizations.

 

Contextual changes

 

 

With the increasing number of disabled persons this will become a priority area that requires much attention and allocation of resources to meet not only the need of the Intifada casualties but other people who are already registered disabled with the Ministry of Social Welfare, this is estimated at 27000 people through out Gaza and the West Bank.

 

Implications on disability management

 

1-    The increase demand for disability services is clear as the number of disabled people is on the increase

2-    The nature of disability becomes too complex and requires specialized care

3-    The closure of the West Bank and Gaza prevents patients and staff to reach rehabilitation and disability centers

4-    Those who received acute care injuries are unable to reach a rehabilitation center for follow up treatment particularly those who live in the southern part of the West Bank

5-    The worsening economic situation in the West Bank and Gaza causing so many hardship cases.  The Palestinian Authority is at times unable to pay salaries to its employees.  How will it be to non-governmental or charitable organizations.  The current unemployment rate is running at 65%.  This is creating crisis for individuals, families and institutions.

6-    There are other serious psychological effects from the intifada.  Many children are affected with new psychological conditions.

 

Implications on the Four Homes of Mercy

 

The FHOM (Four Homes of Mercy) is going through a transitional period of service revision and management restructuring.  The FHOM continue to be committed to provide care for those who have profound and complex disabilities.  While the FHOM is working hard to ensure that appropriate care is provided for its 90 residents and their quality of life is optimized within its available resources, the FHOM like other institutions have been very much affected by the current contextual changes

 

Problem 1

 

Access of families to visit their loved ones at the FHOM;  This has become a big problem where almost all families are currently unable to reach Bethany and visit the residents at FHOM.  Residents become quite agitated and anxious because of lack of family contact.  Those with full or some cognitive ability are continuously asking and demanding that their families visit.

 

Possible Solutions

 

·        We encourage residents to contact families through the telephone and those who can’t communicate we update their families accordingly

 

·        We encourage local volunteers to visit residents and participate in the existing social recreational activities such as reading newspapers, knitting, or taking them out to the gardens.

 

·        Students from the nearby universities visit three times a week and assist in different activities.

 

Problem 2

 

Some staff are unable or are facing major difficulties to reach the Four Homes.  Two of our staff from Gaza are unable to travel to the West Bank.  One of them has been in Gaza since October 2000 and the other since January 2001.  The chance of their getting out of Gaza is very slim particularly if the current situation continues.

 

The staff who come from Ramallah are unable to get to work every day or if they do manage to get to work they arrive very late as they get stopped at check points for long periods or they have to walk long distances.

 

Possible Solutions:

 

·        We have to rely on the good will of our local staff who live in the vicinity to do extra shifts and cover for other staff. Even though this is adding to the existing financial pressures.

 

·        We offer accommodations to staff and even we opened new rooms to accommodate other staff to stay overnight, with no charge

 

·        We provide transport to four designated areas; Abu Dies, Ramallah, Bethlehem and Jerusalem using our vehicles or sometimes hiring cars.

 

 

Vocational Training for residents:

 

After careful assessment with Life Gate (an international organization specialized in vocational training for disabled people based in Beit Jala) it was agreed that Souma Ahmad, Faisal, Afaf and Mahmoud will be suitable for vocational programmes.  Unfortunately the staff at life gate are unable to come to work and also we are unable to send the residents to Beit Jala as it is not safe, in addition we need another vehicle to cope with increasing demand on transporting staff.

 

We will continue to evaluate the situation and are looking for possible solutions, no magic answer just yet!  However we built a small shop in mid entrance, and Nemeh a resident patient will be the shop attendant, selling chocolates, soft drinks and other items.  Nemeh finds the shop fascinating and is herself seen with a broad smile.

 

Meeting the existing demand of those disabled during the Intifada

 

We are currently discussing the possibility to open an outpatient clinic, using our existing rehabilitation team to provide outpatient consultations for those who received their acute rehabilitation at other centers and require follow up.  We realize that there is at least 1000 persons in the area of Bethlehem and Hebron who cannot reach Ramallah and thus need our patient rehabilitation services.

 

Financial constraints:

 

The FHOM is committed to improve its services to residents within its existing resources.  One can look at previous balance sheets and know that the resources are very humble.  The FHOM relies mainly on generous donations and lately on some subsidy from the Palestine National Authority. The worsening of the economic situation is not helping anyone.  The changes we made during the last six months added extra pressure on to the existing financial difficulties.

 

Additional staff cost was incurred as follows:

 

The employment of 2 physiotherapist         each                            @2500NIS   monthly

The employment of one occupational therapist                             @2500NIS   monthly

The employment of Head of Therapy services                              @3000 NIS  monthly

The employment of a neuro-psychiatrist one day a week            @1500 NIS  per month

The employment of a neuro-rehabilitation consultant

Three days a week                                                                           @4000 NIS  a month

Employment of a clinical nurse supervisor                                     @2500 NIS  per month

Employment of 2 practical nurses   each                                        @1500NIS   monthly

Employment of 3 aid nurses each                                                   @1200NIS   monthly

Employment of head of catering and housekeeping                    @3000 NIS  per month

Employment of a sewing lady                                                          @1500 NIS  per month

We are also still in great need to employ

Two more occupational therapists  each                                        @2500NIS  monthly

One psychologist                                                                              @2500 NIS monthly

One social worker                                                                             @2500 NIS monthly

One speech and language therapist                                               @4000 NIS per month

                                                                                    Subtotal 34,700 NIS (US$ 8,175)

Equipment

 

We purchased the basic necessary equipment for the patient’s dayrooms such as tables, TV and recreational games.  We also purchased new stainless steel display units for the new staff dining room.

 

We are still in great and urgent need to purchase at least 50 new wheel chairs @ least US$1000 each (total US$ 50,000)

 

Medical, nursing apparatus and rehabilitation equipment.  We are still short on the basic necessities.  We applied to the Welfare association to help us but we are still awaiting their decision.

 

The internal environment

 

We continue to effectively make good use of existing space and have converted utility rooms for the use of residents.  We just completed the work of converting two small rooms in the children section to become a bigger room which will be used as physiotherapy room for children and young disabled ones.  The conversion only cost us 4000 NIS; as our own staff did all the work.

 

We installed a new hot water boiler to provide continuous hot water for residents, at a total cost of US$12000

 

We repaired the existing washing machines at a total cost of 4000 NIS

 

We upgraded the lounge and the main entrance at a cost of 50000 NIS

We upgraded the men's & women's ward with the help of Welfare Association

 

External environment

 

Building safety wall and railings around the children gardens at a cost of 5000 NIS (US$ 1,178)

 

Building a safety wall and a safety railing around the external gardens at a cost of 15000 NIS (US$ 3534)

 

We built a ramp for residents to reach the back garden at a cost of

10000 NIS (US$ 2356)

 

Repair of the paths around the FHOM at a cost of 10000 NIS (US$ 2356)

 

Meeting the cost of utility bills and other outstanding costs

 

Despite the efficiency measures we are taking, we are still unable to meet the following outstanding bills:

 

          Diapers                                            NIS55125 for three months

Diesel Oil (crude)                            NIS  32000 monthly in winter time

Electricity                                         NIS  5000 monthly

Water                                               NIS  3000 monthly

Gas                                                   NIS  8100 for six months

Employee insurance                       NIS12000 a year

Telephone                                       NIS  2500 monthly

As well as the extra cost of

needed extra staff                           NIS16000

                             Monthly Deficit subtotal: 67,975 NIS(US$ 16,015)  

Outstanding projects

 

Renovating the children’s ward:

 

The children’s ward was not originally designed to cater for children with severe and complex disabilities.  The bathrooms, clinical and activity areas are not suitable for children with this kind of disability.  The ward is also in need of essential equipment and materials such as shower trolleys, bed-steads and beds to fit and other furniture.  Please see below a list of urgent needs for the children’s ward.

 

Structural modification and rehabilitation to suit the needs of disabled children will require construction, decorating, electrical rewiring, installation of false ceiling work through out the ward.  The work is estimated at  US$70000.

 

Purchasing costs of bed-steads at least 25 beds @US$1200 each.  A total cost of US$30000

 

Purchasing shower trolleys at least 4 @US$1500 each, a total cost of US$6000

 

Total of renovating the children’s ward is US$150000

 

 

 

1-    Renewal of the existing kitchen

 

The present main kitchen is in need of radical renewal and updating to meet the health and safety guidelines

 

·             The existing refrigeration and freezing systems are old and not functioning properly, they need replacement urgently

·        All wooden surfaces and cupboards need to be replaced by

stainless steel surfaces

·        There is need to replace the existing electrical wiring

 

·        New decoration, painting and installing doors and windows in the kitchen compound

 

The estimated total cost is between US$65000 and US$75000. More detailed specifications is available on request.

 

Conclusion

 

While there is a general feeling among staff, residents, families, professional and other institutions that there is a marked improvement at the FHOM, we have to be realistic and objective about the current changes and future plans within the current unstable political and economical situations.  We are certainly proud that the  FHOM is still functioning and strengthening its operations. Still we realize the challenges ahead.

 

We are currently viewing our performance indicators with all our staff and we need to objectively measure our successes.  This is certainly necessary for us at an operational level to ensure that we are running effective and efficient services and for the committee and donors to ensure that they are getting good value for their money.

 

One of the most obvious indicators is the feedback we receive from residents, families and other professionals who visit the Homes.  These can be summarized as follows:

 

1-    There is marked improvement in the physical health of residents as one visitor said (at last their facial muscles are moving and smiling).

 

2-    Residents have become more assertive and realize that they have a say, each section has a representative and every two weeks they present me with their list of suggestions and concerns.

 

3-    Families show more interest and have become more involved in the well being of residents, at least those who are close by

 

4-    We work very closely with the local community and are interacting with community based programmes, we just admitted a 30 year old man who has been left in a room of his, totally isolated, with no food, cover or personal hygiene attend to.  He has 7 brothers and sisters and both his mother and father are unable to cope.  The whole family have two rooms to live in.  We admitted the young man and we certainly see the drastic improvement in his well being.  We are currently writing a case study about him with videotape.  Once finished I shall send you copies.

5-    Young Mohammad in the childrens’ ward who came to us totally unable to walk, now is walking with help of a walking aid, this is a result of intensive rehabilitation.  Mohammad soon will be able to go home and live a normal life with his family.  Unfortunately his family is in Gaza, once there is an access we will make the necessary arrangements.

 

6-    There is a sense of professionalism among all staff, they apply themselves to their patients and certainly we can see improvement among all patients in the following areas:

 

·        Mobility and proper use of wheelchairs

·        5 patients have been trained to feed themselves

·        Straps  are being used to position patients

·        Rehabilitation of Nema who is now keen to be in charge of the shop at the FHOM

·        Personal hygiene of patients, they are washed, cleaned and dressed in a professional manner and individualized way

·        Meals are arranged around patients time and needs.  Food is cooked and presented in a nice civilized manner

·        Residents are encouraged to get out and enjoy the garden, also go out shopping.  If need requires knowing that the road is presently under construction

·        We are working closely with other institutions and Ministry of health and Social Welfare and participate fully and even take the lead in drafting national policies on disability management.

 

The FHOM had made a good and steady progress during the last 6 months.  There is a sense of harmony a certain amount of professionalism and commitment.

There is one special person who has an extraordinary faith and I am sure the Lord is listening to her prayers.  She continues to be the candle that lights our road through this time of change and challenge.  We in return ask the Lord to give her the health and strength to keep the Homes open.

 

 

                                                                            

                                                                   Dr.Ibrahim El Ziq

                                                                   General Director

                                                                   The Four Homes of Mercy