The Covid Impact

The COVID-19 crisis is causing grave socio-economic consequences for individuals and populations across the globe. Early in the pandemic the Fondation Dr Javad Nurbakhsh (FDJN) experienced a substantial decrease in the number of persons coming for care. Fewer patients resulted in a significant reduction in income. FDJN was forced to find creative ways to maintain key medical and social services for those most in need.


1 – Impact on the activities of the medical center

a – The decrease in the number of clients

A 50% decrease in health center attendance started in March and continued into June 2020. Indeed, our average daily number of patients dropped from 25 per day to a mere 12 per day. As a result, we saw a significant reduction in revenues, yet the medical center needed to continue meeting its Social Program and operational fixed costs.


b – Cost saving measures
As we already strive to run efficiently, there were few options for cost-savings. As indicated in the chart below, our income was substantially reduced for many months.
Salaries are our biggest expense, so we discussed several options with our staff. The possibility of technical unemployment by rotation was raised as well as the option of closing the center at night and thereby eliminating night staff expenses. Normally we operate 24 hours a day, 7 days a week and have observation beds for patients not ready to be sent home from the clinic.
In a tremendous gesture of generosity and devotion our staff proposed what they called “the COVID effort : an accross the board salary cut for all employees. The COVID effort was accompanied by an emphasis on judicious utilization of all single-use medical and office supplies as well as of water and electricity. Donations were received from the health district and private donors including hand washing soap, hydroalcoholic gel, masks, and gloves. Additionally, the Sufi Service Committees of California and Abidjan provided continued financial support during this period of crisis.
All these actions enabled much needed savings over the period from May to July 2020. Starting in July routine activities gradually resumed which allowed us to restore everyone’s full level of compensation. We remained at full salaries despite another dip in attendance due to the tense political context around the October presidential election.

c – Patient care
During this period of low patient attendance we trained all employees and volunteers on our written policies regarding Covid-19 preventive measures, including reminders on proper use of PPE’s. Additionally, medical staff were educated on the Ministry of Health’s protocol for identification and referral of all suspected cases of COVID-19.


2 – Impact on social service activities
When the government decreed the closure of schools and other places of gathering, the music, reading and support group activities of our Social Program were all suspended. However, our Social Program continued the payments for medical care, prescription medications and the monthly distribution of food kits. These are all key services relied upon by our patients who were in great need even before the pandemic. All food kits are now accompanied by sanitation supplies to encourage families to wear masks and use additional hygienic measures to prevent transmission of the virus.

Month Monthly Income 2020 Monthly Income 2019
March
14 130 280 FCFA
21 291 520 FCFA
April
10 633 764 FCFA
17 075 300 FCFA
May
12 391 975 FCFA
19 225 825 FCFA
June
16 588 274 FCFA
20 942 042 FCFA

Overhead reduction measures

To cope with its various charges and to keep the medical center open over the period, several options were considered, concerning the payment of salary charges which represent the most important charge for the center.

Indeed, with the decrease of activity, the center can no longer ensure the payment of salaries for all the staff, several options were considered, among others, the possibility of technical unemployment by rotation was raised as well as that of eliminating night guards by opting for part-time work (the center usually operates 24 hours a day, 7 days a week) to reduce staff costs.

These options were finally not retained because the staff supported by the temporary service workers spontaneously offered to contribute to the reduction of costs thanks to a “COVID effort” gesture which consisted for each employee of the medical center to voluntarily transfer part of his salary to help the center cope with this difficult period. The COVID effort was also accompanied by a measure to rationalization the use of consumables and other office supplies. Staff have also been made aware of the proper use of water and electricity resources.

All these actions have enabled a reduction in load of approximately 3,500,000 FCFA over the period from May to July 2020. It should be noted that from July 2020, we are witnessing a gradual resumption of activities which should now allow the FDJN to face its charges, nevertheless the somewhat tense national political context due to the presidential elections scheduled for this month of October 2020 has resulted in a decrease in attendance at the medical center.

Patient care

From a medical point of view during this period, the staff was educated and trained on the COVID 19 pandemic and the barrier gestures to avoid the transmission of this disease. A health protocol has been put in place and a patient circuit has been defined to identify and refer suspected cases of COVID.

Donations were received from the health district and private donors including hand washing soap, hydroalcoholic gel, masks, etc.

Impact on social service activities

As of the first health measures decreed by the government concerning the closure of schools and other places of gathering, the group activities of the social service (music and reading workshop, support group) were suspended.

The other activities (medical care and distribution of food kits) were maintained to allow our precarious patients to benefit from social support during this difficult period. The distribution of food kits is now accompanied by hygiene kits to help and encourage families to adopt barrier gestures.

The distribution of food kits and hygiene kits has been carried out since March 2020 outside the support groups organized at the FDJN. Beneficiaries receive their kits during individual appointments set outside the FDJN to minimize the risk of contamination. Every month, 84 food and hygiene kits are distributed to more than 75 families and vulnerable people.

Vulnerable families have also benefited from free medical and psychosocial care throughout the duration of the COVID crisis through free medical care, the purchase of drugs and social support from the social worker and community counselors.

The distribution of school kits is also taking place to provide children from vulnerable families with school kits and supplies for the 2020-2021 school year. For this distribution of school kits, 279 children were beneficiaries, 123 primary school children and 149 secondary school children received school kits thanks to the generosity of the Aeria company and the Sufi Service Committee in Abidjan.