When crisis disrupts daily life, health workers often continue carrying responsibilities that communities cannot afford to lose.

For Mr. Abass Jouny, IT and Data Specialist at the Lebanese Ministry of Public Health, continuing public health surveillance meant working while displaced from his home and living through repeated periods of uncertainty and insecurity. His reflection offers a personal account of sustaining essential surveillance efforts, witnessing the health needs of affected communities, and continuing to serve while experiencing the crisis himself.

His experience is a reminder that behind every surveillance report and every alert are communities, and health workers living through the realities that the data represent. He shares his experience and reflections in his own words:

“Before the crisis, my work with the surveillance team was focused on supporting public health surveillance and ensuring that information from the field was collected, managed, analyzed, and reported in a timely way. Much of my work involved DHIS2 and data management, communicating with health facilities, cleaning and analyzing data, and preparing reports that could help the public health team understand what was happening and respond appropriately.

When the crisis escalated in 2024, my experience with the situation changed completely. I was no longer looking at the crisis only from the perspective of a health worker. I was also directly affected by it. My family and I were displaced from the South to the North, where I spent around a month. Despite being displaced, I continued working. I went to the office in the North when possible, while other activities continued remotely and online.

The displacement also affected professional activities. Several travels related to trainings had to be cancelled. Plans that would normally be part of our work suddenly became difficult or impossible because of the security situation and the uncertainty surrounding movement.

This year, the experience was somewhat different. We were displaced to Mount Lebanon for a couple of weeks. We returned to the South, but the situation remained unpredictable. Whenever there was an alert or our village was targeted by bombing, we would leave again and return when we felt it was possible. This created a different kind of pressure. You could be working normally and then suddenly receive an alert and have to think about leaving your home.

During these periods, much of my work continued remotely. I continued with data cleaning and analysis, reporting, DHIS2-related work, and communication with health facilities. The location may have changed, but the need for surveillance did not.

One of the health concerns that became particularly important was the risk of infectious diseases and outbreaks. During a crisis, displacement and disruption of normal health services can create conditions where infectious diseases can spread more easily. This made surveillance especially important. Having timely information from health facilities and being able to monitor alerts and reported cases helps health teams identify potential problems early and understand where attention is needed.

What made this experience particularly difficult was that we were not working from a place of complete safety or stability ourselves. We were also living with uncertainty and stress. We would hear the sounds of the war, follow alerts, and sometimes have to leave our homes, while at the same time continuing our responsibilities as health workers.

What kept me motivated was mainly a sense of responsibility—to the affected communities and to the health team I was working with. I also knew that surveillance has an important role during emergencies. Even when many things around us are disrupted, diseases do not stop, and health needs do not disappear. If anything, the need to know what is happening becomes greater.

This experience taught me that public health surveillance is not something that can simply be put on hold during a crisis. In fact, emergencies make surveillance more important. When health systems are under pressure and populations are displaced, decision-makers need reliable information to understand emerging health risks and direct limited resources where they are most needed.

There is also something very personal about continuing this work while being affected yourself. You begin to understand that the people you are monitoring are not just numbers in a database. Behind every report and every alert are people living through the same uncertainty, displacement, fear, and disruption.

Today, we are back in the South. We still hear and feel the effects of the war, and the uncertainty has not completely disappeared. After experiencing this repeatedly, some aspects of it have become part of our daily reality. But that does not mean the stress is gone. We continue to live with the possibility that an alert could change our plans or force us to leave again.

Looking ahead, I believe continued attention to infectious disease surveillance and outbreak preparedness is essential. Health services need to remain accessible, surveillance systems need to remain functional, and health workers need the support and resources required to continue their work, particularly when they themselves are affected by the crisis.

For me, the main lesson is simple: during a crisis, maintaining public health surveillance means maintaining our ability to see what is happening to communities when almost everything else around them is changing. Continuing this work matters because timely information can help health teams recognize risks early, respond faster, and protect people who are already facing extremely difficult circumstances.”

Photo:©UNICEF