The suburb of Abdullah Al-Salem contains three health centers: Badr Al-Nafisi Health Clinic, Abdul Karim Al-Saeed Center, and the Dermatology Specialist and School Capital Program for Oral and Dental Health, in addition to the Primary Health Care Unit. Furthermore, there are also 7 mosques, 6 schools, one police station, a central Cooperative Society market (and four branches of it.) There is also the Badr Khaled Al-Nafisi Health Clinic, which was a key driving force behind the initiative. Members of the coordination committee investigated the needs of the health center and neighboring health centers, considering that this is a health crisis first and foremost. The committee also investigated the needs of other, non-health related centers in anticipation of the consequences of COVID-19, and this is based on the role of a healthy city in times of crisis.

Around mid-April, the staff of the four health centers (45 employees) were housed in their respective centers. This was instructed by the Ministry of Health in order to preserve the health of workers at this important time to prevent them from mixing with infected individuals or carriers of the virus. Furthermore, in light of the preoccupation of the Ministry of Health and its workers with the men and women combatting the virus on the frontlines, the city office coordinated with the local community so that they could offer a helping hand to these centers by providing sleeping mattresses, blankets, personal hygiene supplies and washing the staff’s clothes. The local community also prepared iftar meals for medical staff during the blessed month of Ramadan during the partial curfew and inevitable total curfew, which made it impossible for many humanitarian organizations to deliver meals and even to enter residential areas.

The initiative also enabled donors in the region to provide breakfast and suhour meals to the workers during the month of Ramadan Al-Mubarak, since most of the workers are Muslims and they are forbidden from cooking inside health centers for safety reasons. They were prevented from leaving the premises, therefore 10 families volunteered to deliver food to the staff, and young volunteers in the area deliver food from their homes to the health centers. It is important to mention the cooperation of the police station, as they permitted volunteers to deliver food to medical staff as long as preventative measures were being followed.

Everyone cooperated in donating ingredients, foodstuffs, and disposable containers to volunteers who prepared meals for the workers at a time when it was difficult to shop for these materials in large quantities due to restrictions that prevented entry to supermarkets. This had a positive effect on medical staff as it indicated that members of the community were eager to help.

Also, charitable societies have been contacted to provide food for workers present in health centers after the curfew ends so that the initiative can continue after the lockdown.

Furthermore, the staff of local mosques in the region have been contacted to indetify their basic needs during the month of Ramadan, and all the mosques in the seven suburbs were provided with food baskets (containing rice, meat, chicken, oil, frozen vegetables, juices and water) on a weekly basis, which were donated by the local community.

The Medication Delivery Initiative:

A number of volunteers with a health background have been formed to support the work of Badr Al Nafisi Health Clinic by delivering medicines to patients with chronic diseases.

Six volunteers from the suburb participated in coordination with the city office and in coordination with the dispensary to deliver medicines. More than 150 home deliveries were made over a period of two months, from 1/4/2020 to 1/6/2020. The medication delivery service aimed to limit visits to health centers and to encourage members of the community to stay home in order to limit the spread of Coronavirus (COVID-19).

As part of the health city’s goal to provide the highest standards of service, the healthy city of Abdullah Al Salem has provided its volunteers with heat protectors to safely transport medicines, due to the onset of the summer and subsequent rise in air temperature. Furthermore, the volunteers, in coordination with the Coordinating Committee of the Health City, made a plan to deliver medicines to non-Kuwaiti workers in the region, through the creation of a digital tool that facilitates the payment of fees for medications online so that they do not need to leave their homes.

Also, the members of the Coordination Committee were keen to contribute by distributing instructions to volunteers containing guidelines for protecting their safety during the volunteering period.

The head of the Badr Al-Nafisi Clinic also spearheaded efforts to revitalize the clinic’s Instagram page in order to keep pace with the Ministry of Health in the speed of publishing preventive health information about COVID-19, as Abdullah Al-Salem Health City Office did not have an Instagram page yet. The City Office coordinated with the District Association to set up telephone numbers for the dispensaries, which were also shared on the Instagram page. The number of followers on the Instagram page increased from 265 to 505.

The Volunteer Delivery Initiative

The City Health Office formed a team of 21 volunteers consisting of the youth of the region for the purpose of delivering food/medications to people who need them. In order for this to happen, the City Office took a pre-emptive step with the police station by providing them with the names of volunteers who would deliver meals/medicines to the people who need them.

This guaranteed the success of the delivery initiatives, as the services provided were not interrupted or delayed due to advance planning and coordination with local security forces.  The Healthy Cities Office played an important role in developing plans and ensuring preparedness, especially during times of crisis.

The Volunteer Management Initiative

The City Office partnered with the local Cooperative Society supermarket to coordinate volunteer work. 43 volunteers were identified to work at the Cooperative Society, and they were divided into two parts: team leaders to make and implement decisions and team members (with training and supervision from the association.)

Volunteers worked in stores by helping to arrange shelves and serve as cashiers. Team leaders managed volunteer work and spread team efforts over two shifts (7 AM – 11 PM and 11 PM – 3 AM) Volunteers were allocated based on the tasks that were required, and only 50 volunteers were allowed at a time—and they were instructed to follow strict social distancing guidelines.

A Google Form was also created to streamline the volunteer registration process and to allocate tasks/shifts for all volunteers.

The Healthy Cities Office played an instrumental role in the successful coordination of volunteers, and it successfully highlighted the importance and merits of volunteering among the local youth.

Quotes from Stakeholders:

• The Governor of the Capital (His Excellency Sheikh Talal Al-Khaled Al-Sabah): "The staff at the Healthy Cities Office are on the front lines and we are proud of their efforts.” (Source: Al Jarida newspaper, date: 4/17/2020)
• The responses of workers inside the health centers: “Thanks to all the employees in the office Healthy Cities Office; thanks a million thanks and may God grant you a thousand blessings.”
• Message from a questionnaire respondent in the city: “I would like to thank them for the love and care they have for the community.”
• Head of the Health Cities Office in Kuwait, Dr. Amal Al-Yahya: "Your work during the deserves to be documented. '' (Source: On WhatsApp)

The COVID-19 response plan aimed to coordinate initiatives and response efforts among all stakeholders, and to efficiently facilitate government directives during the crisis. The plan also aimed to inspire and encourage community participation.

After analyzing community feedback gained by distributing an online survey, the following insights were gained:

• 100% of all community members felt that they had enough food during the lockdown, and they stated they were comfortable and happy as a result.
• 100% of all community members said that they actively followed the advice/guidance provided by the Healthy Cities Office.
• A random sample of 15 houses (10%) out of the 150 houses that received medication were phoned for the purpose of an evaluation. The recipients praised the professionalism and performance of volunteers, and 100% of all recipients called praised the volunteers’ adherence to safety measures.
• The clinic’s Instagram page received praise.
• Suburb residents praised the community-based initiatives and highlighted their importance.
• A newspaper article and a letter from the governor praising the above initiatives.
• A letter of thanks was sent to the Healthy Cities Office.

In terms of post-pandemic prospects, the above initiatives have forged a strong bond among members of the community and local and organisations, thereby inspiring a strong sense of duty within the local community. In addition to raising general health awareness, community members are now more confident that they can withstand crises when response efforts are coordinated and organized.

 The initiative resulted in the below outcomes:

• Medicines were delivered to 150 homes within two months, through the cooperation of volunteers.
• Food and resources were provided to health center staff in the region.
• Food and resources were provided to mosque workers in the region.
• Volunteers were successfully trained in safety procedures and correct conduct.

The Abdullah Al Salem Healthy City response plan was a unique experience that was launched on 2/2/2020, and based on the evaluations of the aforementioned initiatives we have outlined recommendations to enhance the role of Healthy Cities in this region:

• Giving more power to the Healthy Cities representatives.
• Clarifying the role of Healthy Cities so that local communities can better understand its purpose.
• Defining the role and authority of Healthy Cities to local stakeholders, such as dispensaries, security forces, etc. so that the coordination of initiatives is more fruitful.
• Defining the role and authority of Healthy Cities vis-à-vis the role and authority of the mayor. There is a lot of overlap between Healthy Cities and government representatives, since the Healthy Cities does not work under the Ministry of Interior but cooperates with it instead. These matters are not clear to government authorities.

• By following the above recommendations, the Healthy Cities Office will be in an optimal position to provide support to the government when coordinating response efforts. Furthermore, every district contains vital centers, such as schools, mosques, hospitals, police stations, etc., but they lack coordination and it is the responsibility of Healthy Cities to encourage cooperation through promoting partnership with the community alongside health standards.