SIDON, Lebanon: A leading infectious disease specialist has warned of the risk of epidemic outbreaks in Lebanon, as a number of factors increase pressure on the country’s already fragile medical system.
The Syrian refugee presence, inadequate medical infrastructure, a lack of safe drinking water and chronic water shortages are all major factors that increase the risk of epidemics, according Dr Abdul-Rahman Bizri.
A former mayor of Sidon, Bizri said the resulting conditions have increased the chance of an outbreak of diseases such as cholera and hepatitis A, adding that there’s only so much the existing infrastructure can handle.
Studies from as far back as the ’50s and ’60s have shown that more than half of the Palestinian refugees in Lebanon live in ill-equipped camps. A study by the American University of Beirut and UNRWA in 2010 showed little change, according to Bizri.
“This is of great consequence, because conditions in the camps – unsafe health conditions and incomplete infrastructure, coupled with overcrowding and a lack of necessary medical services – facilitate the spread of disease,” Bizri told The Daily Star in an interview.
Even with a relatively strong infrastructure, with the influx of Syrian refugees and the rise in Lebanon’s own population the health care system was doomed to collapse, according to Bizri, and its failures have been reflected in number of ways, including the emergence of new epidemics.
“Recently, Lebanon has suffered from three epidemics, the first of which is Leishmania.”
Leishmania is a parasitic disease that used to be uncommon in Lebanon, with only one or two cases reported each year, Bizri explained.
“[But] the disease is very well known in Syria,” he said. “With the Syrian migration, the dermatological disease spread to Lebanon.”
Over the past couple of years, Lebanon’s health care system has treated “1,300 to 1,400” cases.
“This called for a fast mobilization,” Bizri said. “Centers for early detection and treatment were created, and those affected were given free care.”
“The disease has been confined and is starting to fade away, but this should not prevent us from maintaining readiness,” Bizri said.
The second epidemic affecting the country’s medical infrastructure is measles, according to Bizri. A huge treatment campaign was launched seven years ago by the Health Ministry and the country continues to battle the disease, but “during the past two years, measles rose back,” he said.
This pushed medical bodies in Lebanon to take more drastic actions to contain the disease. Vaccination and immunization campaigns were launched in different areas.
“This is in addition to the adjustment of the national immunization program: a vaccine for measles was reintroduced in the program for 9-month-old children.”
Two doses of the MMR vaccine – measles, mumps and rubella – are also starting to be given to children between 1 and 2 years old. “This fast mobilization led to the control of the spread of measles, but the vaccination processes [must continue].”
Bizri said hepatitis A, the third epidemic, is the most important, as it’s yet to be contained.
“Lebanon now suffers from the presence of more than 4,000 cases of hepatitis A, and the number is expected to increase,” Bizri said.
Its projected rise is due to the pressures on available medical resources and the country’s polluted drinking water. “Lebanon, until now, has not had a response to this problem, and as experts we recommend the Health Ministry include hepatitis A vaccine in the national immunization program,” Bizri stressed.
There have also been warnings that the disease is emerging in Syrian towns and is then being transferred by refugees to Lebanon.
Bizri said the pressure on Lebanon’s medical infrastructure requires the country to focus on two approaches. “The first is refugee medicine and the second is crisis medicine,” he said.
The latter focuses on how to deal with medical crises during wars and natural disasters. The World Health Organization warns in such conditions, three diseases are at risk of emerging: Ebola, cholera, and polio.
Cholera could emerge because of the water problem in Lebanon and Syria, according to Birzi, and the warning regarding polio is a result of the lack of immunizations during times of war. The disease has been recorded in Syria.
Bizri explained that neither Ebola nor polio currently exists in Lebanon but warned of unpreparedness. He recommended the training of Lebanese doctors, nurses and paramedics in crisis medicine, and said there is also a need to train medical and health institutions to better provide services to refugees.
“The world has become a small village, diseases are now easily transferred from one country to another,” Bizri explained.
“The government and its institutions are responsible for the Syrian refugees; it should give medical care a great deal of importance.”
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