Lebanon’s cholera outbreak
Cholera is a water-borne disease that can spread quickly in places with poor sanitation, such as Lebanon’s refugee camps.
The first cholera outbreak since 1993 is now spreading across Lebanon and Syria. This comes at a time when the region is already struggling with political instability, economic crisis, collapsing healthcare systems, banking restrictions, and a devaluating currency among others. Here, staff at our partner MERATH give an update of what is happening and what they are doing to respond.
WHAT IS CHOLERA AND HOW IS IT SPREADING?
Cholera is a rapidly dehydrating diarrheal disease, where the Vibrio cholerae bacteria spreads through contaminated food and water. While symptoms are usually moderate, cholera may cause coma and death within hours.
Cholera most likely arrived in Lebanon from Syria where the first cholera case was detected in August 2022. Since then, cases rapidly increased in Syria and spread throughout all of Syria’s 14 governorates with over 20,000 suspected cases and 75 reported deaths. The first cholera case in Lebanon was reported in October and only a few weeks into the outbreak there are almost 5,000 suspected and confirmed cases and there have been18 deaths, according to the Lebanon Ministry of Health.
WHY IS THE CHOLERA OUTBREAK AND EMERGENCY FOR SYRIA AND LEBANON?
The disease is spreading quickly due to the deterioration of water and sanitation across Lebanon, alongside extended power outages which interrupt clean water infrastructure. In recent cholera testing, traces of Vibrio cholerae were found in Beirut and Mount Lebanon water sources. The impact of this epidemic may be further exacerbated by the medicine shortages, unaffordable medical care, and high resistance to antibiotics in Lebanon, due to communal overconsumption of antibiotics. Meanwhile in Syria, people are forced to purchase untreated water because the water infrastructure is severely damaged after 11 years of war. Moreover, only 52% of Syria’s hospitals are operational. This poses a threat to individuals infected by cholera who need emergency treatment within hours. In both countries, individuals living in informal settlements are increasingly at risk of contracting cholera.
WHAT IS THE CURRENT RESPONSE TO THE CHOLERA OUTBREAK?
As of November 1, Lebanon has no president or official government despite numerous attempts to elect replacements for the current caretaker government. Caught in a power vacuum, the Lebanese caretaker government has faced difficulties in carrying out its duties in helping local authorities tackle the cholera epidemic. One town mayor in the North, Kifah Kassar, does believe the Health Ministry has helped after setting up a field hospital and promising that “all cholera patients will receive medical care and the ministry will cover their medical bills”.[1] Even if the ministry stands by this promise, municipalities cannot rely on government funding due to the nationwide economic crisis.
Meanwhile, international organizations like the International Committee of the Red Cross (ICRC), UNICEF, and WHO are coordinating with the Ministry of Public Health and Ministry of Energy and Water to designate hospitals to carry out the cholera response, secure needed medicines, and distribute cholera test kits. France also donated a total of 13,000 oral cholera vaccine doses, which will be initially used for frontline responders. However, national response may continue to face challenges given the worsening economic crisis and a weakening public sector.
Similarly in Syria, organizations like ICRC are assisting in the rehabilitation of water supply systems in main cities such as Aleppo, Damascus, Homs, and Hama. Medical supplies are also being distributed to seven hospitals in the main cities to strengthen the cholera response. For community awareness, organizations are distributing tens of thousands of materials about the spread and prevention of cholera. This is merely an emergency response by the international community, and not a long-term solution to Syria’s multiple complex challenges in the midst of economic and political instabilities.
HOW ARE EMBRACE PARTNERS HELPING TO REPOND?
On the ground in Lebanon and Syria, MERATH is actively raising awareness about the spread and prevention of cholera through conversations, distributions of posters and flyers, an SMS campaign, and awareness sessions, when possible, through its local partner churches.
However, humanitarian needs across Lebanon and Syria continue to increase, especially as the coming winter approaches and many families will be faced with choosing between using fuel for boiling clean water or for warming themselves in bitter cold temperatures.
[1] https://today.lorientlejour.com/article/1316449/waiting-for-things-to-get-worse-inside-the-epicenter-of-lebanons-cholera-outbreak.html
