Cholera returns to crisis-hit Lebanon after three decades

By Noemi Jabois

Bebnine, Lebanon, Nov 5 (EFE).- A one-year-old baby cries inconsolably as nurses try to insert an IV at a makeshift hospital set up in the basement of a mosque in Bebnine, the epicenter of the first cholera outbreak in Lebanon in nearly 30 years.

As soon as he is placed in his mother’s arms, a team of medics in blue gowns and disposable booties assigns him to one of the compartments flanked by curtains that divide the austere room that was set up last week in response to the deteriorating health situation.

Bebnine is located just 15 kilometers from the Syrian border, where the initial outbreak of the disease began two months ago, in the northern district of Akkar, where the first case of cholera was detected on Lebanese territory since 1993.

Since then, the health ministry has counted more than 2,400 suspected cases and about 20 deaths, while the World Health Organization warned this week of its “rapid” spread to reach all of the country’s provinces.

In Bebnine, the situation became uncontrollable at the end of October, Nahed Saad al Dien, director of the Al Iman medical center, tells Efe inside the mosque in whose basement a special unit has been improvised to deal with this acute diarrheal disease.

“The first case was a displaced Syrian who contracted cholera and died. He was living in a refugee camp near a water spring in Al Fouar, where the epidemic spread to the village through the water,” she said.

Heavy rainfall one night and the consequent overflowing of the sewage system served as the trigger for the catastrophe in the village which is home to a mixed Lebanese and Syrian population.

According to Saad al Dien’s count, during the peak they received more than 100 cases a day, some of them in “critical” condition, and so far at least 11 deaths have been recorded, almost all of them ill with pre-existing ailments.

Although the figures began to drop this week, the health ministry continues to recruit doctors and train nurses amid fears of new case surges.

Cholera, often linked to environments of poverty and war, has returned to Lebanon with the country in the midst of one of the worst economic crises in its history, with medicines in short supply and much of the medical community having emigrated in search of job opportunities.

“The medicines sent by the Ministry and Unicef were limited, but with the help of the International Medical Corps and with the medicines we had at the center, we were able to control the situation,” acknowledged the director of Al Iman.

Pulmonologist Khalil Hussaibani, who was hired as a backup during the emergency at Bebnine, is more concerned about treating water sources than the rest of the measures, saying that most patients only require taking oral rehydration solutions.

“We need resources to clean and decontaminate the water, which is the primary source of this outbreak,” the doctor told Efe, announcing that Unicef and the International Medical Corps have already managed to treat the affected water sources in the area with chlorine.

The cholera-causing bacteria, which is spread by the fecal-oral route, is resurging amid a conspicuous absence of public services due to the economic crisis, with many sewage treatment plants out of service and households affected by constant water cuts.

In the crowded refugee settlements spread across Akkar, among other Lebanese regions, minimum hygienic conditions and access to clean water are not available.

Hussaibani also warns of an awareness “problem” in the communities and believes that most of the deceased were unaware that loss of body fluids must be immediately compensated orally or intravenously.

In his case, Abdel Naser Kassar, 52, ran to the basement of the Habib al Mustafa Mosque as soon as dawn broke, just two hours after starting early in the morning with severe vomiting, diarrhea and a headache.

“I couldn’t take it anymore, it’s the first time I feel like this (…) I was surprised and I didn’t have time to go to the doctor. I came here; I was very bad,” he tells Efe from one of the beds in the makeshift hospital. EFE

ar-hu-njd/ks