Hepatitis A spreading in south Damascus amidst poor living conditions

March 19, 2015

Hepatitis A has begun to spread in opposition-controlled areas of southern Damascus, with local medical organizations recording two deaths and 250 cases of infections in the last month. Hepatitis A is one of three forms of the hepatitis disease, caused by the consumption of unsanitary food and water or exposure to those who are infected.

Treatment for the virus usually takes at least three months, with victims in the meantime suffering from intense stomach, joint and muscle pains, fatigue, weakness, and sometimes jaundice. Local medical and civil society organizations in the area have attempted to spread awareness of the disease by distributing pamphlets warning of its dangers and steps that can be taken to prevent its spread.

But due to a lack of supplies and facilities–only two medical centers exist in all of southern Damascus–local doctors have found themselves unequipped to treat the patients they do receive.

Doctors attribute the breakout to the total regime encirclement imposed on areas of southern Damascus since mid-2013, which have prevented residents from obtaining regular access to food and water, causing hundreds to die from starvation and thirst, including at least 20 people since the beginning of this year.

Yelda is one of three main towns in southern Damascus where Free Syrian Army (FSA) fighters signed truces with the regime roughly one year ago. However the presence of Jabhat a-Nusra fighters in Yelda and surrounding areas has worked to undermine the truce, with regime forces using it as a pretext to bomb the area and maintain the blockade at will. Trapped from all sides, desperate citizens eat what they can, says Ammar Aisa, 30, a physician who works at the Shahid al-Mahrab hospital in Yelda.

“People nowadays will eat anything they can find, with farmers in some cases resorting to irrigating their land with sewage water,” thereby poisoning the crops grown with it, Aisa tells Syria Direct’s Muhammad al-Haj Ali.

The regime sporadically allows in medical supplies from the World Health Organization and Red Cross, but it is not nearly enough, he says. The lack of supplies and equipment prevents doctors from identifying hepatitis-positive patients and quarantining them.

Infected people “can easily come into contact with others, and the disease can further spread.”

Q: How have people’s standards of living and general conditions in southern Damascus been affected by the siege?

There’s a number of things, most important being the lack of food and water. People nowadays will eat anything they can find, with farmers in some cases resorting to irrigating their land with sewage water. This causes locally produced vegetables, people’s main source of food in southern Damascus, to become contaminated and dangerous. All this causes the spread of diseases and epidemics. 

Q: What are the latest statistics for hepatitis and who has the highest rate of infection?

As far as statistics, we estimate that a total of 1,500 people in southern Damascus have contracted Hepatitis A. Children are infected more frequently than adults.

However, this is just the number of people we’ve been able to register and keep track of. There are those who haven’t been taking their children to the hospital because they know there’s no available treatment for the disease.

This type of behavior is dangerous, because it leaves patients out in the open as opposed to being properly isolated, where their condition can be monitored and evaluated.

Q: So infected individuals are living amongst non-infected people?

Yes, and this is a big problem because the disease can spread through breathing and using shared personal items. The reality is that it’s extremely difficult for us to separate those who don’t have the disease from infected individuals.

The availability of supplies has been significantly curbed due to the [regime] blockade. This prevents us from being able to identity, treat and quarantine affected people. They can come into contact with others, and the disease can further spread.

Q: Is the disease spreading quickly?

Yes, quite rapidly, due to the deteriorating living conditions in southern Damascus as a result of the blockade imposed by the regime, which has caused clean water people receive from utilities to be cut off.

Q: Has anyone made any attempts to try to halt the spread of the disease or its primary causal factors?

No, such a project would require the efforts of entire governments to track and control the disease. Here, we can barely ensure basic treatment and prevention.

Q: Which other diseases exist in southern Damascus? How dangerous are they?

We’ve seen the existence of jaundice, intestinal inflammation, and other forms of hepatitis among children and adults, as well as anemia.

The latter results from people relying on a single source of usually unhealthy food, which is common in southern Damascus, as opposed to a balanced diet, which is necessary in order for someone to maintain a strong immune system. 

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