November 12, 2014

Syrian refugees living in makeshift camps in the Lebanese border town of Arsal are facing an outbreak of all three strains of hepatitis, which typically spreads through contact with infected blood or stool.

Health officials in the area are concerned about poor sanitary conditions, in particular the lack of clean water and sanitation, as the number of new cases climbed from 130 in September to 182 in October. 

Syrians “eat and drink from the same containers” in the camp, Qasim a-Zain, a Syrian epidemiologist who heads the Arsal Medical Council, tells Syria Direct's Mohammed al-Haj Ali.

The Council, which runs the hospital treating Syrian refugees in Arsal, is experiencing a “severe shortage” in medical supplies and equipment to treat hepatitis. It is part of the wider problem of providing services to the more than one million Syrians seeking shelter in Lebanon, a-Zain says.

“If Lebanon does not want to welcome refugees, I hope steps will be taken to move Syrians to Turkey or north Syria.”

Q: What's the danger of the disease [Hepatitis A] spreading in locales such as the refugee camps in Arsal?

Packed places like refugee camps lead to Hepatitis A spreading faster, especially with the lack of a clean water system and sanitation, extreme poverty, and [people] eating and drinking in group fashion from the same containers.

ArsalHepititisAn Arsal health worker teaches children about hepatitis . Photo courtesy of @aboalhodaalhoms

Q: When did the disease start to appear?

The disease has been around continuously. It decreases significantly in the winter, and increases in the end of summer and fall. Cases started to increase in August of this year.

Q: What is the medical center's role in combating this situation?

There are several hospital and clinic sections in the medical center in Arsal, including dialysis and a section for wounded and disabled patients. We see 800 patients a day, and we have a laboratory.

I am the only epidemiologist in Arsal, in addition to a pediatrician and the lab doctor who assists in treating Hepatitis A. There is a recovery section for patients who need to stay in the hospital for treatment.

We also visit schools and the camps to raise awareness of health-related issues and perform checkups on children.

Q: Do you have sufficient equipment to treat this disease?

Unfortunately, right now we are suffering from a severe shortage of medicine, and even laboratory necessities to combat this disease and other epidemics. Add to that a lack of vaccines, and the fact that a number of Syrian refugees are not taking their vaccines on time.

Q: Did you request aid from international organizations?

Yes, from all local and international organizations. We sent our reports to the International Red Cross and the UN, and the Lebanese ministry of health.

We received some support from the Red Cross, and we learned that the UN and the Lebanese health ministry—by way of the UN—sent some baskets filled with disinfectants for the patients, and some food aid. They promised to improve the water and sanitation situation, but the work is very slow.

Q: Have relations improved with the Lebanese authorities in Arsal?

Unfortunately no. The siege of Arsal continues. All the aid organizations are afraid of coming here, and face difficulty doing so.

The latest detentions, burning of the camps and refusal to build camps to replace the ones that were burned down—no, we have not noticed a serious change, despite the good will from the Lebanese ministry of health.

Q: How can this problem be solved?

The best solution would be a return to our beloved Syria.

Barring that, [we need to] improve refugee conditions, and establish humanitarian camps that enjoy a good water network and sanitation, in addition to humanitarian, food, and education aid, and disinfectants.

The camps need protection, and acknowledgement of the rights of refugees, and the guarantee of health care and food security, and good water, electricity, food, and medicine.

Q: Any last thoughts?

If Lebanon does not want to welcome refugees, and prefers to fight them and accuse them of terrorism, then I hope that steps will be taken to move Syrian refugees to Turkey or northern Syria.

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