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Since the first cholera case was registered in October, the authorities have confirmed more than 4,966 people affected and 23 deaths from cholera. The vulnerable situation of the Lebanese population due to the economic crisis, and the limited access to water and sanitation, put the entire country at risk of contagion.
Difficult living conditions in the Arsal refugee camps in the Bekaa Valley are compounded as the cholera outbreak, the first in 30 years, spreads among the vulnerable refugee population. Mohamed Juban, a 2-year-old Syrian, became infected a few weeks ago after the first cases appeared in his camp. Now that Mohamed has recovered, his mother Alya fears for her other four children.
When little Mohamed started having severe diarrhea, his mother was unaware that it was cholera. “It’s a disease she hadn’t heard of since she was a child. I could not imagine that my little one had cholera”, explains Alya Hani to France 24.
Mohamed’s mother is taking the necessary precautions so that the rest of the family does not get infected, now that cholera is spreading in the Arsal camps. The absence of basic services, such as potable water and sewage networks, in the places where the refugees congregate constitutes fertile ground for the epidemic.
After several decades, cholera has reappeared in Syria and Lebanon, –leaving to date more than 4900 cases and more than twenty deaths in the second country-, and threatens to spread to the rest of the region.
Health professionals estimate that the number of cases with symptoms is usually 3 times higher than that reported by the Ministry of Health due to the limited number of tests due to the lack of laboratories in the country.
Children under 14 years of age account for more than 50% of all cases and children between 0 and 4 years of age account for more than a third. Although the largest number of infected has been registered among the refugees due to their extreme vulnerability, the deficient and insufficient public water supply and purification services, which have been deteriorating due to the prolonged economic crisis, have put the entire population at risk of contagion. the population.
Distribution services and drinking water treatment plants have been interrupted by continuous power blackouts, which has led part of the population to have to depend on unsafe water sources. Since the beginning of the crisis, supplies have fallen dramatically, often below 35 liters per capita per day considered the minimum acceptable amount. Limited access to clean, quality water in vulnerable settings has contributed to the rapid spread of the epidemic in urban areas.
The World Health Organization says the cholera outbreak can be contained through vaccinations and access to clean water and sanitation. But in a state that has collapsed, and which has led to the collapse of the Lebanese health system, the challenges to curb the epidemic are very high. Humanitarian organizations have taken the lead in the fight against cholera. NGOs on the ground such as Action Against Hunger are assisting in disinfection and supervising the transport of drinking water in the affected areas.
“Access to safe water is one of the most urgent measures to stop the cholera outbreak. We control and measure the quality of the water when the supply trucks arrive to fill the tanks in the camps. Clean water and good hygiene practices can slow it down,” says Thibault Makridis, WASH project manager for Action Against Hunger.
Making the population aware of how to prevent cholera is also an effective containment tool. “Explaining to residents in an area where there is a cholera case how they should wash food and keep toilets disinfected can prevent the spread to the rest of the neighborhood,” says Kamila Assaf, an aid worker. But in a country where 80% today live below the poverty line, few can afford disinfectant products such as bleach and chlorine tablets to purify water. Given the scale of the problem, if a rapid response is not mobilized, cholera could become endemic in Lebanon.
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