Cholera in Lebanon: “We are afraid of everything”

Muhammed is a farmer, and he needs to work in his field, sickness means big trouble for him, coughing again, turning from side to side on his bed in pain. But he’s determined to tell me who he thinks is to blame for all of this.

He asks: “Is there a Nobel Peace Prize? Lebanon deserves the Nobel Prize for failure. All the politicians in the country are corrupt. It is not surprising that we have reached this tragic situation.”

Of course, political failures in the country are one of the main reasons that contributed greatly to the outbreak of this disease.

Although the elections took place last May, a new government has not been formed. The national electricity grid provides electricity for only one hour a day at best, and the Lebanese currency has lost about 90 percent of its value, and it has become very difficult to procure medicines, and more than

80 percent of the population here lives in conditions of extreme poverty.

Lebanon has collapsed, transforming from a fairly affluent country to one that risks chaos that could be caused by a preventable and treatable disease like cholera.

Cholera is spread through dirty water and in a place where most of the basic sewage systems are broken, such as in Lebanon, it can spread quickly.

The last case of cholera in Lebanon was three decades ago and the disease returned on 6 October, and since then there have been hundreds of suspected cases, but due to the lack of simple diagnostic tests, the real number could be much more. high and could reach thousands. .

Now Lebanon is one of 29 countries that have reported an outbreak of the disease since January of this year.

Neighboring Syria has already reported thousands of cases and Afghanistan, Pakistan and Haiti are among the affected countries.

Over the past five years, an average of fewer than 20 countries have reported cases and the World Health Organization has described the surge in infections in 2022 as “unprecedented”.

It even had to suspend its two-dose cholera vaccine strategy due to a lack of global supplies.

As I walk from room to room on the children’s floor at Abdullah Al Rassi hospital, I come across more and more younger patients.

Five-year-old Ziyad al-Ali lies quietly in his bed, his brown eyes staring at the ceiling.

Mira Soufan, a Syrian refugee, is 18 months old. She needs an intravenous replacement, but she cries and screams in pain as her mother tries to comfort her.

Jad Husam al-Jundi was born just four months ago, his body lying on a white hospital bed that looked like a tiny speck. His parents brought him here from Tripoli, which is about an hour from the hospital, because they couldn’t find a place closer to home where their baby could be treated.

The sound here is different from the normal hospital ward, as the silence is not permeated by the usual whistles and hums of advanced machines. Each child has a sachet of intravenous liquid that is silently hung on the bed.

With proper health care, cholera can be easily cured. But the answer must be quick.

There was a man who desperately wanted to tell me about the difficulties he had encountered in securing treatment for his daughter.

“They will not accept her in the hospital unless we pay 2 million Lebanese pounds (equivalent to 50 dollars according to the black market price). What can I do? Should I steal? Kill? We do not carry weapons .. We are poor.”

The Lebanese government recently agreed to cover the medical bills of its cholera-affected citizens.

But for the roughly one million refugees in the country – it’s hard to know exactly how many live here – the picture is less clear.

Their medical care is provided by the United Nations High Commissioner for Refugees, but many Syrians fear they will have to bear the costs.

Which means they sometimes avoid going to the hospital until the last minute. But for a rapidly transmitted disease, cholera, this delay can be fatal.

Abdullah Al-Rassi hospital is the only general hospital in Akkar, in northern Lebanon, the poorest part of the country. The hospital director, Dr. Muhammad Khadrin, fears the growing epidemic will lead to an overcrowded hospital.

“We have now allocated 70 percent of our beds to cholera cases,” he says.

“After Health Minister Firas Abyad visited here, he asked us to provide more beds, and we will soon have around 120 beds, but this is a small hospital serving a large area and cases are increasing … if the problem is not contained, we will not be able to face it “.

Most of the country has so far recorded cases of cholera, as it was discovered in the wastewater of the capital, Beirut.

The city of Benin in the north has seen the largest cholera outbreak in Lebanon to date.

You can see an artificial channel of brown water running through the heart of the city, its waters are dark and murky, and you can’t see anything that might be beneath the surface.

The houses lie on the edge of the water that flows slowly downstream, one of which is inhabited by Hussain Ali.

His brother Hassan died of cholera three days before we met. His wife, niece and nephew are also receiving treatment.

“We don’t know where cholera comes from, is it the air or the water? We live in a state of panic and we are afraid of everything,” he says.

Still very sad, he wipes his face with his hand and says: “I lost my dearest person. He was my soul mate and soul mate, we spent our days together and only parted at night to sleep.”

Usually when death occurs, neighbors, acquaintances and relatives flock to offer their condolences. The average number of mourners can reach a thousand. But outside Hussein’s house, the brown plastic chairs were stacked and empty, and the date tray served to the mourners almost intact.

Almost no one visited the family, as many were afraid of contracting a cholera infection.

The brown water river is often used to irrigate crops, which increases the spread of disease.

Outside the houses there are pipes that bring water from the canal inside, and others that hang above it to drain household waste and sewage.

Umm Ahmed, her husband and children live on a small plot of land and have to grow crops for the landlord as part of the lease.

In a few days, they will plant new shoots in the brown soil under the multiple tunnels. He knows there’s a good chance the pipes that water that piece of land will bring cholera from the stream.

But she told me they had no choice.

“Of course I’m worried,” she said darkly. “My brother has contracted cholera and many of our neighbors have died from it, including a young man who died today. We try to avoid it but we don’t always have a choice.”

Etty Higgins, deputy representative of the United Nations Children’s Fund (UNICEF) in Lebanon, said she had been warning of a cholera outbreak for more than a year.

There were serious indications that if he traveled through Syria, the harsh conditions here would inevitably lead to an epidemic.

A big problem that made matters worse was the collapse of the Tripoli wastewater treatment plant, another victim of the electricity crisis in Lebanon, which usually processes everything from human feces to industrial waste from factories and slaughterhouses. . But now there is nowhere for this waste to go.

“Usually, this waste goes through an initial screening and is pumped 1,600 meters into the sea. But due to the lack of fuel, they couldn’t even pump it into the sea. So it was dumped directly on land instead,” Higgins explains.

The cases of cholera in Lebanon continue to increase by the day and the problems it causes are too many to solve.

Unless real and tangible improvements are made to the country’s infrastructure, it is difficult to see that this alarming cholera epidemic can be kept in check.