Third polio vaccination round March 2014 Bekaa informal tented settlementAs of March 2014, it has been almost three years since the onset of the Syrian crisis. Since March 2012 military escalation in Syria has been unprecedented, causing more than 4 million Syrians to flee the violence inside Syria, and more than 2 million to be displaced outside Syria. Lebanon hosts the greatest number of displaced Syrians in the Region, the officially registered number exceeds 1 million whereas unofficial numbers suggest a count of over 2 million. The WHO country office in Lebanon has been greatly involved in ensuring that displaced Syrians in Lebanon have access to primary and secondary health care services, that communicable disease are prevented and monitored, and that the population at large is prepared for bigger challenges in health.

The main objectives of the WHO Lebanon country office support are to:

• oversee and provide leadership, coordination and technical support to the health sector within the framework of humanitarian response for the Syrian crisis in Lebanon;
• ensure sustainable access of displaced Syrians to preventive and to curative primary health care services, with an emphasis on communicable and noncommunicable diseases, child health, mental health and reproductive health needs; and
• support the monitoring activities of health trends and their impact on needs and priorities, in addition to enhancing the Ministry of Public Health’s role in the early detection and response to disease outbreaks.

In consequence, the WHO country team is participating in all monthly interagency coordination meetings, where briefings on the situation of the Syrian crisis at country and regional levels are provided from and to UN heads of agencies. During these meetings main issues pertaining to the UN response to the Syrian crisis in Lebanon are also discussed as well as issues of public health importance and the engagement of the Government in strategy and response decisions.

WHO has also focused its support to the primary health careservices provided to the displaced  in terms of training and capacity-building, as well as to ensure gap filling for critical health issues; the achievements so far include:

• replenishing three batches of chronic and essential medications for a population of 10 000 to primary health care centres where shortage in medications has been documented; proving through the YMCA chronic medications (essentially for NCDs) sufficient for 75 000 patients for a period of 6 months
• replenishing the Ministry’s vaccines to ensure the availability of excess vaccines for routine vaccination and to implement an outreach vaccination for all children (Lebanese and displaced) under 5 years old in Bekaa and the north through the Ministry of Public Health. A total of 5000 doses of DTP-HIb were procured for the Expanded Programme on Immunization (EPI);
• conducting 180 community awareness sessions in the north, Bekaa, and Nabatiyeh through the joint project with UNICEF, UNFPA, and YMCA on selected topics: mental health, skin diseases, substance abuse, communicable diseases, noncommunicable diseases, upper respiratory problems in children, breastfeeding and safe motherhood and family planning, vaccination, hygiene and water sanitation, STI/HIV. A set of standard presentations was prepared and revised by WHO and used by most partners implementing health awareness activities. The awareness sessions reached 6700 displaced Syrians and host community members;
• conducting two workshops on communication skills for around 40 staff from primary health care centres in areas with high concentration of displaced Syrians;
• developing and piloting a module on mental health in the context of refugees; 3 nongovernmental organizations providing mental health services were provided with “in service “ training; and
• conducting a 6-day workshop in the north on clinical management of selected health conditions in the context of refugees;
• piloting a training module with the society of family medicine for general practitioners, on management of the most common primary health care conditions, targeting in this initial phase 5 primary health care centres and 15 medical doctors

In the context of chemical nuclear and biological hazards, WHO organized, in coordination with the Ministry of Public Health and in collaboration with the Syndicate of Hospitals, a set of 11 workshops on management of exposure to these hazards, with focus on the medical and public health aspects. The training reached 189 health staff from public and private hospitals, as well as public health staff from the Qada health offices, the armed forces, the Ministries of interior, industry and environment. The training module was prepared by the WHO country office team, based on WHO reference material adapted to the Lebanese health system; the training included interactive sessions, with case studies and hands on practical session on the use of personal protective equipment.

WHO jointly with UNICEF has conducted a vaccination outreach community-based intervention, with measles and polio vaccines; vaccination activities focused on areas with high concentration of displaced Syrians reaching a total of 250 000 children less than 5 years, around 30% of them are displaced Syrians.

WHO provided 10 000 doses of antimonials to provide treatment for the cutaneous leishmaniasis reported among DS; recommendations for vector control were also provided to the Ministry and the Water Sanitation and Hygiene (WASH) working group. Leishmania clinics have been established by the MOPH in 11 public hospitals, with the support of WHO for necessary medical supplies.

WHO will keep focusing its interventions based on the below strategic objectives:

• lead coordination and management of the health sector response
• provide timely, up-to-date information on health trends, health systems, needs and response
• advocate for health in humanitarian agenda
• prevent, detect and respond rapidly to infectious disease outbreaks
• provide technical assistance on key public health issues
• facilitate access to quality primary, hospital and referral health care services.

Expand images to view

Photo credits: Pier Paolo Balladelli, MD, Emergency Support Team WHO Regional Syria Crisis Coordinator