Kőrösi: Cholera in Lebanon Won’t Become Epidemic

Cases exceeded 1,400 with over 17 deaths in the country

Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
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Kőrösi: Cholera in Lebanon Won’t Become Epidemic

Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)
Mira, 18 months old, is one of the patients being treated for cholera in Lebanon (BBC)

The number of cholera cases in Lebanon has exceeded 1,400 with over 17 deaths according to the latest official figures, while the President of the United Nations General Assembly, Csaba Kőrösi, said Wednesday in a statement to Asharq Al-Awsat he was very confident that cholera will not become a major epidemic in the country. Lebanon has recorded more than 1,400 cholera cases and 17 deaths as of Tuesday, since the first case appeared in the country on the fifth of October, according to the “World Health Organization” (WHO).

Commenting on this outbreak, Kőrösi expressed to Asharq Al-Awsat his confidence that despite the major crises that Lebanon is experiencing, cholera will be contained in the country. “I am very confident that cholera is not going to become a major epidemic in Lebanon, it should be contained,” he stated. He also pointed out that there might be some other very dangerous outbreaks that need to be prevented worldwide.

Concurrently, cholera continues to spread in Syria on a large scale, bringing the number of infections to about 25,000 cases, according to the latest figures, with more than 80 deaths.

Origins of Cholera

As reported by WHO, cholera transmission is closely linked to inadequate access to clean water and sanitation facilities. Menaced areas include outskirts slums, and camps for displaced persons or refugees, where clean water and sanitation lack the minimum requirements. The consequences of a humanitarian crisis, such as disruption of water and sanitation systems, or the displacement of populations to inadequate and overcrowded camps, can increase the risk of cholera transmission, should the bacteria be present or introduced.

Symptoms

According to WHO, cholera is an extremely virulent disease that can cause severe acute watery diarrhea. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water. It affects both children and adults and can kill within hours if untreated. Most people infected with cholera do not develop any symptoms, although the bacteria are present in their body for 1-10 days after infection and are shed back into the environment, potentially infecting other people. Among people who develop symptoms, the majority have mild or moderate symptoms, while a minority develop acute watery diarrhea with severe dehydration. This can lead to death if left untreated.

Cholera spread in Syria and Lebanon

In Syria, the outbreak has likely started, according to the international NGO “Save the Children”, due to communities consuming contaminated water and food irrigated by the Euphrates River, which is experiencing historic low water levels mainly due to Syria’s worst drought in decades.

In Lebanon, cholera has been diagnosed firstly in rural areas bordering Syria, and is "probably due to population movements," according to the head of World Health Organization (WHO) technical team in Lebanon, Alissar Rady. “Most cholera cases in Lebanon have been in the camps, among the roughly 1 million Syrians who have taken refuge over the past decade from the conflict in their homeland”, according to Lebanese Health Minister Firass Abiad. While the outbreak was initially confined to northern districts, it has spread rapidly, said WHO’s office in Lebanon on Tuesday, with laboratory-confirmed cases reported from all eight governorates and 18 out of 26 districts.In Syria, cholera has already spread over the 14 Governorates of the country.

Tackling the disease

To contain the spread of the disease, the World Health Organization recommends improving access to proper and timely case management of cholera cases, prevention, and control in healthcare facilities, improving access to safe drinking water and sanitation infrastructure, as well as, improving hygiene practices and food safety in affected communities, with these counting as the most effective means of controlling cholera.

Oral cholera vaccine should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in targeted areas known to be at high risk for cholera. Key public health communication messages should be provided to the population.

Surveillance for early case detection, confirmation, and response in other provinces and regions of Lebanon should be reinforced especially at the district level while expanding community-based surveillance.

According to information provided by Hala Habib, the communications officer of WHO Lebanon, the long-term solution for Cholera control lies in economic development and universal access to safe drinking water and adequate sanitation. Actions targeting environmental conditions include the implementation of adapted long-term sustainable WASH solutions to ensure the use of safe water, basic sanitation, and good hygiene practices in cholera hotspots.

In addition to cholera, such interventions prevent a wide range of other water-borne illnesses, as well as contribute to achieving goals related to poverty, malnutrition, and education. The WASH solutions for cholera are aligned with those of the Sustainable Development Goals (SDG) number 6.

Vaccination

WHO recently announced that the standard two-dose vaccination for cholera will be suspended temporarily to allow for the available doses to be used in more countries, although Lebanon took delivery on Monday of its first vaccines to combat the worsening cholera outbreak from donor nation France. However, despite global shortages in cholera vaccines, WHO is supporting the Lebanese Ministry of Public Health to secure 600,000 doses for those most at risk, including frontline workers, prisoners, refugees, and their host communities.

Humanitarian Aids

In Lebanon, WHO is joining with the Ministry of Public Health and other health partners to curb the evolving cholera outbreak. For instance, WHO and other humanitarian partners have supported the Ministry to develop a national cholera preparedness and response plan, outlining the most urgent response interventions required, while scaling up surveillance and active case-finding in hotspot areas. UNICEF distributed thousands of liters of fuel to water pumping stations and waste-water treatment stations in locations with confirmed and suspected cholera cases. It has procured emergency medical supplies to support the treatment of several thousands of cholera cases and symptoms including moderate to severe diarrhea. It delivered Chlorinated Trucked water, wastewater desludging, and ensured disinfection in informal settlements with suspected or confirmed cases.

UNICEF trained over 4000 frontline workers and partners on cholera awareness, including transmission, symptoms, treatment, prevention, and referral mechanisms, scaled up safe water deliveries, and increased desludging to over 250,000 people living in informal settlements. In Lebanon also, the “Save the Children” organization is responding with partners through the interagency cholera prevention, preparedness, and response Plan. “Save the Children” will be working to ensure children in schools and communities are protected from possible water-related outbreaks, have access to safe water, sanitation, and hygiene, and affirm that their well-being is maintained. This includes awareness messaging, health hygiene promotion in schools, and distribution of soap, hygiene kits, and chlorination tablets for supported communities, as well as providing support for sustainable solutions such as UV solar-powered systems for cleaning water.

In Syria, UNICEF is distributing millions of water treatment tablets to more than 350,000 people in affected governorates. It distributed over 400 tons of sodium hypochlorite during the first two weeks of October to increase chlorine dosages and concentration, as chlorine is often distributed in cholera response because it effectively inactivates the Vibrio cholerae bacteria, that causes cholera. Since the beginning of the cholera response, more than a ton of sodium hypochlorite has been distributed, providing more than 13 million people with safe and clean water. UNICEF delivered acute watery diarrhea (AWD) kits to support treating thousands of moderate and severe Cholera cases. UNICEF also trained hundreds of healthcare workers and hygiene promotion teams across Syria.

Save the Children’s response to cholera in Syria, is helping the restoration of basic services, including water and sanitation, as key to helping communities recover from the impact of conflict. Save the Children’s response plan includes chlorination of restored water, water quality monitoring, distribution of hygiene and cleaning kits, as well as hygiene promotion.



Palestinian Families Flee West Bank Homes in Droves as Israel Confronts Militants

Israel expanded its West Bank operation, which began last month, to Nur Shams in recent days © Zain JAAFAR / AFP
Israel expanded its West Bank operation, which began last month, to Nur Shams in recent days © Zain JAAFAR / AFP
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Palestinian Families Flee West Bank Homes in Droves as Israel Confronts Militants

Israel expanded its West Bank operation, which began last month, to Nur Shams in recent days © Zain JAAFAR / AFP
Israel expanded its West Bank operation, which began last month, to Nur Shams in recent days © Zain JAAFAR / AFP

By car and on foot, through muddy olive groves and snipers’ sight lines, tens of thousands of Palestinians in recent weeks have fled Israeli military operations across the northern West Bank — the largest displacement in the occupied territory since the 1967 Mideast war.

After announcing a widespread crackdown against West Bank militants on Jan. 21 — just two days after its ceasefire deal with Hamas in Gaza — Israeli forces descended on the restive city of Jenin, as they have dozens of times since Hamas’ Oct. 7, 2023, attack on Israel.

But unlike past operations, Israeli forces then pushed deeper and more forcefully into several other nearby towns, including Tulkarem, Far’a and Nur Shams, scattering families and stirring bitter memories of the 1948 war over Israel’s creation, The AP reported.

During that war, 700,000 Palestinians fled or were forced from their homes in what is now Israel. That Nakba, or “catastrophe,” as Palestinians call it, gave rise to the crowded West Bank towns now under assault and still known as refugee camps.

“This is our nakba,” said Abed Sabagh, 53, who bundled his seven children into the car on Feb. 9 as sound bombs blared in Nur Shams camp, where he was born to parents who fled the 1948 war.

Tactics from Gaza Humanitarian officials say they haven’t seen such displacement in the West Bank since the 1967 Mideast war, when Israel captured the territory west of the Jordan River, along with east Jerusalem and the Gaza Strip, displacing another 300,000 Palestinians.

“This is unprecedented. When you add to this the destruction of infrastructure, we’re reaching a point where the camps are becoming uninhabitable," said Roland Friedrich, director of West Bank affairs for the UN Palestinian refugee agency. More than 40,100 Palestinians have fled their homes in the ongoing military operation, according to the agency.

Experts say that Israel's tactics in the West Bank are becoming almost indistinguishable from those deployed in Gaza. Already, President Donald Trump's plan for the mass transfer of Palestinians out of Gaza has emboldened Israel's far-right to renew calls for annexation of the West Bank.

"The idea of ‘cleansing’ the land of Palestinians is more popular today than ever before," said Yagil Levy, head of the Institute for the Study of Civil-Military Relations at Britain’s Open University.

The Israeli army denies issuing evacuation orders in the West Bank. It said troops secure passages for those wanting to leave on their own accord.

Seven minutes to leave home. Over a dozen displaced Palestinians interviewed in the last week said they did not flee their homes out of fear, but on the orders of Israeli security forces. Associated Press journalists in the Nur Shams camp also heard Israeli soldiers shouting through mosque megaphones, ordering people to leave.

Some displaced families said soldiers were polite, knocking on doors and assuring them they could return when the army left. Others said they were ruthless, ransacking rooms, waving rifles and hustling residents out of their homes despite pleas for more time.

“I was sobbing, asking them, ‘Why do you want me to leave my house?’ My baby is upstairs, just let me get my baby please,’” Ayat Abdullah, 30, recalled from a shelter for displaced people in the village of Kafr al-Labd. “They gave us seven minutes. I brought my children, thank God. Nothing else."

Told to make their own way, Abdullah trudged 10 kilometers (six miles) on a path lighted only by the glow from her phone as rain turned the ground to mud. She said she clutched her children tight, braving possible snipers that had killed a 23-year-old pregnant woman just hours earlier on Feb. 9.

Her 5-year-old son, Nidal, interrupted her story, pursing his lips together to make a loud buzzing sound.

“You’re right, my love," she replied. “That’s the sound the drones made when we left home.”

Hospitality, for now In the nearby town of Anabta, volunteers moved in and out of mosques and government buildings that have become makeshift shelters — delivering donated blankets, serving bitter coffee, distributing boiled eggs for breakfast and whipping up vats of rice and chicken for dinner.

Residents have opened their homes to families fleeing Nur Shams and Tulkarem.

“This is our duty in the current security situation,” said Thabet A’mar, the mayor of Anabta.

But he stressed that the town’s welcoming hand should not be mistaken for anything more.

“We insist that their displacement is temporary,” he said.

Staying put When the invasion started on Feb. 2, Israeli bulldozers ruptured underground pipes. Taps ran dry. Sewage gushed. Internet service was shut off. Schools closed. Food supplies dwindled. Explosions echoed.

Ahmad Sobuh could understand how his neighbors chose to flee the Far’a refugee camp during Israel's 10-day incursion. But he scavenged rainwater to drink and hunkered down in his home, swearing to himself, his family and the Israeli soldiers knocking at his door that he would stay.

The soldiers advised against that, informing Sobuh's family on Feb. 11 that, because a room had raised suspicion for containing security cameras and an object resembling a weapon, they would blow up the second floor.

The surveillance cameras, which Israeli soldiers argued could be exploited by Palestinian militants, were not unusual in the volatile neighborhood, Sobuh said, as families can observe street battles and Israeli army operations from inside.

But the second claim sent him clambering upstairs, where he found his nephew’s water pipe, shaped like a rifle.

Hours later, the explosion left his nephew's room naked to the wind and shattered most others. It was too dangerous to stay.

“They are doing everything they can to push us out,” he said of Israel's military, which, according to the UN agency for refugees, has demolished hundreds of homes across the four camps this year.

The Israeli army has described its ongoing campaign as a crucial counterterrorism effort to prevent attacks like Oct. 7, and said steps were taken to mitigate the impact on civilians.

A chilling return The first thing Doha Abu Dgheish noticed about her family's five-story home 10 days after Israeli troops forced them to leave, she said, was the smell.

Venturing inside as Israeli troops withdrew from Far'a camp, she found rotten food and toilets piled with excrement. Pet parakeets had vanished from their cages. Pages of the Quran had been defaced with graphic drawings. Israeli forces had apparently used explosives to blow every door off its hinges, even though none had been locked.

Rama, her 11-year-old daughter with Down syndrome, screamed upon finding her doll’s skirt torn and its face covered with more graphic drawings.

AP journalists visited the Abu Dgheish home on Feb. 12, hours after their return.

Nearly two dozen Palestinians interviewed across the four West Bank refugee camps this month described army units taking over civilian homes to use as a dormitories, storerooms or lookout points. The Abu Dgheish family accused Israeli soldiers of vandalizing their home, as did multiple families in Far’a.

The Israeli army blamed militants for embedding themselves in civilian infrastructure. Soldiers may be “required to operate from civilian homes for varying periods," it said, adding that the destruction of civilian property was a violation of the military's rules and does not conform to its values.

It said “any exceptional incidents that raise concerns regarding a deviation from these orders” are “thoroughly addressed,” without elaborating.

For Abu Dgheish, the mess was emblematic of the emotional whiplash of return. No one knows when they’ll have to flee again.

“It’s like they want us to feel that we’re never safe,” she said. ”That we have no control.”