Lebanon’s Economic Crises Affect Fertility Rates

 A pharmacy employee holds a box of medication in Beirut, Lebanon, May 28, 2021. (Reuters)
A pharmacy employee holds a box of medication in Beirut, Lebanon, May 28, 2021. (Reuters)
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Lebanon’s Economic Crises Affect Fertility Rates

 A pharmacy employee holds a box of medication in Beirut, Lebanon, May 28, 2021. (Reuters)
A pharmacy employee holds a box of medication in Beirut, Lebanon, May 28, 2021. (Reuters)

Lebanese mother, Hiyam, in her twenties, preferred to undergo an abortion rather than having a second child in a country torn apart by crises, as she told Asharq Al-Awsat.

Despite what she described as a “rational” decision, she expressed her “deep sadness and fear of violating the Sharia.”

But she continued with a series of questions: “How will we secure milk, diapers, and medicines? How will we be able to afford the expenses of two children? And before all that, in which hospital will I deliver the baby and at what cost?”

While no official statistics indicate the number of abortions currently taking place in Lebanon, as such operations are usually kept secret, Hiyam said that the decision was not easy, and she always hoped that her little daughter would have a brother or sister.

“But a crime that's greater than abortion is to bring a helpless child into a country where we do not know from where the strikes will come,” she added.

Stressing that her doctor advised her not to resort to this option, Hiyam said: “We know more about our financial capabilities, and we can hardly secure milk and diapers for my young daughter... We refuse to be unfair with our two children!”

Lebanon has been rocked by a severe economic collapse since 2019, the worst in decades. Its repercussions did not exclude any aspect of the life of the Lebanese citizens, affecting vital needs of food, water, fuel, medicine and hospitalization.

As a result of this collapse, many Lebanese are reluctant to take the step of having children, fearing that this would increase their daily suffering amid the high prices of the needs of newborns on one hand and the severe shortage of medications and vaccines on the other.

The price of a box of infant formula increased from LBP 12,000 to LBP 100,000, while the price of diapers, according to quality, now ranges from LBP 150,000 to LBP 250,000. With the lifting of government subsidies, the prices of medicine and vaccinations for children, if found, have also soared.

Sabine, 36, who has been married for four years, told Asharq Al-Awsat that her dream of motherhood “may have evaporated with all the crises we are witnessing in Lebanon.”

She said that she got married in 2018, and she and her husband chose to postpone the step of having children for two years to be able to pay off the debts of the wedding ceremony and home furniture and also enjoy life before bearing a great responsibility.

Sabine and her husband are looking for a job in an Arab country or for emigration to a European country “to start a better life and a suitable environment for raising children.”

In remarks to Asharq Al-Awsat, Researcher at Information International Mohammad Shamseddine said that 92,957 childbirths were registered in Lebanon in 2018, compared to 86,584 in 2019. The number continued to decline in 2020 and reached 74,049.

Although the numbers for 2021 are not final yet, Shamseddine expects an additional decrease in the number of births in Lebanon, which he said will not exceed 60,000.

Several reasons led to this decline, he explained, including the outbreak of the Covid-19 pandemic and the severe economic crisis.



3 days, 640,000 Children, 1.3M Doses...the Plan to Vaccinate Gaza's Young against Polio

FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip, walk through a dark streak of sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, on July 4, 2024. Health authorities and aid agencies are racing to avert an outbreak of polio in the Gaza Strip after the virus was detected in the territory's wastewater and three cases with a suspected polio symptom have been reported. (AP Photo/Jehad Alshrafi, File)
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3 days, 640,000 Children, 1.3M Doses...the Plan to Vaccinate Gaza's Young against Polio

FILE - Palestinians displaced by the Israeli air and ground offensive on the Gaza Strip, walk through a dark streak of sewage flowing into the streets of the southern town of Khan Younis, Gaza Strip, on July 4, 2024. Health authorities and aid agencies are racing to avert an outbreak of polio in the Gaza Strip after the virus was detected in the territory's wastewater and three cases with a suspected polio symptom have been reported. (AP Photo/Jehad Alshrafi, File)

The UN health agency and partners are launching a campaign starting Sunday to vaccinate 640,000 Palestinian children in Gaza against polio, an ambitious effort amid a devastating war that has destroyed the territory's healthcare system.

The campaign comes after the first polio case was reported in Gaza in 25 years — a 10-month-old boy, now paralyzed in the leg. The World Health Organization says the presence of a paralysis case indicates there could be hundreds more who have been infected but aren’t showing symptoms.

Most people who have polio do not experience symptoms, and those who do usually recover in a week or so. But there is no cure, and when polio causes paralysis it is usually permanent. If the paralysis affects breathing muscles, the disease can be fatal.

The vaccination effort will not be easy: Gaza’s roads are largely destroyed, its hospitals badly damaged and its population spread into isolated pockets.

WHO said Thursday that it has reached an agreement with Israel for limited pauses in the fighting to allow for the vaccination campaign to take place. Even so, such a large-scale campaign will pose major difficulties in a territory blanketed in rubble, where 90% of Palestinians are displaced.

How long will it take? The three-day vaccination campaign in central Gaza will begin Sunday, during a “humanitarian pause” lasting from 6 a.m. until 3 p.m., and another day can be added if needed, said Dr. Rik Peeperkorn, WHO’s representative in the Palestinian territories.

In coordination with Israeli authorities, the effort will then move to southern Gaza and northern Gaza during similar pauses, he said during a news conference by video from Deir al-Balah in central Gaza, according to The AP.

Who will receive the vaccine? The vaccination campaign targets 640,000 children under 10, according to WHO. Each child will receive two drops of oral polio vaccine in two rounds, the second to be administered four weeks after the first.

Where are the vaccination sites? The vaccination sites span Gaza, both inside and outside Israeli evacuation zones, from Rafah in the south to the northern reaches of the territory.

The Ramallah-based Health Ministry said Friday that there would be over 400 “fixed” vaccination sites — the most in Khan Younis, where the population density is the highest and there are 239,300 children under 10. Fixed sites include healthcare centers, hospitals, clinics and field hospitals.

Elsewhere in the territory, there will also be around 230 “outreach” sites — community gathering points that are not traditional medical centers — where vaccines will be distributed.

Where are the vaccines now? Around 1.3 million doses of the vaccine traveled through the Kerem Shalom checkpoint and are currently being held in “cold-chain storage” in a warehouse in Deir al-Balah. That means the warehouse is able to maintain the correct temperature so the vaccines do not lose their potency.

Another shipment of 400,000 doses is set to be delivered to Gaza soon.

The vaccines will be trucked to distribution sites by a team of over 2,000 medical volunteers, said Ammar Ammar, a spokesperson for UNICEF.

What challenges lie ahead? Mounting any sort of campaign that requires traversing the Gaza strip and interacting with its medical system is bound to pose difficulties.

The UN estimates that approximately 65% of the total road network in Gaza has been damaged. Nineteen of the strip's 36 hospitals are out of service.

The north of the territory is cut off from the south, and travel between the two areas has been challenging throughout the war because of Israeli military operations. Aid groups have had to suspend trips due to security concerns, after convoys were targeted by the Israeli military.

Peeperkorn said Friday that WHO cannot do house-to-house vaccinations in Gaza, as they have in other polio campaigns. When asked about the viability of the effort, Peeperkorn said WHO thinks “it is feasible if all the pieces of the puzzle are in place. ”

How many doses do children need and what happens if they miss a dose? The World Health Organization says children typically need about three to four doses of oral polio vaccine — two drops per dose — to be protected against polio. If they don’t receive all of the doses, they are vulnerable to infection.

Doctors have previously found that children who are malnourished or who have other illnesses might need more than 10 doses of the oral polio vaccine to be fully protected.

Are there side effects? Yes, but they are very rare.

Billions of doses of the oral vaccine have been given to children worldwide and it is safe and effective. But in about 1 in 2.7 million doses, the live virus in the vaccine can paralyze the child who receives the drops.

How did this outbreak in Gaza start? The polio virus that triggered this latest outbreak is a mutated virus from an oral polio vaccine. The oral polio vaccine contains weakened live virus and in very rare cases, that virus is shed by those who are vaccinated and can evolve into a new form capable of starting new epidemics.