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Source: World Health Organization (WHO)
26 September 2007

Lebanon Crisis: Health Cluster Bulletin No. 31,
26 Sept 2007

The Lebanon Crisis Health Cluster Bulletin aims to give an overview of the health activities conducted by the health cluster partners in relation to the latest Lebanon conflict as well as the crisis in the Palestinian camps. It compiles health information received from the different organizations working in the most affected areas.
The Health Cluster Bulletin will be issued every other Wednesday.


No major outbreak was reported through the Early Warning and Response System (EWARS) in the South and Bekaa. However, an outbreak of an acute self-limited febrile illness was reported in North Lebanon.

The situation in Lebanon remains uncertain and tense leading among others to cancellation and reporting of some events.

Additional Landmines/UXOs/cluster bombs’ casualties are reported by the Lebanese Mine Action Center (LMAC) report.

Nahr El-Bared Crisis

The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) is leading the Humanitarian and Relief interventions in response to the Nahr El-Bared Crisis.

Temporary shelters and schools are being established in and around Beddawi Camp.

Situation Overview

· EWARS reports for the last two weeks, registered seven cases of Hepatitis A that were confirmed clinically and serologically (One case in Shibaa-Hasbaya, one case in Kafaroman-Nabatiyeh, one case in Tyr, one case in Hasbaya and 3 cases in Ayta Shaeb-Bent Jbeil). Water testing is carried on. In addition, one case of Hepatitis B was reported from Ter Diba-Tyr and one case of Tuberculosis in Douer-Nabatiyeh. Further, two cases of Brucellosis were registered in Nabatiyeh district; one in Habouch (still under investigation) and another in Adshit clinically and serologically confirmed.

· According to the Ministry of public Health, an outbreak of an acute, self–limited illness characterized by headache, myalgia and polyartharlagia with/without leucopenia in Akkar and Menieh-Dinnieh districts North Lebanon from July 1 with sporadic cases still occurring. Upon the request of the Ministry, WHO experts were mobilized to further assess the situation. Samples sent for testing at the US Naval Medical Research Unit-3 were negative to Leptospirosis, Q fever, rickettsial disease and dengue fever. Additional samples sent to the Centres Nationaux de Référence des Arbovirus et des fièvres Hémoragiques Virales in Lyon-France are still being examined.

· The situation in Lebanon remains uncertain and tense.

· An explosion killing five persons among them a deputy and injuring 92 persons according to official sources took place in East Beirut on September 19.

· According to the Lebanese Mine Action Center (LMAC), the total number of military and civilian casualty figures due to landmines/UXOs/cluster bombs as of September 26 is 268. Cluster bombs are responsible for around 85% of the casualties. Children 18 years and below constitute approximately 34% of the injuries and 22% of the deaths.

Nahr El-Bared Crisis

· The Lebanese army is allowing humanitarian relief agencies to enter the “new camp” after issuing security clearance to requesting organizations and institutions.

Health Response to the Humanitarian Crisis

National and international Health Cluster partners are providing support in four core areas:

1. Assessment and monitoring

· INTERSOS supported by UNHCR and in collaboration with the Danish Refugee Council assessed health, environmental health and social problems and gaps in 173 villages in the districts of Tyr, Bent Jbeil, Marjeyoun, and Nabatiyeh. To respond to the population needs in terms of medical care and treatment, INTERSOS, in partnership with Al-Kayan, will run a mobile clinic in three districts Tyr, Marjeyoun, and Nabatiyeh providing elderly and needy families with health services. Furthermore, INTERSOS contracted Al Rissaleh Scout to provide ambulatory door-to-door services, thus addressing the problem of accessibility to health services.

· United Nations Resident Coordinator (U NRC) “one-year after follow up” report related to Nabatiyeh district was completed. Currently Marjeyoun district is targeted. Further details can be retrieved from the UN website:

· WHO Public Health focal point visited 12 health centers in Bent Jbeil district aiming to improve surveillance data reporting.

Nahr El-Bared Crisis

· According to UNRWA report, dated on September 18, UNRWA team conducted, escorted by the Lebanese Army, an exploratory visit to Naher El-Bared camp on September 12. Results underlines the following:
· According to UNRWA, reports from Beddawi and Mina clinics as well as the mobile clinic showed no changes in the incidence of communicable diseases.

2. Health coordination

· The Health Cluster meeting took place on September 18 and was attended by four partners. The next meeting is scheduled for October 16 at 15:00 p.m. at WHO office within the Ministry of Public Health premises-Tyr.

· The Mental Health and Psychosocial Support sub-cluster coordination meeting took place on September 24 and was attended by five partners. The next meeting is planned for October 29 at 12:00 p.m. at WHO office within the Ministry of Public health premises-Tyr.

· The next WATSAN will be held on October 11 at 12:00 p.m. at the Water Authority Establishment-Saida. The meetings are taking place on monthly basis.

· The General Coordination Meeting took place on September 21 at the UN house-Tyr and was attended by all UN agencies and 25-30 Non Governmental Organizations. The next meting will take place on October 5 at 11:30.

· The Health Cluster and Mental Health Matrices are regularly updated and shared with partners.

Nahr El-Bared Crisis

· The Fourteenth Health Cluster meeting chaired by UNRWA took place on September 18 at UNRWA Lebanon Field Office in Beirut. Seven partners attended the meeting and were briefed on the results of the exploratory mission carried on by UNRWA team to Nahr El-Bared Camp on September 12. September 25 meeting was cancelled because of security issues. The next meeting is planned for October 2 at the same time and venue.

3. Filling health gaps

Nahr El-Bared Crisis

· UNRWA started the establishment of two prefabricated schools at the borders of Beddawi camp. The two schools will host within the two shifts approximately 4.000 complementary and secondary students. The construction work is expected to end within one month from September 19.

· UNRWA and PRCS started the disinfection activities in Naher El-Bared camp.

4. Preserving and supporting local health systems

· WHO in its efforts to integrate Baby Friendly Hospitals Initiative (BFHI) within the health care system in Lebanon agreed with the Order of nurses to undertake certain capacity development activities. The project includes training of 35 BFH national assessors, for assessing and promoting BFH, training 25 master trainers on “Infant Young Child Feeding (IYCF) counselling” to be called upon for in house training in hospitals and developing educational audiovisual materials.

· International Organization for Migration (IOM) in collaboration with the Lebanese University and in partnership with UNICEF, Belgian Development Cooperation and the Higher Council for Childhood launched on September 22 the 8-months Master Degree on “Psychosocial Animation in War Torn Societies". Thirty participants from the civil society institutions and organizations in addition to UN agencies, International Non Governmental Organizations as well as the Lebanese University are enrolled to the Master whose courses are taking place at Lebanese University-Hadath Campus.

· WHO in coordination with the Ministry of Public Health, the Ministry of Agriculture, FAO and the municipalities will launch on October 18 a series of awareness sessions on “Prevention of Brucellosis”. The sessions targeting the public as well as orders of Agriculture and doctors will cover Tyr, Nabatiyeh, Marjeyoun, Tebnine, Bent Jbeil and Mais Al-Jabal.

· International Medical corps (IMC) in partnership with UNICEF launched the second phase of the five days-First Aid Emergency trainings. Twenty-nine teachers and head counselors from four governmental schools in Tyr district and 20 teachers from nine governmental schools in Bent Jbeil and Marjeyoun in addition to 25 teachers and health counselors from five governmental schools in Akkar district were trained. Moreover, a computer training targeting the health counselors of Tyr district’s schools was conducted in the Ministry of Social Affairs center in Tyr.

· UNFPA organized a technical meeting on August 27 addressing Non Governmental Organizations, representatives from the Ministry of Social Affairs and UNIFIL working in the context of UN SC Resolutions 1325 - Women, peace and Security - and 1308 - Damaging impact of HIV/AIDS on the health of international peacekeeping personnel. UNFPA Regional Advisor on socio-cultural and gender issues and a gender expert among peacekeeping forces sensitized the 20 participants on the UNSCR 1325 and discussed the progress and barriers in implementing UNSCR particularly concerning gender mainstreaming in HIV/AIDS programs.

· WHO, the Ministry of Public Health, the Syndicate of hospitals and the Lebanese society of Emergency medicine are organizing a one-day workshop on “Hospital Emergency Preparedness planning”. So far, five out of the 13 planned workshops were implemented and reached 157 participants from 35 hospitals. The September 20 cancelled workshop due to the security situation will probably be rescheduled for October 4, 2007.

· WHO process to support Community Based activities lead to the selection of 10 proposals out of the 14 received from Non Governmental Organizations. An expert committee composed of WHO acting representative, WHO national professional officer, the director of the prevention unit at the Ministry of Public Health and the science research focal point at the National Center for Scientific Research reviewed the above-mentioned proposals based on eligibility and selection criteria.

World Health Organization http:/www. leb. emro.

All inputs are welcome on: health@leb. emro.
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