Date: Mon, 4 Apr 2016 05:15:50 +0200
By Maya Gebeily

Naameh, Lebanon, April 4, 2016 (AFP) - Imagine living near a trash dump so putrid that you would rather move to war-torn Syria.   That's what Fayyad Ayyash, his wife Riham and their four young daughters plan to do next week, leaving behind their home in Lebanon for neighbouring Syria.

Their modest two-storey house in the town of Naameh, about 20 kilometres (12 miles) south of the Lebanese capital, directly overlooks the infamous and odorous landfill by the same name.    "We're going next week. In Syria, there's a possibility I might die. Here, we'll definitely die," Fayyad tells AFP.    From his grassy backyard, dozens of large trucks carrying tonnes of waste can be seen -- and smelled -- lining up to add their load to the "trash mountain."

The July 2015 closure of the notorious landfill lies at the heart of Lebanon's trash crisis, which has seen rivers of trash spread across the Mediterranean country, triggering protests nationwide.   Then last month, the government made a controversial decision to reopen it -- and this was the last straw for residents like Fayyad.   Pulling out a bright blue inhaler, he says his family has been suffering from respiratory problems for months because of the dump.

His daughters, whose ages range from just under two to 10 years, all have trouble eating and sleeping.   "It's always worse at night than during the day. The whole area is swarming with the same smell and the same sickness," he says.   Fayyad says it's become so bad, he's decided to flee across the border to the town of Libeen in southern Syria, a country where a conflict has been raging since 2011.

- Costly medical bills -
The Naameh landfill opened in 1997 and was meant to be a temporary dump, but an alternative site was never opened.    For 20 years, the waste generated in Beirut and Mount Lebanon -- the country's most populous areas -- was dumped in Naameh.   The verdant valley swelled into a trash mountain of more than 15 million tonnes.    Furious residents forced the closure of the site in July 2015, saying it was leading to high cancer rates, skin diseases and breathing problems.

Uncollected rubbish began piling up around Beirut and its suburbs, emitting a horrible stench that sparked protests in downtown Beirut demanding a long-term solution.   After months of political wrangling, Lebanon's cabinet announced a four-year plan to end the waste crisis -- and its first step was reopening Naameh for two months.    "When the dump reopened, my baby immediately started throwing up again," Fayyad says.

Fayyad and his Syrian wife, Riham, are both Druze, an offshoot of Islam.   Riham estimates that she spends about $1,000 (around 880 euros) per month on doctor's visits, inhalers, and other medication for her children.    Pointing to her bare finger, she says she had to sell her wedding ring to cover the costs.    "I wish my kids would eat food as much as they take medicine," she says.    Riham's family hails from Libeen, in Syria's southern Sweida province. That's where she will travel to next week, in the hope that the open plains there will be good for her children.

- Suitcase 'packed and ready' -
Sweida, the heartland of Syria's Druze minority, has come under attack by jihadists of the Islamic State group but has seen less fighting than other parts of the country.   "No, it isn't safe, but I'm forced to leave... I have a suitcase packed and ready on top of the closet," Riham says.    Farouk Merhebi from the American University of Beirut says the smell has probably made life incredibly uncomfortable for hundreds living within a one-kilometre radius of the dump.

Before the crisis began, trash trucks would dump between 2,800 to 3,000 tonnes of waste per day in Naameh, says Merhebi, who is AUB's director of environmental health, safety and risk management.    "Now it's about 8,000 to 9,000 tonnes. The operations almost tripled because they're playing catch-up with the trash that had accumulated," he says.   "The waste that has accumulated in streets has fermented, so the smell is offensive...

The smell is worse because it's been there for seven to eight months."   But the long-term health effects of the dump on the surrounding area remain untested.   Merhebi is part of a team at AUB hoping for funding to complete research in the area "to test the surface water, ground water, and some samples of the soil as well as samples of ambient air."    But Fayyad and his family say they cannot wait.    "Riham's family said they were thinking of coming to Lebanon," he says.    "But we told them, 'do you want to die here from the smell?'"
Date: Wed, 10 Feb 2016 18:51:23 +0100

Beirut, Feb 10, 2016 (AFP) - Swine flu has killed four people in Lebanon since the beginning of the winter season in November, health officials said on Wednesday.   Walid Ammar, the general director of Lebanon's health ministry, told AFP there were "four confirmed H1N1 deaths this winter season."    "The cases that needed emergency care this winter season is up 20 percent compared to last winter," partly due to a more efficient referral system between the hospitals and the health ministry, he said.

Health Minister Wael Abu Faour said the four fatal cases were a child aged three, a 31-year-old woman, a 36-year-old pregnant woman, and a 58-year-old man.    He also said reported cases had increased by 20 percent but that the number of deaths was comparable with the previous winter season, in which five people died of H1N1.    "The solution would be to decrease kissing, unless extremely necessary," Abu Faour said jokingly to journalists.

His comments sparked a new hashtag on Twitter -- #KissForFaour -- that saw Lebanese users post pictures themselves kissing their partners, children, or even pets.    A regional outbreak of swine flu in 2009 sparked warnings from governments and the World Health Organisation.    By August 2010, when the WHO lifted its warning, the virus had killed 18,500 people in 214 countries.
Date: Tue, 8 Sep 2015 15:50:56 +0200 (METDST)

Beirut, Sept 8, 2015 (AFP) - A dense sandstorm engulfing parts of the Middle East left at least two people dead in Lebanon and hundreds suffering from respiratory problems on Tuesday, as officials warned residents to stay indoors.   Large parts of Lebanon, Syria, Israel and Cyprus were shrouded in a thick cloud of dust from the storm that began sweeping into the region on Monday.   In Syria, the storm cut visibility for government warplanes and helicopters, which carried out many fewer strikes than usual, a monitor said.

Among those worst affected were Syrian refugees living in official and informal camps, particularly in Lebanon.   The Lebanese health ministry said two women had died at hospitals in the Bekaa Valley region because of the storm, without specifying their nationality.   "The number of cases of choking and shortness of breath caused by the sandstorm has risen to 750," the ministry said.

Police distributed face masks on city streets as authorities warned people suffering from health problems, the elderly and pregnant women to stay indoors.   The storm was felt particularly in Lebanon's dozens of informal camps where hundreds of thousands of Syrian refugees live with limited shelter.   In the Bekaa region, a woman wrapped her headscarf over her mouth as she walked by a makeshift tent in one camp.   Lebanon's weather service said the storm was expected to abate from Wednesday night.

Mouin Hamzeh, secretary general of Lebanon's governmental National Council for Scientific Research, said satellite images "clearly show that the sandstorm came from northern Iraq in the direction of central and northern Lebanon, north and east Syria, and southern Turkey."   "It usually happens twice or even three times a year in Lebanon but during spring, March and April, and the unusual thing today is the density of the storm," he told AFP.

In neighbouring Syria, the storm also swept across much of the country, reducing visibility everywhere from coastal Latakia province to eastern Deir Ezzor.

- Storm impedes Syria strikes -
In the city of Mayadeen in Deir Ezzor, several hospitals were no longer receiving patients suffering respiratory problems after running out of oxygen tanks, said the Syrian Observatory for Human Rights, a monitoring group.   Syria's health minister urged citizens to "avoid prolonged exposure to the outdoors" and said hundreds of people had been treated for cases of asthma and other respiratory problems.

The dust cut visibility for government aircraft, which carried out relatively few strikes during the storm, the Syrian Observatory for Human Rights monitor said.   "The sandstorm has paralysed regime airplanes, there were only a few strikes in Damascus province," said Observatory chief Rami Abdel Rahman.   Thick haze was hanging over Jerusalem and much of Israel and the Palestinian Territories, with officials also warning the vulnerable to stay indoors.

The view from the Mount of Olives -- which normally offers a sweeping panorama of Jerusalem's Old City and the Al-Aqsa mosque compound with its golden Dome of the Rock -- was completely obscured by the dust.   The thick cloud also enveloped parts of the eastern Mediterranean island of Cyprus, where residents were told to limit their time outdoors.   Health officials warned that the concentration of dust particles in the air was many times above normal levels.   Several flights were diverted from the coastal airport of Larnaca as visibility dropped to 500 metres (yards). 

The island was also suffering from a heatwave, with inland temperatures hitting 41 degrees Celsius (106 degrees Fahrenheit).   The interior ministry said that dozens of Syrian refugees who had been rescued from a fishing boat off the coast of Cyprus on Sunday had been moved from a makeshift camp to a better-equipped facility because of the extreme weather.   The effects of the storm had also reached Cairo, where the city skyline was obscured by a thick haze.   Wahid Saudi, a top official at Egypt's weather authority, said the dust had blown in from the eastern Mediterranean region and was expected to clear after several hours.
Date: Wed 22 Apr 2015
Source: Daily Star [edited]
<http://www.dailystar.com.lb/News/Lebanon-News/2015/Apr-22/295288-cases-of-contagious-hepatitis-a-reach-epidemic-levels-in-lebanon.ashx>

Health officials say that Lebanon has seen a sharp rise in the number of hepatitis A cases over the past 2 years. The contagious viral infection is spread through oral ingestion of contaminated water and food. "We are living now in a current epidemic of hepatitis A. It has been going on for more than 2 years," infectious disease specialist Abdul-Rahman Bizri said. Bizri is part of a team of infectious disease advisers helping the Health Ministry trace and monitor the epidemic.

Those who have monitored the spread of hepatitis A in Lebanon point to a range of factors that facilitated its spread and severity: namely, Lebanon's weak public health infrastructure in the face of a rapid influx of Syrian refugees, a substandard water management system, and a shift in the age of hepatitis A onset among the Lebanese population.

In 2014, there were 2500 recorded cases of hepatitis A, up from 1000 cases in the year prior, Bizri said. "Our regular average used to be around 300 cases per year. Now we are witnessing 5 times the average."

Randa Hamadeh, the Immunization and Essential Drugs Program manager for the Lebanese Health Ministry, described the prevalence of hepatitis A as a "huge problem". Hamadeh pointed to culprits similar to those mentioned by Bizri, namely an overburdened health care system, contaminated water and unhygienic living conditions. "We are trying to work with NGOs and municipalities to enhance hygiene and prevent disease," she said.

The outbreak of war in Iraq, and more recently Syria, has lead to a crisis of mass displacement and the breakdown of regional-level disease prevention measures, Bizri said. "The untold effect of this crisis is not only direct casualties from war, but also the spread of disease, due to the fact that many public health systems in the region have failed."

Nadim Farajalla, faculty research director of the Climate Change and Environment in the Arab World Program at the American University of Beirut, said that both groundwater and surface water in Lebanon are at risk of carrying hepatitis A due to sewage that largely goes untreated "in most areas of Lebanon."

"It is estimated that 80 per cent of the surface water in Lebanon is contaminated with sewage effluent," Farajalla said. In residential buildings across the country, "some people build a well to augment water supply, but it might be contaminated," Farajalla said. Consequently, household water reserves could become a point of cross-contamination, where well water is mixed with the government water supply.

Speaking on water safety deficiencies, Bizri said the recent drought between 2013 and 2014 exacerbated the risk of disease outbreak. "Drought means less water, less water means less hygiene, less hygiene means more disease."

Bizri said the ministry recommends hepatitis A vaccination as part of its official schedule, but implementation is not universal. Private health care providers dominate the health system in Lebanon, and offer the vaccine at a cost. Public health facilities are at a relative disadvantage in their ability to offer the vaccine. "If you go to a private physician you will get the vaccine," Bizri said.

Hamadeh, of the Health Ministry's Immunization and Essential Drugs Program, said the ministry was prioritizing hygiene awareness campaigns over vaccinations in the fight against hepatitis A. But financial limitations prevent the ministry from providing the vaccine to all in Lebanon, she said. "We don't have the capacity, knowing that vaccine was very expensive and no one was able to secure the necessarily funds," Hamadeh said.

Hamadeh said that the Health Ministry has focused on community-based preventive hygiene measures in communities to prevent hepatitis A, specifically in "securing clean water, and [hygiene] at the level of schools." She mentioned that Arsal, an area heavily populated with Syrian refugees in the eastern Bekaa Valley, had previously seen a hepatitis A outbreak, which has since been contained.  [byline: Sarah Weatherbee]
======================
[The following is extracted from
<http://www.cdc.gov/hepatitis/A/aFAQ.htm#overview>:

"Hepatitis A is usually spread when the hepatitis A virus is taken in by mouth from contact with objects, food, or drinks contaminated by the faeces (or stool) of an infected person. A person can get hepatitis A through:

person-to-person contact
- when an infected person does not wash his or her hands properly after going to the bathroom and touches other objects or food
- when a parent or caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person
- when someone has sex or sexual contact with an infected person (not limited to anal-oral contact)

Contaminated food or water
- Hepatitis A can be spread by eating or drinking food or water contaminated with the virus. (This can include frozen or undercooked food.) This is more likely to occur in countries where hepatitis A is common and in areas where there are poor sanitary conditions or poor personal hygiene. The food and drinks most likely to be contaminated are fruits, vegetables, shellfish, ice, and water. In the USA, chlorination of water kills hepatitis A virus that enters the water supply.

Who is at risk for hepatitis A?
Although anyone can get hepatitis A, in the USA, certain groups of people are at higher risk, such as those who:
- travel to or live in countries where hepatitis A is common
- are men who have sexual contact with other men
- use illegal drugs, whether injected or not
- have clotting-factor disorders, such as hemophilia
- live with someone who has hepatitis A
- Have oral-anal sexual contact with someone who has hepatitis A."

A HealthMap/ProMED-mail map can be accessed at
<http://healthmap.org/promed/p/85>. - ProMED Mod.LL]
Date: Tue, 9 Dec 2014 08:07:32 +0100 (MET)

BEIRUT, Dec 09, 2014 (AFP) - Syrian warplanes carried out air strikes in a border region of eastern Lebanon overnight, killing three people and injuring two others, Lebanon's official news agency said Tuesday.   The National News Agency said the strikes hit the outskirts of the border town of Arsal, which has regularly been targeted by Syrian government air raids and shelling.   Local residents said a house was among the targets of the raids.   The town of Arsal and the area around it are largely Sunni Muslim, and residents sympathise with the Sunni-led uprising against Syrian President Bashar al-Assad.

The nearby border is long and porous, and has proved an easy crossing point for smugglers, refugees and fighters.   Tens of thousands of Syrian refugees are being hosted in the town, and opposition fighters have bases in the mountainous border area outside Arsal.   The town was overrun briefly in August by jihadists coming from Syria, who withdrew after several days of fighting.   They took with them some 30 Lebanese police and soldiers as hostages, and have since executed four of them.
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