Yesterday, the World Health Organization (WHO) said that 22 people are suspected of having polio, most of them under age two and living in eastern Deir al-Zor province. Earlier this month, the organization detected the country’s first polio case in more than 14 years. WHO spokesman Oliver Rosenbauer said Thursday that more than 100,000 children are at risk for the disease in Deir al-Zor.
Fouad M. Fouad is a Syrian public health doctor and a visiting assistant professor in the Faculty of Health Sciences at the American University of Beirut. He talked about the factors that could make Syria ripe for a disease outbreak.
Syria Deeply: Is Syria poised for an outbreak?
Fouad M. Fouad: It’s so sexy for the media to speak now on infectious disease, especially something with a strange name like polio or leishmaniasis. They prefer to talk about that because it scares people more than talking about the Syrians who are dying of heart disease or renal failure or respiratory diseases. It’s more attractive for the media to talk about polio.
As a Syrian, and as a public health worker in Syria for a long time, it’s a huge concern, because it’s wasting all the improvements we made in Syria over all those years.
Beyond that, we need to prevent the spread of that one case of polio to neighboring countries. If we have one case in Syria and we have a mobilization of refugees crossing borders without inspection and coming into contact with people in Syrian communities or neighboring countries, there’s a possibility that the disease could spread. So it is really a concern, and sometimes it can be a cause or a pretext to start thinking collectively that it would be not just a Syrian problem, but a regional burden.
SD: Whose responsibility is it to provide the vaccines? What is stopping them from being administered now?
FMF: It’s the responsibility of both the World Health Organization and the Syrian Ministry of Health to provide the vaccines. As far as I know the vaccine is available. It’s a simple vaccine to administer, it’s just drops in the mouth. The issue is that there’s no way for children to get access to medical centers for vaccination. We need to convince both fighting sides to allow safe corridors to let children and others through to areas where they can take care of these medical needs.
Syria has been clean from polio for 14 years, so now, if we have a case, it will sound an alarm that highlights the fact that we have bad infrastructure and have had a collapse of the entire vaccination system. Even before this polio case emerged, there were reports of measles cases in northern Syria: in Aleppo, and in the area between Aleppo and the Turkish border. Some unconfirmed reports said there were as many as 7,000 cases. Measles is now in Aleppo and even among refugees here in Lebanon.
SD: Has Syria’s medical and infrastructure collapse created a breeding ground for infectious disease? What is the solution?
FMF: Infectious diseases, and vaccination-related or waterborne diseases or diseases caused by the environment like respiratory illness, are facing a medical system that has collapsed in Syria, and difficulties facing refugees when it comes to accessing services. All factors tell us that because of this, there will be an infectious disease outbreak, whether it be measles or polio or Hepatitis A or B.
We’re talking about diseases normally protected by vaccination campaigns. Every country should have campaigns against diseases that happen in childhood, like measles, Hep A, polio and mumps. When the Syrian health system collapsed, implementing these campaigns becomes difficult in conflict areas, whether because of direct fighting or an inability to access these areas, or a lack of medical staff. When you don’t have widespread use of the polio vaccine, we call it “wild polio virus,” and it can be spread through water, soil or through contact between people.
The only way to protect people is to keep doing vaccination campaigns. It’s not just about better water or stopping contamination. But when there’s no protection process like sterilized water or having access to clean food, or if there is decreased immunity due to malnutrition, that can lead to exposure to some diseases.