Lebanon, identified as a Fragility, Conflict and Violence (FCV) state by the World Bank, is enduring one of the world's worst economic crises since the mid-19th century. 1 Also known as the Lebanese Republic, it is one of the most densely populated countries in the Mediterranean area bound northeast by Syria, and south by Israel. 1,2 In 2020, GDP shrunk by 20.3% amounting to US$33 billion loss, whereas GDP per capita decreased by 40%. 1 Additionally, inflation has averaged to 84.3%. 1 This economic crisis is projected to be worse in 2021 with an expected 9.5% contraction in GDP. 1 Coupled with a 6.7% decrease in GDP in 2019 and a loss of US$55 billion in 2018, the economic impacts are catastrophic, especially for healthcare workers (HCW). 1 Besides this, the Lebanese pound has lost 81% value since 2019, 3 marking high inflation all whilst coping with a pandemic, recovering from the Beirut Port explosion, and experiencing social unrest. 4 The Beirut Port explosion, which rendered half of the capital's healthcare centres non-functional brought new challenges to health care. 4 Not only this, poverty has increased by 27% from 2019 to 2020. 3 Fiscal mismanagement, a weak healthcare system, inflation, higher rates of poverty, social unrest, scarcity of resources, increasing workload and previous traumas have challenged HCWs trying to battle a pandemic in Lebanon, severely affecting their mental health. 3 Since 2019, 1000 of 15,000 doctors have left Lebanon to neighbouring Iraq and other countries, and alone at American University Beirut Medical Centre in Beirut, 40% emergency staff and 50% nurses have left. 5 As a result of this crisis, HCWs are experiencing a deduction in their salary that amounts to a couple thousand dollars a year. 5 A country that primarily relies on import (80% of medications in Lebanon are imported), the crisis has impacted availability of essential healthcare equipment, and has exacerbated workload for HCWs grappling with financial stress, and insecurity further fuelling their anxieties and contributing to burnout. [4][5][6] In addition, there are only 40 HCWs per 10 ,000 people in Lebanon, reported in 2018 prior to the economic crisis, which contrasts with WHO's requirement of 4.45 HCWs per 1000 people. 3 Mental health needs are poorly addressed as there are only 60 psychiatrists and 100 psychologists per 4 million people, and the country has no national mental health policy. 6 This not only complicates availability of mental health services, it creates issues for a healthcare system that is rapidly losing all its frontline workers. 3 Thus, the aim of this paper is to address the mental health crisis faced by HCWs in Lebanon, the implications of it and provide some recommendations. | DISCUSSIONMajority of the Lebanese people including frontline healthcare workers, elderly, juveniles and grownups suffer from alarming levels of anxiety and stress due to occasional periods of violence, specifically bombings in civilian areas, and political and economic instability. 7 Such pre-existing challenges h...
Meningitis is a severe infection and a major public health challenge. The meningitis outbreak which had resurfaced amid the coronavirus disease 2019 (COVID-19) pandemic in the Democratic Republic of Congo (DRC) has been further stressing the health care systems that are already overburdened with detecting, preventing, and treating the current coronavirus disease. The recent meningitis outbreak in the DRC has resulted in a high case fatality ratio of 50% - an extremely worrying concern. Robust strategies are hence needed to curb the spread of the disease amid the COVID-19 pandemic, to prevent further adverse health outcomes and to mitigate the compounding burden on the country's healthcare systems. Several measures such as vaccination campaigns, adherence to sanitation and hygiene, improved surveillance and diagnostic capabilities could help prevent future epidemics in the country.
Healthcare workers (HCWs) have faced an increased amount of mental health struggles amidst the COVID-19 pandemic. However, those in conflict-based settings with fragile healthcare systems meet additional challenges. This study reviews violence, conflict and mental health among HCWs in five countries: Syria, Palestine, Yemen, Afghanistan and Lebanon. Our study reports that HCWs are targeted by violence, bombings, mistreatment and different forms of abuse, including verbal and physical. With the additional burdens of the pandemic including prolonged working hours, limited resources and insufficient humanitarian aid, the healthcare workers fall victim to increased levels of burnout and mental illnesses. The situation leads to dire consequences on their personal lives and professional development, compelling them to quit their job or country all together. Although healthcare workers remain resilient in these conflict-based settings, immediate interventions are required to prevent violence against them and cater to their rapidly declining mental health.
Palestine, a country afflicted by protracted political instability, has suffered vast crises throughout its history. The recent turmoil between Israel and Palestine that started in May 2021 has aggravated the challenges posed by poverty, the COVID-19 pandemic, political occupation, and a deficient healthcare system. 1 As health care is already considered a stressful field, facing this upscale in events not only puts healthcare workers (HCWs) in physical stress but also affects their psychological capability and mental health. 2,3 The healthcare system in Palestine already faces shortages in infrastructure and HCWs. This additional psychological pressure will decrease the working efficiency of HCWs.Mental health services in the West Bank and East Jerusalem are based entirely upon community care and are quite limited in terms of the extent of healthcare delivery. The Ministry of Health provides the main services but there are only 13 community mental health clinics. 4 Psychiatric services provided by Ministry of Health include 280 beds in West bank and 39 beds in Gaza. 5 Mental health disorders in Palestine remain underreported and under-treated. 6 These services are unable to meet the burden of need, as there is no proper funding and policy. 7 Concurrently, services have suffered through an upsurge in the demand, lack of latest medications and an ineffective management structure. 8 In effect of the ongoing political turmoil and conflict, a majority of Palestinian people, especially HCWs, children and young adults are at great risk of developing some form of psychopathology. 9 Research suggests about a third of the Palestinians are in need of mental health services and more than 40% of them suffer from depression. 10 This is due to the ongoing events of violence specifically bombings in civilian areas which compounds the country's challenges such as poverty and social mobility; more than 72,000 people have been displaced because of hostilities in the Gaza strip. 11
Maternal well-being is the foundation for a sound and healthy population; however, 830 women die daily from preventable causes due to subpar maternal care. 1 This has not been achieved despite the United Nation's (UN) mission to decrease worldwide maternal mortality proportions by 75% by 2015 through the Millennium Development Goals. 2 Almost 99% of mortality is in low-income countries, with half of these deaths in Sub-Saharan Africa, where maternal mortality is very high. 3 Moreover, 7700 maternal deaths occur every year in Kenya, accounting for 32% of deaths in females of reproductive age. 4 This is due to limitations in accessing maternity care with challenges such as transportation and proximity of dispensaries as primary. 5 A study conducted in 2021 states that one in four pregnant women did not have access to antenatal care. Most of these women were in Chad (37%) and Nigeria (38%).The challenge for people who are able to afford antenatal health is the low quality healthcare being provided to them. 6 Concurrently, early childbearing age brings increased health concerns for moms and newborns, especially with socioeconomic disparities. Not only that, but Africa also has the highest birth rate among young people with roughly 120 births per 1000 young women. 7 To add, the obligations related to childbirth, from conception to childhood, are thought to be carried out exclusively by women. 5 Moreover, a fear of Human immunodeficiency virus diagnosis and predetermined gender roles also have a great influence.
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