Beyond Bullets and Explosions: the Silent Health Crisis in the MENA-Region
Following the Arab Spring, wars in Iraq, Syria and Afghanistan, conflicts between ethnic groups and the ever-lasting feud between Israel and Palastina, it is projected that the number of deaths due to direct war violence was somewhat less than 90.000 casualties in 2016 and growing every year. This is therefore one of the most violent regions in the world due to conflict. Behind the direct casualties however, lies a not-often discussed humanitarian health crisis…
It is generally known that war and conflict can have far-reaching implications for the infrastructure and accessibility of a country or region. It affects the accessibility to clean drinkwater, hospitals and vaccinations and the availability of shelter and sanitation in these regions. All these implications have a malign influence on the development of infectious diseases. Epidemics of cholera, malaria, measles and dysentery are all ongoing in this region and are all an unfortunate logical consequence of war and conflict inflicted limitations.
It is understandable that you might think: ‘But these diseases are preventable?’ or ‘vaccinations and medications should be available, right?’. That is unfortunately not the case. The effective prevention of most infectious diseases lies in a fast reaction and adequate approachability of the area by professional caregivers. Sadly, it is more and more commonly seen that in conflict areas such as the discussed region, hospitals and the supportive infrastructure are disabled. This disablement and violence causes the in-accessibility of these regions and vaccinations/medications alike.
The rise of these preventable infectious diseases cause great concern regarding the overall burden of disease in the MENA-region.
Last year, it was reported by a french charity organisation that at a certain point in time in Yemen, 70 people were coming in per day to seek care due to shrapnel, landmine and bullet wounds. It also discussed that poor sanitation and hygiene in the (field) hospitals cause the rise of infections among harmed civilians with large wounds. This in it’s turn can then induce infectious outbreaks in a region. Cholera outbreaks are mainly caused by this mechanism in the MENA-region.
The WHO states that sexual abuse in conflict areas is one of the biggest spreaders of HIV and STD’s in the world. They report that the number of women that have been sexually abused is approximately 10% of the complete women population in the MENA-region . These were most of all women or young boys, either alone or in large groups, that have been raped by invading parties. As these horrific actions speak best for itself, these collateral casualties and raped women pose a threat to the spread of communicable diseases.
The link between injuries and communicable diseases is worrying. The earlier discussed infectious burden together with the joined burden of communicable diseases and injuries give rise to a complicated and rapid emerging disease pattern. As treatments are present for these disease patterns, it is important that we act as a united world against the humanitarian crisis that resides behind the curtains of war and conflict in the North-African & Middle-Eastern region.
