Palais Briefing – February 1, 2013
Speaker: Glenn Thomas, thomasg@who.int, 0795090677
The shortage of medicines is becoming more critical, both in public sector hospitals and medical clinics and in private sector facilities.
Hospitals are in severe need of anesthesia, antibiotics, serums and other essential medicines. Local pharmacies are increasingly unable to provide basic medicines, such as pain killers, and health authorities in the Governorates are not receiving sufficient supplies from central authorities.
The ongoing crisis continues to heavily impact waste management and the availability of water and safe drinking water. These factors have a direct impact on poor hygiene conditions which increases the risk of lice, scabies, leishmaniasis, hepatitis A and other infectious diseases.
Recently, doctors from Aleppo and Der Ezzor have reported an increase in number of leishmaniasis cases.
This has been noted since early December, when 160 cases were reported from one sentinel site in Alhasaka governorate in the northern area and 82 cases in Hamah.
WHO is in regular contact with the director of communicable diseases and the leishmaniasis focal point at the Ministry of Health (MoH) regarding the reported increase in cases of leishmaniasis in Hama, Alhazaka, Aleppo and Der Ezzor.
As cutaneous Leishamnia is known to be endemic in Syria, particularly in Aleppo, population movement and the deterioration in sanitary conditions coupled with the lack of proper waste management have provided an environment conducive to an increase in the number of reported cases in areas in which there was previously a lower incidence of the disease.
The reported cases, as described, are classified by WHO experts as an “outbreak of zoonotic cutaneous leishmaniasis” caused by Leishmania major and transmitted by Phlebotomus.
Humans become infected by being bitten by sandflies that carry the disease. As it is not yet sandfly season, measures to control sandflies (such as spraying) are not effective during this period of the year. All of the current human cases were likely infected in September/October 2012 and the sores are appearing now after an incubation period of a few weeks to 3 months. Immediate action is required to ensure proper case management.
The MoH has sent the required quantities of medicine to treat leishmaniasis (Amp of Glucantim) to the relevant Governorates including Aleppo and Der Ezzor, but some of the areas which are heavily affected by the conflict cannot be reached by the Government -- delivery of medicine and access to health services for patients therefore remain a key concern.
The WHO Country Office has contacted its implementing partner in Der Ezzor which confirmed the increase in leishmaniasis cases and have offered their support to assist the MoH in delivering the required medication. NGOs are also assisting in Aleppo and Alhazaka.
WHO recently procured treatment for scabies and lice and will increase distribution to shelters for internally-displaced persons and health facilities in affected areas.
This week, WHO provided the Islamic Charity Organization in Deir Ez-Zor with medicines to treat noncommunicable diseases such as cardiovascular disease; antibiotics and anesthesia.