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Lebanon
Index
Before 1975 Lebanon boasted advanced health services and
medical institutions that made Beirut a health care center for the
entire Middle East region. The war, however, caused enormous
problems. Emergency medicine and the treatment of traumatic injury
overwhelmed the health care sector during the 1975 Civil War.
Indeed, the problems in health care continued into the 1980s. A
World Health Organization (WHO) study conducted in 1983 found that
the private sector dominated health care services and that public
sector health organizations were in chaos
(see table 4,
Hospitals, Beds, and Dispensaries by Province, 1982, Appendix A).
The weakened Ministry of Public Health maintained little
coordination with other public sector health agencies, and over
two-thirds of the ministry's budget (US$58.5 million in 1982)
flowed to the private sector through inadequately monitored
reimbursements for private hospital services. As of 1983 there were
about 3.2 hospital beds (0.23 of them public) for every 1,000
persons, but control over the quality of hospital and medical
services was minimal, and many public and private hospital beds
were unoccupied. There was about one doctor for every 1,250
inhabitants, but nurses and middle-level technical personnel were
scarce. Furthermore, health personnel were concentrated in Beirut,
with minimum care available in many outlying areas. The Ministry of
Public Health as well as other government and private agencies
operated small clinics and dispensaries, but few such centers
existed in Beirut. Nowhere in Lebanon was there a health center
which delivered a full range of primary health care services.
Although epidemiology is central to public health programs, the
WHO delegation found that government health services in Lebanon
lacked appropriate epidemiological techniques. At the local or
community level, health personnel, especially doctors, rarely
reported diseases to the health department, although they were
legally obliged to do so for some diseases. A similar situation
existed with respect to health establishments such as clinics,
dispensaries, and hospitals. Consequently, not only was there a
conspicuous absence of health records, but where available, they
were often incomplete.
Because of the lack of adequate data, only cautious inferences
based on partial data and observations and interviews by the WHO
mission can be made concerning the incidence of disease. Upper
respiratory tract infections and diarrheal diseases headed the list
of causes of morbidity, and infectious diseases were endemic.
Malnutrition was reported to be restricted to groups living in
particularly difficult situations, such as the Palestinian and
Lebanese refugees. Studies on the growth and illness patterns of
Lebanese children, initiated in 1960, indicated a s;
table 5 to 10
percent of undernutrition (defined as low weight and height for
age) in children under five. Various sources reported a high
incidence of mental retardation among children, with cases
occurring in clusters and seemingly related to consanguineous
marriages in certain communities.
* * *
Rare are the books that are devoted exclusively to the study of
Lebanese society. The small collection of such books includes: Nura
Alamuddin's and Paul Starr's Crucial Bonds: Marriage among the
Druze, Halim Barakat's Lebanon in Strife, Joseph
Chamie's Religion and Fertility, Dominique Chevallier's
La société du Mont Liban a l'époque de la révolution
industrielle en Europe, Anne Fuller's Buarij: Portrait of a
Lebanese Muslim Village, Samir Khalaf's Lebanon's
Predicament and Persistence and Change in 19th Century
Lebanon, Fuad Khuri's From Village to Suburb, Sami
Makarem's The Druze Faith, Huda Zurayk's and Haroutune
Armenian's Beirut 1984: A Population and Health Profile.
Salim Nasr's and Claude Dubar's Social Classes in Lebanon,
and Pierre Rondot's Sects in the Lebanese State are two
valuable Arabic sources. Albert Hourani's Minorities in the Arab
World is a classic treatment of this subject and Robert C.
Betts's Christians in the Arab East gives a useful account
of Christian denominations.
Also useful are some general works on Lebanon that contain
relevant information. These include Helena Cobban's The Making
of Modern Lebanon, David Gordon's Lebanon: the Fragmented
Nation and The Republic of Lebanon, Albert Hourani's
Syria and Lebanon, Michael Hudson's The Precarious
Republic, and Kamal Salibi's The Modern History of
Lebanon. (For further information and complete citations,
see
Bibliography.)
Data as of December 1987
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