Mhd Bahaa Aldin Alhaffar

On August 21, 2013, sarin gas was used as a weapon of war in multiple areas of Ghouta, rural Damascus, Syria, in the largest confirmed chemical weapons attack against civilians in the 21st century. Despite the scale of the attack, little is known about the long-term medical symptoms experienced by survivors. This study documents the lived experiences and the short- and long-term physical and psychological consequences of sarin exposure among civilian survivors more than a decade after the attack. We conducted a retrospective qualitative descriptive study using thematic analysis based on semi-structured narrative interviews with survivors of the 2013 Ghouta chemical attacks. Participants were selected based on confirmed exposure and willingness to provide detailed accounts of their health status, experiences, and healthcare-seeking behavior. Thematic analysis was used to identify recurrent patterns and outcomes across different domains. Participants reported several medical symptoms ranging in severity, including chronic respiratory issues, neurological complaints, fatigue, and sensory disturbances. The psychological impact was universal, with widespread reports of anxiety, nightmares, panic attacks, and social withdrawal. Most participants experienced significant disruption to their quality of life and described barriers to accessing healthcare. The long-term consequences of sarin exposure in Ghouta extend far beyond the initial event, affecting nearly every aspect of survivors’ lives. These findings suggest a substantial long-term burden of self-reported physical and psychological symptoms among survivors. They highlight the need for sustained medical, psychological, and social support, and underscore the importance of integrating survivor perspectives into post-conflict recovery and health system responses.

Background: Venezuela present a complex political and humanitarian context as the country is suffering from internal conflict and socio-political crisis which led to the deterioration of the health services, hyperinflation, and migration crisis, and this presents a unique case to explore the impact of conflict intensity on health outcomes. This study investigates potential relationships between conflict intensity and key health indicators in Venezuela from 2001 to 2016, focusing on malaria, heart disease mortality, and infant mortality rates. Methods: Employing an ecological panel data analysis approach, this research analyzes state-year level data from the Uppsala Conflict Data Program and the Venezuelan Health Observatory. The study focuses on assessing if and how conflict intensity influences malaria incidence, heart disease mortality rates, and under-1 infant mortality rate across Venezuelan regions, using panel data regression with fixed effects for state and year. Results: The study identifies a statistically significant correlation between conflict intensity high estimate and higher rates of infant mortality and heart disease mortality. Interestingly, no significant correlation was found between conflict intensity and malaria incidence. These findings suggest the multifaceted impacts of armed conflicts on health outcomes, indicating that while some health indicators deteriorate with rising conflict intensity, others may not exhibit direct correlations. Conclusion: This study underscores the complex relationship between armed conflict intensity and health outcomes in Venezuela, highlighting significant correlations with infant mortality and heart disease mortality, but not with malaria incidence or the conflict death best estimate. The best estimate from UCDP didn’t show correlation, while the high estimate showed significant correlation. The limitations posed by the UCDP database constraints, and the absence of recent health data publication invite further research to explore the nuanced impacts of conflict on health.

Scabies is a dermatological parasitic infestation prevalent in many regions worldwide. Classified as a neglected disease by World Health Organization (WHO) since 2017, it is often associated with poor living conditions and overcrowding. Towards the end of 2021, unusual high numbers of scabies cases in outpatient consultations were observed in two Médecins Sans Frontières’ (MSF) Primary Healthcare Centers (PHCs) in Rohingya refugee camps in Cox’s Bazar, Bangladesh. Here, we aimed to describe the epidemiological and clinical characteristics of patients with scabies consulting the clinics from July 2022–November 2023. A cross-sectional study using routinely collected data from scabies’ consultations at two MSF clinics located in camp 14 and 15 (total population 91,241 in 2023) was conducted. We retrospectively analyzed programmatic data of patients of all ages attending outpatient consultations and clinically diagnosed as scabies. Data were extracted from MSF clinical routine monitoring databases and descriptive statistics were reported. During the 16-month period, a total of 178,922 scabies consultations were recorded, amongst whom 57.7% were women and 42.3% men. Children <5 years constituted 20.5% of the cases, age-groups 6-14, 36.6%, and ≥15 years, 42.9%. Camp 15 had the highest number of cases (39.4%), followed by other camps (29.7%), and then camp 14 (24.4%). Most cases were simple scabies (79.5%); one in five were scabies with secondary infection cases. Patients were mainly treated with oral ivermectin (71.2%) and topical permethrin (24.3%); 19.5% of patients also received antibiotics. Our findings indicate that scabies is a significant health concern in the Cox’s Bazar refugee camp. This study recorded over 178000 cases in the above period. The scale of this outbreak warrants further actions, including a prevalence survey, quality implementation of mass drug administration, and multidisciplinary interventions related to camps’ living conditions such as water and sanitation.

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