Lebanon Table of Contents
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.
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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
Lebanon Table of Contents