THE MULTIDIMENSIONAL IMPACT OF CBRNe EVENTS ON HEALTH CARE IN THE MIDDLE EAST: THE ROLE OF EPIDEMIOLOGICAL SURVEILLANCE IN THE LONGTERM RECOVERY OF PUBLIC HEALTH SYSTEMS

Abstract

Chemical, biological, radiological, nuclear and explosive (CBRNe) hazards used as agents during conflicts and terrorism are a threat to any civil society, negatively impacting economical, human, political and environmental aspects. When a country is stricken by CBRNe, several related events can significantly debilitate the public health system’s assets, placing additional demands on the health care organization of the
country and neighbors. The consequences for the health of a population might be both direct, such as deaths and injuries, and indirect with long-term aftereffects such as disruption of basic health services, damages to infrastructures and lack of medical personnel. This article provides an overview on the multidimensional impact of CBRNe events on the healthcare sector in the Middle East (Afghanistan, Iraq, Lebanon and Syria) and the countries’ efforts in setting up the basis for health system recovery. Our main aim is to emphasize that the rebuilding of an effective healthcare system is a long-term process that requires multiple actions and actors, with epidemiological surveillance being the cornerstone. We maintain that reinvesting in effective health monitoring systems is essential to support countries in meeting the health needs of their populations in post-CBRNe events. This is the first necessary step for appropriately allocating resources, driving investment, setting up preventive strategies and decision-making responses. Furthermore, especially when
referring to fragile states, acquiring knowledge on the health needs of the threatened population holds a paramount importance for providing preparedness planning and enhancing resilience of the public health system in case of future CBRNe events.
Keywords: CBRNe events; epidemiological surveillance; health monitoring system; health system recovery; Middle East.

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