Monthly Archives: February 2015

Polio in the Middle East, the vaccination campaigns are working


Preventive vaccination campaign against polio that was conducted for twelve months in eight countries of the Middle East was able to stop the progression of the disease in this region of the world, after the appearance of more than thirty-eight cases in Syria and Iraq.

According to experts from the World Health Organization and UNICEF, other preventive vaccination campaigns against polio have yet to be conducted over the coming months.

The disease appears to be limited according to the experts who met recently in Beirut. In a statement released by UNICEF and the World Health Organization, they explain that following the diagnosis of the cases mentioned above, a wide vaccination campaign was conducted in Lebanon, Syria, Iraq, Jordan, Egypt, Turkey, Iran, Gaza and the West Bank, targeting some 27 million children aged between 0 and 5 years. More than a year has passed since the onset of the last case in Syria and nine months since the last case in Iraq.

“Under normal circumstances, we would have said that the epidemic was stopped”, said Maria Calivis, Regional Director of UNICEF in the Middle East and North Africa. “But since the conflicts continue in the area, UNICEF and its partners will spare no effort to ensure the protection the children need against this terrible disease.”

According to the experts gathered in Lebanon, many children could not receive regular vaccine, because of fighting in Syria and Iraq. This is the reason why other vaccination campaigns have yet to be conducted over the next few months, they said.

According to Chris Maher, head of department of eradication of the disease at WHO, the next step is to “reach all children in the region, even those living in the most conflict-affected areas.”

It should be recalled that WHO had confirmed the outbreak of the disease in Syria in late 2013, reporting at least ten cases of paralysis, that is to say, almost fourteen years after the disappearance of the disease in 1999. The resurgence of polio is mainly due to the deterioration of health facilities and lack of vaccination campaigns. The WHO said that the virus came from Pakistan. The disease also affected Iraq where vaccination has sometimes been hampered in some places because of the war.

Polio is a highly contagious disease that results in flu-like symptoms with fever, fatigue, headache, vomiting, neck stiffness and pain in the limbs of the body. The disease is caused by poliovirus that multiplies in the intestine and is transmitted primarily through fecal-oral route. Not everyone develops the disease. Nevertheless, when mention of a reported case of polio, that is to say a case of paralysis due to the virus, this means that 200 people are already infected.

Preventive vaccination campaign aims to create this intestinal immunity. According to the national immunization schedules worldwide, every child should receive the injectable vaccine. But it provides individual protection to the child, and does not prevent it from being a carrier of the virus, hence the importance of these massive campaigns within which the oral vaccine is administered to children. This actually allows creating the intestinal immunity, preventing the virus to multiply. There is a catch, however. The oral vaccine may represent a risk for people with severe immune deficiency (cancer, AIDS…), since it is composed of attenuated viral strains. If they receive the vaccine, these children will develop a vaccine-associated paralysis, that is to say, they will develop the disease in response to the vaccine. That is why this category of children was excluded from the vaccination campaigns against polio that were conducted to date in Lebanon.

There is no treatment against polio. It is only possible to prevent it through vaccination. Some symptoms may nevertheless be relieved with medication (such as antispasmodics to relax the muscles). The WHO says, “Polio does not respect borders – every unvaccinated child is exposed. For every case of paralysis, between 200 and 1,000 children are infected without symptoms. It is therefore difficult to detect polio and also difficult to prevent the virus from traveling. Children living in areas with low levels of immunity are particularly vulnerable. Eradication of the virus is the best defense against polio imports. It is only once this goal is achieved that all children are protected.”





The Middle East is definitely obese!


According to a recent study that gathered private data and trends among 188 countries, it was found that more than 58% of the men and more than 65% of women across the Middle East and North Africa suffer from either overweight or obesity in 2013. More than three-quarters of the countries in the region have seen their rates of overweight and obesity increasing by more than 50% for both men and women. Altogether, there are 259 million people suffering from obesity or overweight in the Middle East. 180 million people are actually overweight and 79 million people suffer from obesity.

The study was published under the name “Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013”*. It was conducted by the Health Metrics and Evaluation Institute (IHME) at the University of Washington and published in The Lancet on May 28th, 2014.

According to the study, the prevalence of overweight and obesity of adults in North Africa and the Middle East increased from about 53% to 62% during the study period. In 2013, the prevalence of overweight and obesity rate among men was almost 59%, while it was higher among women, approaching 66%. In this region, Kuwait has the highest prevalence of overweight and obesity in adults in general.

During the 33 years of research, many Middle East countries showed a large increase in global obesity rates, including Bahrain, Egypt, Saudi Arabia, Oman and Kuwait. The top three countries in terms of increasing prevalence of obesity among men in 2013 are Qatar (44%), Kuwait (43%) and Bahrain (31%). The rate of obesity among women exceeded 50% in three countries in the Middle East, which are Kuwait (59%), Libya (57%) and Qatar (55%).

In most countries, including Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates, rates of overweight and obesity reached more than 50% in both men and women.

Overweight and obesity are some of the major health issues for children in the Middle East and North Africa. The prevalence of overweight and obesity in the region among children dramatically increased from approximately 19% to 25% during the study period, making the region occupy the third place in terms of regional spread of obesity and overweight in 2013.

The top three countries in terms of increasing prevalence of overweight or obesity among girls are Kuwait (46%), Oman (42%) and Libya (42%). The countries with the highest rates among boys are Qatar (34%), Libya (33%) and Lebanon (33%).

In Egypt, approximately one-third of boys and 40% of girls suffer from either overweight or obesity. Approximately 40% of Saudi girls also suffer from overweight or obesity. And it is the same situation for nearly a quarter of boys.

What should we do to fight obesity?

The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health” stating that “The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended”.

Governments at all levels should act on the problem of obesity as they do to counter an outbreak of infectious disease or to protect the population of a toxic substance in the environment. They had to pass legislation to reduce smoking, as they were also right to mandate the wearing of seatbelts. The current situation of excess weight in the population has developed over several decades, especially because our environment has become absolutely unhealthy. Slowing weight gain and reversing the situation cannot be done in a few years. The impacts of these actions will certainly take place gradually. An annual improvement, however small it may be, will result in health benefits and considerable long-term economic benefits for the entire society.

By taking measures to promote the health of the population, governments play their role, which is not limited to looking after people who already became ill. Diseases caused by tobacco are in decline, deaths caused by drunk driving too. These successes are largely due to government policies and, of course, citizens who supported them. It will be the same for the obesity epidemic.


Have the Arab Springs dried up?


The fourth anniversary of the Arab Springs was celebrated in Egypt with a climbing death toll that just reached 17. A further 50 people were injured with the greatest degree on unrest being reported in the Matariya district, Cairo.

Far from peaceful, the demonstrations were marred with bombings. There was also causalities in Giza, in the Mediterranean city of Alexandria and in a village west of Nile Delta where two people were killed.

The political context for the demonstrations must have Egyptians wondering if their country will ever be a truly peaceful place. It has been four years since Hosni Mubarak was ousted and two since the then-army chief Abdel Fattah el-Sisi ousted elected Islamist president Mohamed Mursi in July 2013.

Abdel Fattah el-Sisi, sits as the sixth president of Egypt after running for elections. He resigned from the military and democratically earned the post he removed from his predecessor. As a leader he is adored by some and hated by many. His strong stance against the Muslim Brotherhood and speeches which can be construed as motivational or dissident, depending on your point of view, appeal to some and appal others.

Abdel Fattah el-Sisi called for an Islamic reinvention, during a speech at the World Economic Forum in Davos, Switzerland.

“The terrible terrorist attacks and this terrible image of Muslims led us to think that we must stop and think and change the religious discourse and remove from it things that have led to violence and extremism” He said.

In a region where religion and politics are intertwined to the detriment of both Indoctrinations and a political leader is assessed, more so on their piety than policies, one begins to wonder, at what a reinvented Islam could look like.

Thought provoking speeches aside Abdel Fattah el-Sisi has been accused of suppressing journalist freedoms. Human rights watch released a damning report that details scores of detainees dying and wasting away in government custody; many of whom are members of the imprisoned Muslim brotherhood. He has also been accused of prosecuting government critics and gay people.

He shows little reluctance to jail people on political grounds and the twenty three people still sit in jail, who were arrested June 21 for protesting, anti-protesting laws.

Peter Greste, Mohamed Fahmy and Baher Mohamed are the three Al-Jazeera journalist jailed for supposedly aiding a terrorist organisation, the Muslim Brotherhood. Their charges include publishing lies that harmed the national interest and supplying money, equipment and information to 16 Egyptians.

A statement from Al-Jazeera said: “Baher, Peter and Mohammed have been unjustly in jail for over a year now.

“The Egyptian authorities have a simple choice – free these men quickly, or continue to string this out, all the while continuing this injustice and harming the image of their own country in the eyes of the world. They should choose the former.”

It’s business as usual in Egypt. The Arab spring’s anniversary a yearly reminded to all Egyptians that in spite of their best efforts these monstrosities still occur in their country. Political stability seems an unachievable goal and whoever finds their way into office be it through uprisings or democratic election is more determined than their predecessor to persecute, control and imprint backwards ideologies on the nation.

The Arab Springs briefly had massive momentum. It saw the ousting of the ruler in Tunisia, with the jasmine revolution/ Sidi Bouzid Revolt, long-time President Zine El Abidine Ben Ali in January 2011. The country now has free and democratic elections. After a troubling three years in which their economy plummeted, jobs were lost and living conditioned worsened the country optimistically took to the polls again in 2014. In the hope that with time and consistency democracy might hold the answers.

Libya is still struggling with local conflict. Colonel Muammar Qaddafi’s is dead but the countries problems refused to die with him. The country is at war with its self, split into fractions it is now a constant battle field, with electricity for less than four hours a day, schools have been disband the economies in tatters and two thirds of its people are below the poverty line. The political situation in the country is too complicated to go into but the ousting of a dictator has created a power vacuum in which several struggle for control.

Yemen, began their revolution at the same time as Egypt. The protests, initially protesting poor living condition and unemployment grew to calls for the stepping down of President Ali Abdullah Saleh and after 33 years in power he signed The Gulf Cooperation Council Agreement. The last three years in Yemen have seen some progress with the creation of a transitional unity government, and the completion of the National Dialogue Conference (NDC), a complete break with the past is yet to be seen. The country is yet to see any political restructuring and officials are still appointed based on their alliances and status with the parties.

Civil uprisings also occurred in Bahrain and Syria. Major protests broke out in Algeria, Iraq, Jordan, Kuwait, Morocco, and Sudan; and minor protests had occurred in Mauritania, Oman, Saudi Arabia, Djibouti, Western Sahara, and Palestine.

While some progress has been made the Arab springs failed to bring about any real order and prosperity. The yearly riots and violence to commemorate the anniversary are only taking lives and completely devoid of any kind of structure or political motive.

The problems of the region continue to scroll along the teleprompts of foreign news channels and collectively the world shakes its head and wonders. Paralysed by the extremes of religion and culture. It must be frustrating, the perpetual death, violent protests, corrupt officials and failed democracies. How and when will these problems ramify themselves? If overthrowing governments and civil uprisings can’t fix the region, what will?