Middle East Death Tolls Rise

War and terrorism in dozens of Middle East countries from Tunisia to Afghanistan since 2010 is rolling back health care and leaving open paths for new and old diseases to strike down millions and spread to the Western countries, a new study reports.

"Our study shows that the eastern Mediterranean region is going through a crucial health phase. The Arab uprisings and the wars that followed, coupled with ageing and population growth," threaten thousands in the region and worldwide, said the report, which was funded by the Bill and Melinda Gates Foundation and was published in The Lancet, Wednesday, August 24.

The loss of doctors fleeing their posts, and damage to health centers and hospitals contributed to "deteriorating health conditions for many countries that are threatening ... the region and the rest of the world," the report said.

Even Middle East countries that had recently made progress providing health care and medicine to their people have seen a crushing loss of skilled medical staff, influx of huge refugee populations and interruption of supplies of food, medicine, vaccinations and cooking gas said Dr. Ali Mokdad of the University of Washington in Seattle, an author of the report.

In an interview, Dr. Mokdad said that tens of thousands are dying each year in Syria, Yemen, Libya and other countries in the region due to the damage to public health infrastructure as well as from malnutrition and lack of preventive care such as vaccinations.

"On the basis of our data, we call for increased investment in health in the region and the end of ongoing conflicts," said the report.

There were important improvements in health in the region since 1990, even despite periodic turmoil, but the outbreak of wars and Arab revolutions since 2010 means that "most gains are going away due to the unrest," said Dr. Mokdad.

"There has been a lack of funding, a brain drain and health infrastructure has been destroyed in Libya, Yemen and Syria. Normal functioning of the health ministries has been interrupted."

Where hospitals are able to treat people they remain unable to do preventive medicine such as nutritional help and vaccinations.

Death rates are also rising in wealthy Gulf countries from non-communicable diseases such as obesity, high blood pressure, traffic accidents and drug addiction. In poor countries such as Somalia, Sudan and Yemen infectious diseases are often untreated and spreading.

Dr. Mokdad noted that Ebola, MERSA and other diseases have been rapidly spread from the Middle East to Western countries by rapid airplane travel.

"In 10 to 15 hours it can come to us," he said. "Even diseases we had controlled such as Polio will come back. For our own security as U.S. citizens we need to deal with it in the country of origin. Any instability in the region is not good for us."

Even the mundane lack of cooking gas due to conflict disrupting supplies has forced Afghans and others to revert to cooking with wood or coal indoors, causing millions of deaths from smoke inhalation indoors.

The report covered the years 2010 to 2013 due to the lag time in gathering statistics.

The report also found mental health problems, depression and anxiety related to conflict. This has been widely underreported because of the stigma of not being man enough to handle things.Health is also affected by refugee flows into Lebanon and Jordan that consume lots of medical supplies. And conflict has led to malnutrition as harvesting and exporting fresh vegetables has been interrupted.

The solution is to stop wars, said Dr. Mokdad. He admitted this was above his ability to accomplish.

However, he called for creation of a health road map to rebuild medical infrastructure similar to the Marshall Plan that the United States set up to help Europe recover after World War II.

"We need roads, clinics and for the doctors to come back," he said. "Something needs to happen. This is a cry from all of us in public health. The future is gloomy. Someone has to step in and do it."