TRIPOLI, Lebanon -- A squalid urban slum that has become a haven for refugees fleeing the war in neighboring Syria is at the center of concerns that Lebanon could become a breeding ground for polio.
The sprawling community of Hay al-Tanak -- meaning the "tin neighborhood" in Arabic -- once served as the makeshift home for impoverished Lebanese families. But as war closed in on villages just over the border in Syria, the shantytown crammed between heaping piles of trash quickly became a city of Syrians. Now it has devolved into what may become a nursery for an affliction conquered in another era, yet reinvigorated by the breakdown of modern life amid ceaseless war.
There have been no confirmed cases of polio in Lebanon since 2001, and health workers hope to keep it that way. Last weekend, Lebanon launched a large-scale initiative to vaccinate every child under 5 in the country, regardless of their nationality, after confirmed cases of the disease in Syria prompted widespread panic that it could travel across the region and into Europe where refugees have fled seeking asylum.
Polio, spread through food and water that is contaminated with fecal matter from asymptomatic carriers of the virus, was eradicated 14 years ago in Syria, but has re-emerged as war cripples the country and its health systems. Local production of medicines has fallen by 90 percent in Syria, and 37 percent of hospitals are no longer open, according to the World Health Organization. The disease attacks the nervous system and can leave its victims permanently paralyzed, sometimes leading to death. There is not yet a cure.
Polio isn’t the only crippling disease that Syria is now battling -- outbreaks of typhoid and hepatitis A have also been reported recently.
All of this could now find fertile ground in Hay al-Tanak, where shoeless children splash around in murky, trash-littered pools of water. Dirt cakes their faces. Running water and plumbing are luxuries of which most residents only dream.
In short, the slum presents ideal conditions for the acceleration of an epidemic.
Mobile medical units are now moving across Lebanon, vaccinating thousands of children against polio in medical centers, informal camps and on the border, as families with young kids cross from Syria. UNICEF Lebanon representative Annamaria Laurini says health workers in Lebanon plan to go "house by house, tent by tent" in a bold attempt to prevent polio from flaring up in the country. There are currently more than 800,000 registered refugees in Lebanon, but the number is likely much higher when combined with those who are unregistered.
But Lebanon, unlike Jordan and Turkey, has not set up any formalized camps for Syrian refugees. Many are forced to literally build their own shelters. Some string together cardboard walls and tin to resemble a roof in places like Hay al-Tanak. Others wander the streets begging for spare change in Beirut, alongside chic French cafes and booming nightclubs. Those who are lucky can afford to rent an apartment, where multiple families often live.
The move to vaccinate all young children in Lebanon is part of a broader regional goal to vaccinate 20 million children across the Middle East. Polio outbreaks are not only a concern in Syria: It has also been detected in Egyptian, Israeli and Palestinian sewage samples.
The risk of polio spreading is now a stark reality, with more than 2,210,000 Syrian refugees scattered around the world, some moving to European countries that have opened their doors to asylum-seekers. The disease could incite even more xenophobia in Middle Eastern countries, where populations have surged in size with influxes of Syrian refugees straining already struggling economies and scarce resources.
Analysts and world leaders have long talked about the spillover of violence from Syria into the wider region, but in a war that has already claimed more than 110,000 lives, disease knows no borders.