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. 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 10 percent of children under five had low weight and height for their age. 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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