Development of Emergency Medicine in Lebanon

doi:10.1016/S0196-0644(96)70141-5

Annals of Emergency Medicine

Volume 28, Issue 1, July 1996, Pages 82-86

https://doi.org/10.1016/S0196-0644(96)70141-5 Get rights and content

Abstract

[Musharafieh R, Bu-Haka R: Development of emergency medicine in Lebanon. Ann Emerg Med July 1996;28:82-86.]

Section snippets

INTRODUCTION

In the 1960s and early 1970s the Republic of Lebanon was considered the most advanced country in the Middle East. The economy was booming, and the country was a playground of the rich; it was often referred to as the Switzerland of the Middle East. In 1975 began 16 years of civil war, which destroyed the economy, ruined much of the country's infrastructure, and caused many of the wealthy and educated to seek safer lives in the United States, Europe, Australia, and Africa.

Many of the effects of

HEALTH POLITICS

Since Lebanon gained its independence from France in 1943 the health sector has mainly been the domain of private enterprise. During the civil war the government was either absent or impotent, and this augmented the trend toward privatization. Most hospitals and clinics are privately owned and run by physicians. About 50 nongovernmental organizations emerged during the war years; from these have developed approximately 650 "health care centers", which provide basic general, maternal, and child

MEDICAL EDUCATION

Lebanon has three medical schools: the American University of Beirut (American system), the University of Saint Joseph (French system), and the Lebanese University (a combination of the French and American systems). Together these schools graduate approximately 200 students each year.

Entrance to the American University medical school requires a bachelor of science degree. In the 4-year program, years 1 and 2 are preclinical and are devoted to the study of the normal and abnormal human body.

CURRENT EMERGENCY CARE

Emergency care in Lebanon is currently controlled and delivered by individual private hospitals; as mentioned earlier, no national system exists. Eighty-one hospitals that provide emergency services are unevenly distributed throughout the country, with the more advanced and better-developed systems located in and around Beirut. Hospitals are classified on an A-through-E scale according to availability and number of registered nurses, resident staff, specialists, equipment, and facilities.

CURRENT PREHOSPITAL CARE

Lebanon's nationally organized, staffed, and financed prehospital emergency medicine system is still in the planning phase.

Most patients are transported to hospitals in private cars. Victims of traffic accidents usually arrive at the ED courtesy of passing motorists. Delays in arrival are frequent because of severely congested city roads. Ambulances are used mainly for interhospital transfers. However, many social, political, and charitable organizations have developed teams that provide some

PROBLEMS IN DELIVERING ADEQUATE PREHOSPITAL AND EMERGENCY CARE

Lebanon faces a variety of problems and obstacles that must be overcome before an adequate prehospital and emergency care system can be delivered. Some of these problems could be overcome relatively quickly, whereas others (eg, rebuilding the roads and establishing a viable telephone network) fall within the domain of other government ministries and will take much longer to be resolved.

Much of Lebanon's prehospital care is delivered by volunteers, raising the issues of professionalism,

EMERGENCY MEDICINE: A DEVELOPING SPECIALTY

The MOH is working to produce a comprehensive plan for emergency care in Lebanon. This plan includes finance, legislation, an improved communications network, initiation and integration of a complete prehospital care system, assignment of specialty units (eg, burn units), and startup of education and training programs for health care workers.

Improved coordination between hospitals and triage by ambulance paramedical staff will make transfer of critically ill patients to and from hospitals

References (5)

K Mohama et al.
L'état de la Protection Sociale au Liban après la guerre
A Mroueh et al.
Health Care In Lebanon
(1984)

There are more references available in the full text version of this article.

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^☆: From the Emergency Unit, American Universitiy of Beirut Medical Centre, Beirut, Lebanon.

^☆☆: Address for reprints: Ramzi Moucharafieh, MD American University of Beirut New York Office 850 Third Avenue 18th Floor New York, New York 10022 Fax 212-478-1995

^★: Reprint no. 47/1/74107

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