In 2024, the Center for Pandemic Preparedness and Response (CPPR) launched a partnership with Connecting Research to Development (CRD) to provide support to the Lebanese Ministry of Public Health (MoPH) in the early detection and response to waterborne disease outbreaks in hot spot areas of Lebanon. The aim of this collaboration is to:

Improve passive surveillance on waterborne diseases
Strengthen active surveillance across high-risk governorates
Re-establish the private sentinel epidemiological surveillance
Enhance the local community awareness on waterborne diseases and hygiene measures
Pilot an innovative community-based early detection system for waterborne diseases.

The project has made critical impacts in controlling waterborne diseases despite the challenges presented by the war on Lebanon.

About CRD/Who is CRD?

CRD is an impact-driven research and innovation thinktank that leverages cutting-edge technology, AI-driven analytics, and strategic partnerships to transform health, social resilience, and data-driven policy across the MENA region, with a strong focus on both developmental and humanitarian spheres. Unlike typical NGOs, CRD combines developmental initiatives with emergency response efforts, emphasizing sustainable impacts over short-term solutions. Their work covers various domains, including public health, social protection, and access to justice, with active operations in Lebanon, Jordan, Syria, Yemen, Djibouti, Iraq and more.

CRD’s unique approach bridges gaps between communities and governments, with a focus on collaboration and resilience. During crises, such as the latest war that began in October, their team quickly transitioned from developmental work to emergency interventions, utilizing local resources and networks to implement effective solutions tailored to specific needs.

CRD’s Work During the War: Cholera Case and Response

Amid the recent war, CRD played a vital role in addressing the challenges caused by widespread displacement, deteriorating infrastructure, and intensifying public health risks. Over 1.5 million people were displaced within Lebanon, straining resources, and increasing vulnerability to diseases. In coordination with the MoPH and various other local and international partners, CRD prioritized surveillance and preventive measures to mitigate health risks, with emphasis on waterborne diseases. To highlight Lebanon’s health system resilience, CRD’s CEO, reflected on lessons learned from previous wars: “The shelters grew rapidly, and with the host community, they welcomed around 1.5 million displaced people from the south, suburbs of Beirut, and the Beqaa area to nearby and remote villages. Many were not in shelters but hosted by relatives, putting immense strain on infrastructure. Food supplies were insufficient, shops were unable to cope with the sudden rise in demand, and water and sanitation systems were overwhelmed. We focused on raising awareness and managing resources efficiently to prevent outbreaks. This crisis once again highlighted Lebanon’s health system resilience, built on the strength of civil society and the private sector since the 1975 war and the strong private public partnership.”

Amid the conflict, the CRD teams managed to conduct, despite hostile security conditions, over 1,408 field visits to shelters, communities and health service outlets. During one of these visits, a culture confirmed cholera case was detected in a shelter near the Syrian border, an area facing significant sanitation challenges.

“A few things that we need to look at when we are addressing the issue of the active surveillance is the shift in priorities at the Ministry of Public Health to focus on mass casualties, injuries management, support to the hospitals. We also had areas that had shelters, but the teams were not able to visit them due to the security challenges. The high shift of numbers between the shelters and in the community required a lot of replanning. During this war and displacement, you know, people become disinterested, they don’t like to declare their symptoms or sometimes they over report in order to access more goods. So, these are like kind of typical public health challenges that we see during wars and emergencies.”

Despite these challenges, after the detection of the cholera case, WHO, UNICEF and many other international and national organization including CRD supported the MoPH to act swiftly, provided support to improve coordination activities with multiple stakeholders including local municipalities in order to avert an outbreak in the shelter and potentially in the region. The immediate steps taken to make this possible included:

Enhanced Surveillance: Increased active and passive monitoring to detect further cases.
Community Engagement: Conducted awareness campaigns on hygiene and resource management.
Emergency Water Management: Collaborated with water and sanitation authorities to improve access to clean water and sanitation facilities.
Medical Response: Alerted healthcare providers, including hospitals and laboratories, to monitor and report suspected cases.

These coordinated efforts effectively contained the cholera threat and highlighted the resilience of the local health system, strengthened by CRD’s integrated approach to emergency response.

Moving forward, CRD plans to leverage these lessons learned to enhance immunization efforts, decentralize health responses, and strengthen community resilience against future crises. CRD’s crucial role during the war demonstrates their resilience and commitment to combining humanitarian aid with sustainable health system strengthening, ensuring both immediate relief and long-term impact.

This example of CRD’s exceptional work during the conflict, demonstrating their adaptability in addressing emerging public health threats and preventing a cholera outbreak, offers valuable lessons for organizations in other countries facing similar conflicts and challenges.