• ياسر المصري

Wojouh: Leila Kamareddine

One of the greatest assets of Greater Tripoli is its very own people. Whether in Tripoli or abroad, Greater Tripolitans have continued to excel and innovate. As a result, Tripolicy has decided to launch a series called Project Wojouh to shed light on some notable figures and rising stars.

Yasser El Masri: Thank you Leila for lending us your time and expertise and for being here today.

Leila Kamareddine: Thank you for the opportunity and the feature!

Yasser El Masri: We are honored to have you. To start first, tell us a bit about yourself, your background, your education. I think everyone is interested in knowing about that.

Leila Kamareddine: Thank you, Yasser! I grew up in Tripoli, Lebanon, and I got my Bachelor’s degree in Nutrition and Dietetics from the American University of Beirut as part of their coordinated program. Following that, I pursued my Master’s in Public Health at the University of California, Los Angeles (UCLA) and specialized in community health sciences and disaster management. After graduation, I worked at UCLA on research projects spanning childhood obesity and maternal health.

After my experience at UCLA, I moved to Boston and I worked as a visiting scientist at the Harvard T.H. Chan School of Public Health (HSPH). We were collaborating with the Ministry of Health in Ethiopia on a revision of their essential healthcare package. Following this role, I was appointed as a program coordinator for the National Studies on Air Pollution and Health group in the Department of Biostatistics at HSPH. In short, we study the association between air pollution in the United States and health outcomes ranging from hospitalizations to mortality. Our research helps inform new policies that aim to decrease air pollution and improve environmental justice.

Yasser El Masri: That's quite the CV Layla. I have to say I mean, as a fellow to Tripolitan someone that started in the same school as you, I am very proud to call you a colleague. I would like to ask about what got you into public health initially? Sometimes a lot of people indicate that there is something that drives them towards that route versus another one. So, what do you think got you into it?

Leila Kamareddine: Growing up, I was always interested in health, and when I was doing my Bachelor's in Nutrition and Dietetics, I got a glimpse of what public health was. In simple terms, public health is the science of protecting and improving the health of the communities as well as promoting and preventing disease. I was intrigued by the power of scientific evidence that drives public health policies and interventions to greatly improve the health of a community as a whole. I was passionate about exploring it and becoming a public health professional with the required expertise to make a positive change. When you dive deep into it, you learn that there are multiple factors that determine an individual’s health status beyond their behavior and genetics. These factors are called the social determinants of health, and they are key to decision-making in public health policy and interventions.

Yasser El Masri: Such as what access to food there is and the different types of it?

Leila Kamareddine: Exactly. Social determinants of health include the built environment that one lives in, their access to foods that support healthy eating, the neighborhood crime and violence rates, and the housing situation. Economic stability as well, think employment, or the lack thereof, food insecurity, poverty. Access to healthcare, and health literacy. A person’s education level. Also in a social and community context, social discrimination, and social cohesion.

Yasser El Masri: How did your experience working with the Ethiopian Government inform your approach to dealing with food security and malnutrition and how does it translate to lessons in Lebanon and Tripoli?

Leila Kamareddine: The work that we did with the ministry of health in Ethiopia focused on an essential package for medical interventions specifically. However, there are many lessons that can be drawn from this work to inform the approach that should be applied in dealing with public health problems in Lebanon.

In terms of prioritizing the interventions in Lebanon, three different dimensions should be considered: health benefits, financial protection, and equity.

For example, the framework developed in the case of Ethiopia did not solely prioritize interventions based on the offered health benefits. In addition, it considered interventions with benefits that are equitable across different income groups, and that protect the vulnerable groups from having to pay catastrophic expenditures for healthcare that push them under the poverty line.

Yasser El Masri: How do you think the healthcare sector in Tripoli is doing?

Leila Kamareddine: To evaluate a health system, different features should be evaluated. Health service availability, health service coverage, workforce size, workforce skills, medical supply chains, governmental subsidies of health services, usage, health system capacity, and others. If we examine the current situation in Lebanon during COVID-19, it is clear that the health system capacity has reached its maximum (no vacancies in hospitals), the healthcare workforce size and skills are drastically decreasing because of immigration. The supply chain for medical equipment has been severely impacted as well because of the economic crisis and the recent unfortunate events at the Beirut port. Black markets are surfacing out to sell ventilators and oxygen tanks. Supply chains for vaccines have been impacted, and vaccines are not properly subsidized, people have to pay out-of-pocket.

Yasser El Masri: How would you thus assess the official government response to both COVID-19 and the subsequent socio-economic implications that followed?

Leila Kamareddine: In addition to my previous comments that highlight how the government came short in maintaining the health system in COVID-19, there is a lot of misinformation and disinformation out there that is misleading people and preventing them from protecting themselves and others. I did not see any targeted interventions by the ministry to address these concerns, nor campaigns or ads with COVID-19 specific public health messaging.

The impact of misinformation and conspiracy theories has been significant on COVID-19 and what amplified it is that it was picked up by some political figures and influencers in Lebanon and around the world, which made it mainstream across social media. So, what the ministry of health should do is that it should come up with a consensus of what is true and inform the people from their official capacity. There is however an issue with mistrust which they need to deal with but if they do their work right and they are clear and consistent in their public health messaging it can get through to people.

Yasser El Masri: With all this contradicting information flying around and conspiracy theories making rounds how would the average individual be able to distinguish the truth from false claims?

Leila Kamareddine: That's a good question. It can get confusing with all the conflicting information that is being shared, especially on social media. People do not know what to believe or who to trust, and often end up believing and sharing false information. Basically, as a rule of thumb messages shared on social media are not to be trusted!

Health claims need to be evidence-based and they need to be coming from a trusted source. Some sources of information that you can trust and share are those coming directly from, for example, the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) which translate the most recent evidence and science into public health messages targeted to the general public, national health departments, established experts and peer-reviewed research, and your direct primary care provider, if possible.

In summary, people should check the sources of the information they are receiving, and confirm that it is a trusted source, if you’re not sure it’s a trusted source, assume it is false information and do not share it.

Yasser El Masri: Are there any last words you would like to share with our readers?

Leila Kamareddine: Thank you so much. Lebanon has been in a state of public health emergency for a while now, but unfortunately, it is not being addressed. I hope people living abroad, Lebanese expatriates, and friends of Lebanese people and Lebanon continue to offer support to Lebanon as much as possible. I would also like to share a helpful resource for people to refer to when putting together food parcels.

Yasser El Masri: Thank you so much for your time Leila it has been wonderful talking to you.

Leila Kamareddine: The pleasure is all mine!

About the Author: Yasser is an architect from Tripoli that is currently completing his Ph.D. in Architecture at Georgia Tech in Atlanta USA. He was a Fulbright Scholar and Rhodes Scholarship to Oxford Finalist. He is the Founder of Tripolicy.

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