{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T22:44:31Z","timestamp":1793573071817,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Syrian conflict has produced one of the largest refugee crises in modern times. Lebanon has taken in more Syrian refugees per capita than any other nation. We aimed to study the burden of surgical disease and access to surgical care among Syrian refugees in Lebanon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was designed as a convenient cross\u2010sectional cluster\u2010based population survey of all refugee camps throughout the Bekaa region of Lebanon. We used a modified version of the Surgeons OverSeas Assessment of Surgical Need to identify surgical conditions and barriers to care access. The head of household of each informal tented settlement provided demographic information after which two household members were randomly chosen and administered the survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,500\u00a0individuals from 750 households representing 21 camps were surveyed. Respondents had a mean age of 36.6 (15.0) years, 54.6% were female, and 59% were illiterate. Nearly 25% of respondents reported at least one surgical condition within the past year, most commonly involving the face, head, and neck region (32%) and extremities (22%). Less than 20% of patients with a surgical condition reported seeing any healthcare provider,\u2009&gt;\u200975% due to financial hardship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of surgical disease among Syrian refugees is very high with a fourth of refugees suffering from one or more surgical conditions over the past year. The surgical needs of this vulnerable population are largely unmet as financial reasons prevent patients from seeking care. Local and humanitarian efforts need to include increased access to surgical care.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-06242-w","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T20:03:28Z","timestamp":1627329808000},"page":"3019-3026","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Burden of Surgical Disease and Access to Care in a Vulnerable Syrian Refugee Population in Lebanon"],"prefix":"10.1002","volume":"45","author":[{"given":"Moustafa K.","family":"Moustafa","sequence":"first","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar","family":"Al\u2010Hajj","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Health Management and Policy Department American University in Beirut Bliss Street Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"El\u2010Hechi","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery &amp; Surgical Critical Care, Department of Surgery Massachusetts General Hospital, Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"El Moheb","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia Charlottesville VA USA"},{"name":"Division of Trauma, Emergency Surgery &amp; Surgical Critical Care, Department of Surgery Massachusetts General Hospital, Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahraa","family":"Chamseddine","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Health Management and Policy Department American University in Beirut Bliss Street Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haytham M. A.","family":"Kaafarani","sequence":"additional","affiliation":[{"name":"Division of Trauma, Emergency Surgery &amp; Surgical Critical Care, Department of Surgery Massachusetts General Hospital, Harvard Medical School 165 Cambridge Street, Suite 810 02114 Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.10161"},{"key":"e_1_2_8_3_1","unstructured":"United Nations High Commissioner for Refugees (UNHCR) Health services for Syrian refugees in Mount Lebanon and Beirut(2015) http:\/\/data.unhcr.org\/syrianrefugees\/download.php?id=2257"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20105\u201069"},{"key":"e_1_2_8_5_1","unstructured":"United Nations Office for the Coordination of Humanitarian Affairs (OCHA) Lebanon Crisis Response Plan 2015\u20102016: Sector Plans(2016)https:\/\/docs.unocha.org\/sites\/dms\/CAP\/2015\u20102016_Lebanon_CRP_Sector_Plans_EN.pdf"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010017\u20100269\u20104"},{"key":"e_1_2_8_7_1","first-page":"197","article-title":"Globalization: challenges in abdominal surgery for migrants and refugees","volume":"89","author":"Wilhelm T","year":"2018","journal-title":"Der Chir Z fur alle Geb der Oper Med"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744\u20108603\u201010\u201024"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(14)70213\u2010X"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102243\u2010y"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002687"},{"key":"e_1_2_8_12_1","unstructured":"Overseas S Surgeons Overseas Assessment of Surgical Need (SOSAS) Tool https:\/\/www.surgeonsoverseas.org\/resources\/"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101448\u20109"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2012.10.001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9807"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61081\u20102"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v29i3.1"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2015.3431"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.02.003"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001970"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031\u2010016\u20100088\u20103"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-019-0192-2"},{"key":"e_1_2_8_23_1","unstructured":"CIA The World Factbook(2015)https:\/\/www.cia.gov\/the\u2010world\u2010factbook\/countries\/syria\/"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109525\u20109"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.050435"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(15)70086\u20100"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.03.007"},{"key":"e_1_2_8_28_1","first-page":"1","article-title":"Syrian refugees in Lebanon: the search for universal health coverage","volume":"10","author":"Blanchet K","year":"2016","journal-title":"Confl Heal"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010030\u201035016\u20101_8"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60160\u2010X"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-021-06242-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-021-06242-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-021-06242-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-021-06242-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T16:50:22Z","timestamp":1703350222000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-021-06242-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,26]]},"references-count":29,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1007\/s00268-021-06242-w"],"URL":"https:\/\/doi.org\/10.1007\/s00268-021-06242-w","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,26]]},"assertion":[{"value":"28 June 2021","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no financial or non-financial competing interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}