Combat doctors alarmed at resistance to antibiotics



DUBAI // Doctors who treat victims of Middle East conflicts have expressed alarm at the ineffectiveness of antibiotics, which are too readily available without prescriptions in regional pharmacies.

Overuse of antibiotics can make bacteria resistant to them and doctors say this contributes to the evolution of “superbugs”.

“The situation is terrifying,” said Dr Rasheed Fakhri. “The problem is the effectiveness of generations of antibiotics is decreasing so new generations are very limited by comparison.

“The level of education and acceptance by populations, even by medical teams, for respecting antibiotic prescriptions is not high enough.”

Dr Fakhri was recruited by the Dubai office of Medicins Sans Frontieres (MSF), the volunteer group that treats patients with combat injuries, to work in a reconstruction hospital in Amman, Jordan.

MSF’s project to treat patients with combat injuries began a decade ago, but in that time Dr Fakhri has witnessed a worrying level of bacterial resistance.

Some pharmacists in Abu Dhabi and Dubai hand out antibiotics without prescriptions to treat minor ailments.

“Many patients do not often challenge the need for a prescription from a pharmacy for these kind of drugs,” said Dr Arthur Williams, a family medicine specialist at the American Spine Centre in Dubai.

“Antibiotics should only be prescribed in accordance with illness and by medical professionals. A lot of work is needed here on awareness in the UAE.”

Dr Fakhri’s hospital treats patients who have injuries such as loss of limbs, but sometimes 18 months after they sustained the wounds.

Between 50 and 60 per cent of orthopaedic patients are from Iraq, Yemen, Syria and Jordan.

Drug-resistant bacteria has been steadily increasing since 2009, doctors at the hospital said.

One infection that is hard to treat is war-related osteomyelitis, which is found in the bones of casualties.

There have been six recorded hospital cases where the bug is resistant to all available drugs – four of them in the past 12 months.

Dr Fakhri, who has also worked in Iraq, said: “I am not optimistic that there is a significant strategy to tackle the issues we are facing as a result in these countries.

“We have a very specific war injury in Iraq and Syria [osteomyelitis], so antibiotic resistance is not a direct result of malpractice by doctors.

“But it is a concern for the future as such practices will lead to the development of resistant bacteria. There should be more government control over antibiotics.”

Syrian patient Oday suffered several bullet wounds to his right leg in Duma, Damascus, in November 2012. He was treated in a field hospital but developed severe bone infection osteomyelitis.

Bone samples showed very resistant types of bacteria that could not be treated by the usual antibiotics.

Surgery was done to remove the infected area, with a longer course of stronger antibiotics to stop further infection.

MSF findings support a strong link between war-associated injuries and infection with drug-resistant organisms. To recover, on average, patients need on average at least an extra one or two operations and a six-week course of medication.

“MSF has experienced antibiotic resistance in war-injured Iraqi and Syrian patients in its reconstructive surgery hospital,” said Mohamed Bali, MSF’s executive director in the UAE.

“For a humanitarian surgical project, patients infected with MDR [multiple drug-resistant] organisms lead to formidable diagnostic, treatment, and control challenges. It considered one of the biggest medical humanitarian challenges that MSF is facing in the region.

“Implementing restricted regulations on over-the-counter antibiotic sales and raising consumer awareness to reduce patient demand for antibiotics are critical steps to address antibiotic resistance in the region.”

nwebster@thenational.ae

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Founded in 2002 and set up as a foundation in 2006, Health Valley has been an innovation in healthcare for more than 10 years in Nijmegen, the Netherlands.
It serves as a place where companies, businesses, universities, healthcare providers and government agencies can collaborate, offering a platform where they can connect and work together on healthcare innovation.
Its partners work on technological innovation, new forms of diagnostics and other methods to make a difference in healthcare.
Its agency consists of eight people, four innovation managers and office managers, two communication advisers and one director. It gives innovation support to businesses and other parties in its network like a broker, connecting people with the right organisation to help them further

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Hobbies: Salsa dancing “It's in my blood” and listening to music in different languages

Favourite place to travel to: “Thailand, as it's gorgeous, food is delicious, their massages are to die for!”  

Favourite food: “I'm a vegetarian, so I can't get enough of salad.”

Favourite film:  “I love watching documentaries, and am fascinated by nature, animals, human anatomy. I love watching to learn!”

Best spot in the UAE: “I fell in love with Fujairah and anywhere outside the big cities, where I can get some peace and get a break from the busy lifestyle”

Ziina users can donate to relief efforts in Beirut

Ziina users will be able to use the app to help relief efforts in Beirut, which has been left reeling after an August blast caused an estimated $15 billion in damage and left thousands homeless. Ziina has partnered with the United Nations High Commissioner for Refugees to raise money for the Lebanese capital, co-founder Faisal Toukan says. “As of October 1, the UNHCR has the first certified badge on Ziina and is automatically part of user's top friends' list during this campaign. Users can now donate any amount to the Beirut relief with two clicks. The money raised will go towards rebuilding houses for the families that were impacted by the explosion.”

UAE currency: the story behind the money in your pockets
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Germany: PKK collectors typically bring in $18 million in cash a year – amount has trebled since 2010

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Extortion: Gunman convicted in 2023 of demanding $10,000 from Kurdish businessman in Stockholm

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Denmark: PKK one of two terrorist groups along with Iranian separatists ASMLA to raise “two-digit million amounts”

Contributions: Hundreds of euros expected from typical Kurdish families and thousands from business owners

TV channel: Kurdish Roj TV accounts frozen and went bankrupt after Denmark fined it more than $1 million over PKK links in 2013 

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From Zero

Artist: Linkin Park

Label: Warner Records

Number of tracks: 11

Rating: 4/5

COMPANY PROFILE

Company: Bidzi

● Started: 2024

● Founders: Akshay Dosaj and Asif Rashid

● Based: Dubai, UAE

● Industry: M&A

● Funding size: Bootstrapped

● No of employees: Nine

What is the FNC?

The Federal National Council is one of five federal authorities established by the UAE constitution. It held its first session on December 2, 1972, a year to the day after Federation.
It has 40 members, eight of whom are women. The members represent the UAE population through each of the emirates. Abu Dhabi and Dubai have eight members each, Sharjah and Ras al Khaimah six, and Ajman, Fujairah and Umm Al Quwain have four.
They bring Emirati issues to the council for debate and put those concerns to ministers summoned for questioning. 
The FNC’s main functions include passing, amending or rejecting federal draft laws, discussing international treaties and agreements, and offering recommendations on general subjects raised during sessions.
Federal draft laws must first pass through the FNC for recommendations when members can amend the laws to suit the needs of citizens. The draft laws are then forwarded to the Cabinet for consideration and approval. 
Since 2006, half of the members have been elected by UAE citizens to serve four-year terms and the other half are appointed by the Ruler’s Courts of the seven emirates.
In the 2015 elections, 78 of the 252 candidates were women. Women also represented 48 per cent of all voters and 67 per cent of the voters were under the age of 40.
 

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Stars: Basel Adra, Yuval Abraham

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UPI facts

More than 2.2 million Indian tourists arrived in UAE in 2023
More than 3.5 million Indians reside in UAE
Indian tourists can make purchases in UAE using rupee accounts in India through QR-code-based UPI real-time payment systems
Indian residents in UAE can use their non-resident NRO and NRE accounts held in Indian banks linked to a UAE mobile number for UPI transactions

Zimbabwe v UAE, ODI series

All matches at the Harare Sports Club:

1st ODI, Wednesday, April 10

2nd ODI, Friday, April 12

3rd ODI, Sunday, April 14

4th ODI, Tuesday, April 16

UAE squad: Mohammed Naveed (captain), Rohan Mustafa, Ashfaq Ahmed, Shaiman Anwar, Mohammed Usman, CP Rizwan, Chirag Suri, Mohammed Boota, Ghulam Shabber, Sultan Ahmed, Imran Haider, Amir Hayat, Zahoor Khan, Qadeer Ahmed

The White Lotus: Season three

Creator: Mike White

Starring: Walton Goggins, Jason Isaacs, Natasha Rothwell

Rating: 4.5/5

Skewed figures

In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458. 

The smuggler

Eldarir had arrived at JFK in January 2020 with three suitcases, containing goods he valued at $300, when he was directed to a search area.
Officers found 41 gold artefacts among the bags, including amulets from a funerary set which prepared the deceased for the afterlife.
Also found was a cartouche of a Ptolemaic king on a relief that was originally part of a royal building or temple. 
The largest single group of items found in Eldarir’s cases were 400 shabtis, or figurines.

Khouli conviction

Khouli smuggled items into the US by making false declarations to customs about the country of origin and value of the items.
According to Immigration and Customs Enforcement, he provided “false provenances which stated that [two] Egyptian antiquities were part of a collection assembled by Khouli's father in Israel in the 1960s” when in fact “Khouli acquired the Egyptian antiquities from other dealers”.
He was sentenced to one year of probation, six months of home confinement and 200 hours of community service in 2012 after admitting buying and smuggling Egyptian antiquities, including coffins, funerary boats and limestone figures.

For sale

A number of other items said to come from the collection of Ezeldeen Taha Eldarir are currently or recently for sale.
Their provenance is described in near identical terms as the British Museum shabti: bought from Salahaddin Sirmali, "authenticated and appraised" by Hossen Rashed, then imported to the US in 1948.

- An Egyptian Mummy mask dating from 700BC-30BC, is on offer for £11,807 ($15,275) online by a seller in Mexico

- A coffin lid dating back to 664BC-332BC was offered for sale by a Colorado-based art dealer, with a starting price of $65,000

- A shabti that was on sale through a Chicago-based coin dealer, dating from 1567BC-1085BC, is up for $1,950

The National's picks

4.35pm: Tilal Al Khalediah
5.10pm: Continous
5.45pm: Raging Torrent
6.20pm: West Acre
7pm: Flood Zone
7.40pm: Straight No Chaser
8.15pm: Romantic Warrior
8.50pm: Calandogan
9.30pm: Forever Young

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Seemar’s top six for the Dubai World Cup Carnival:

1. Reynaldothewizard
2. North America
3. Raven’s Corner
4. Hawkesbury
5. New Maharajah
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Company Profile:

Name: The Protein Bakeshop

Date of start: 2013

Founders: Rashi Chowdhary and Saad Umerani

Based: Dubai

Size, number of employees: 12

Funding/investors:  $400,000 (2018)