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“We use it a lot for everything”: Antibioticalization and everyday life in a refugee camp in Lebanon

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  • Spjeldnæs, Amanda Hylland
  • Wick, Livia
  • Fjeld, Heidi E.
  • Lie, Anne Kveim

Abstract

Increasing rates of antimicrobial resistance has accelerated global efforts to reduce antibiotic use. While antibiotic resistance poses a significant threat, especially in low-income settings, there is a scarcity of research on how people in such environments, including refugee camps, access and use antibiotics. This article explores factors that contribute to the shaping of antibiotic use in Shatila refugee camp in Lebanon. It is based on six months of fieldwork from October 2021 to April 2022 in Shatila, consisting of participant observation, semi-structured interviews and group workshops with 32 camp residents and health workers. Following the onset of the Syrian war in 2011, the number of informal pharmacies and Syrian medicines boomed in Shatila. Aiming to describe and analyze how camp residents access and use antibiotics, we address two main themes: 1) the omnipresence of antibiotics in a context of scarcity, and 2) antibiotics as a panacea – a quick-fix for everyday ailments. Antibiotic consumption patterns in Shatila are formed by a scarcity of quality healthcare services on the one hand, and an omnipresence of antibiotics on the other. We demonstrate that in this loosely regulated context, where pharmaceuticals are bought over-the-counter; there is extensive antibiotic consumption. Camp residents often self-medicate with antibiotics for a wide range of purposes, extending beyond the treatment of infections. The high consumption of antibiotics will increase the level of antimicrobial resistance and pose a risk to the camp residents by disturbing local microbiomes and the amount of resistant genes (the resistome) in the environment, thus leading to new potential health risks. Building on theories of pharmaceuticalization and social suffering, we propose the concept of “antibioticalization.” This distinct form of pharmaceuticalization is characterized by the pervasive and generalized use of antibiotics, especially in contexts of healthcare and resource scarcity.

Suggested Citation

  • Spjeldnæs, Amanda Hylland & Wick, Livia & Fjeld, Heidi E. & Lie, Anne Kveim, 2025. "“We use it a lot for everything”: Antibioticalization and everyday life in a refugee camp in Lebanon," Social Science & Medicine, Elsevier, vol. 366(C).
    • Handle: RePEc:eee:socmed:v:366:y:2025:i:c:s0277953624011067
    DOI: 10.1016/j.socscimed.2024.117652
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    References listed on IDEAS

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    1. Lina Cheaito & Sophie Azizi & Nadine Saleh & Pascale Salameh, 2014. "Assessment of self-medication in population buying antibiotics in pharmacies: a pilot study from Beirut and its suburbs," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 319-327, April.
    2. Kihyun Lee & Sebastien Raguideau & Kimmo Sirén & Francesco Asnicar & Fabio Cumbo & Falk Hildebrand & Nicola Segata & Chang-Jun Cha & Christopher Quince, 2023. "Population-level impacts of antibiotic usage on the human gut microbiome," Nature Communications, Nature, vol. 14(1), pages 1-19, December.
    3. Parkinson, Sarah E. & Behrouzan, Orkideh, 2015. "Negotiating health and life: Syrian refugees and the politics of access in Lebanon," Social Science & Medicine, Elsevier, vol. 146(C), pages 324-331.
    4. Bell, Susan E. & Figert, Anne E., 2012. "Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward," Social Science & Medicine, Elsevier, vol. 75(5), pages 775-783.
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