By Stephen Kalin
ZAHLE, Lebanon (Reuters) - Lebanon launched a massive public health initiative on Friday to vaccinate all children under five against polio, following a confirmed outbreak of the crippling disease last month in neighboring war-torn Syria.
The task is a daunting one in Lebanon, where more than 800,000 refugees are spread across the country in nearly 1,600 locations, including 400 informal tented settlements.
Unlike Jordan and Turkey, which each host more than half a million Syrians, Lebanon has avoided establishing large-scale camps and many of the refugees are living among Lebanese.
The vaccination plan in Lebanon is to go "house by house, tent by tent," said Annamaria Laurini, the UNICEF representative in Lebanon.
The campaign, which is a joint effort between the government, UNICEF, the World Health Organization and a local NGO, aims to vaccinate children of all nationalities living in Lebanon, not only Syrian refugees. Lebanon has not had any cases of polio since 2001, according to UNICEF.
The initiative is scheduled to run through December and is estimated to cost about $3 million.
Caretaker Health Minister Ali Hassan Khalil kicked off the nationwide campaign at Tel Chicha Hospital in the eastern town of Zahle, calling inoculation "an extraordinary national duty that cannot be neglected".
At Al Omariya settlement in Lebanon's Bekaa Valley, more than 300 children had already been vaccinated, their fingers stained with purple ink as an indicator.
In a bid to raise awareness for the campaign, the children held colorful neon signs and chanted slogans encouraging parents to vaccinate their children.
Lebanon has dispatched mobile medical units to reach Syrian refugee children across the country in settlements like Al Omariya, where refugees have constructed tents from wooden planks and plastic tarpaulins on vacant farmland.
As the vaccination teams went door to door on Friday, it started to rain - a reminder of another challenge that the refugees are facing as Lebanon's cold winter and harsh rains threaten their flimsy shelters.
Syrians entering Lebanon with young children at the Masnaa border crossing on Friday were ushered into a small wooden office in the parking lot of the customs area where health ministry workers in white lab coats administered the vaccine.
Polio, which is caused by a virus transmitted via contaminated food and water, can cause irreversible paralysis within hours and cannot be cured.
The campaign is part of a regional effort to vaccinate 20 million children, prompted by ten confirmed cases of polio last month in Syria's eastern Deir al-Zor province. They were the first incidents of the disease in that country since 1999.
It has been eradicated in most of the world, but could spread fast in Syria, where a civil war in its third year has led to falling vaccination rates, as well as in unsanitary conditions in the crowded refugee camps abroad.
(Editing by Tom Pfeiffer)