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History

Pediatrics appeared as a medical subspecialty in the western communities at the turn of the 19th century. To the best of our knowledge, Dr Philippe Chedid was the first Pediatrician to start a practice in Lebanon.(1,2,3) Dr Chedid had his MD in general medicine from the French faculty in Beirut in 1923 and finished his postgraduate Pediatric training in Paris in 1926.

Pediatric specialty training program was first introduced in Lebanon at the American University Hospital by Dr W. Moore, an Associate Professor in Internal Medicine, who chaired a newly established pediatric Department from 1932-1939. Dr Henri Nachman was the first Lebanese Pediatrician graduating from that department in 1935. Later on, Dr Nachman became the Acting Chairman of that Department from 1939-1950. (2) To the best of our knowledge the number of Pediatricians in Lebanon at that time did not exceed the fingers of one hand. In addition to Drs Chédid and Nachman we can not but remember the eminent pediatricians of that time; Drs Antoine Ferjallah, Helene Safi, Hassan Idriss and Abd El-Ghani Mikati.

In the early 40s a Pediatric specialty program was initiated at the French Faculty of Medicine (FFM) by Dr. Philippe Chédid at the Sacre Coeur Hospital (SCH). Dr. Chédid who was the head of Pediatric Department at SCH, was also in charge of eaching Pediatrics to FFM medical students. One of his graduated, Dr. Michel Tabet, headed thereafter the Pediatric department at SCH for over two decades.

Yet, there was little interest among the pediatricians of that time to register their Pediatric specialty at the Lebanese Order of Physicians (LOP), whose records revealed Dr Bahij Abdul Rahman Tarabah as the first registered male pediatrician on 29th June,1947 and Dr Carmen Wadih Khouri as the first registered female pediatrician on 28th December, 1951.

The foundation of Lebanese Pediatric Society (LPS) goes back to 1957 when pioneers of Pediatric Medicine in Lebanon Drs Philippe Chedid, Antoine Ferjallah, Henri Nachman, Hassan Idriss, Salim Firzli, Ernest Majdalani, Georges Ghanem, and Fuad Atiyeh felt the need to establish a forum where Lebanese Pediatricians can meet and exchange their clinica experiences and intensify the mission of Lebanon as a reference center of medical knowledge in the region. As some of the early records of LPS are missing, the information we got from data and living members of the 1st cabinet point out that Dr. Philippe Chedid was the 1st elected president of the LPS in 1957 (Doc1).(1,2,5) His cabinet consisted of 5 members: Dr Chedid president, Dr Nachman vice president, Dr Asia Itani secretary , Dr Carmen Khouri treasurer and Drs Idriss and Firzli members.

In 1961, the society put the bylaws of the society and it consisted of 37 members (Doc1). By the end of that year around 17 LPS-members convened at LOP site in Gaumont Palace Building at Bechara El-Khoury street and nominated Dr Henri Nachman to chair the 2nd LPS cabinet that arranged the 3rd Union of Middle East and Mediterranean Pediatric
Societies (UMEMPS) congress and the 1st LPS Congress in Beirut, in May 1963, with Dr Nachman and Dr Firzli as president and secretary of that Congress respectively. Lebanon at that time was in a golden era, the famous Swiss pediatrician Dr Fanconi introduced himself during that congress by saying: I am coming from Switzerland, perhaps you don't know Switzerland, its Lebanon of Europe.

Thereafter, Drs Majdalani and Nachman alternated the presidency of the society every 2 years until 1972 when Dr Georges Ghanem was elected as president for 2 years followed by Dr Samir Najjar in 1974. At that time the society consisted of limited number of pediatricians who held scientific meetings every 2 months and represented Lebanon in several international scientific congresses.

Soon after Dr Najjar appointment, Lebanon entered in turmoil of civil war that split the country into two parts. Pediatricians from both sides used to meet across the borders in international congresses, social settings, or in teaching institutions where they exchanged knowledge and held local conferences in their teaching hospitals.
Name of Pediatricians registered in Lebanese order of physicians but not in LPS ( Left), and Pediatricians registered in LPS (Right).

In 1975 Dr Paul Haddad, vice president of Dr Najjar, being the only executive committee member permanently available in the former eastern side, headed the society in that sector and with the absence of Dr Najjar in 1986 he became the acting president of the LPS through 1991, when he was elected as the LPS president with a cabinet consisting of Drs Mariam Rajab (vice president), Carlo Akatcherian, Bernard Jerbaka, Charaf Abou Charaf, Huda Kronfol and Imad Melki until 1993. Dr Haddad founded for the current pediatric society international contributions.


He took care of all national and international commitments of the society. He converted the available small sum of Lebanese pounds of the society to US dollars at a low rate of 3.50 LL per U.S Dollar and collected subscription fees from accessible members in order to maintain LPS membership accounts with international associations such as the International Pediatric Association (IPA) and the UMEMPS. Dr Haddad left the society with a comfortably positive balance account.
While the country was drowned in bloodshed, Lebanese Pediatricians continued to hold their scientific meetings monthly on the East side of the city from home to home, and on weekly basis on the West side through conferences held at American University Hospital of Beirut.

Dr Haddad relentless efforts to keep up the scientific ambitions of Lebanese Pediatricians enabled him to become a Member of the Executive Committee of the Pediatric Francophone Society (La Société des Pédiatres Francophones), a Member and later on a Treasurer of the MEMPS, and through those posts and his further efforts, the succeeding LPS Cabinets successfully held the XXV UMEMPS Congress, and the 33rd Congrés des Pédiatres de Langue Française in Beirut in the years 1999, and 2002 respectively.

In 1993 Dr Majd Ariss was elected as the president of the society with a cabinet of consisting of Drs Carlo Akatcherian (Vice president), Charaf Abou Charaf (treasurer), Mariam Rajab (Secretary), Bernard Jerbaka, Hassan Fakhoury, and Imad Melki. She was followed by Dr Carlo Akatcherian with a new cabinet of Drs Majd Ariss (vice president), Mariam Rajab (secretary), Ghassan Issa, Huda Abd El-Nour, Issam Maalouf, and Mohamad Hamdar. Dr Akatcherian resigned after six months, leaving his vice president, Dr Majd Ariss, as the acting president with the newly elected cabinet until 1997. She and her cabinet brought important developments to the structure of the society, and its advocacy. They performed several achievements including:

1-They established bylaws for the society which organized its functions from 1993 through 2005, the year at which the scientific committee of LOP introduced standard bylaws that organize the functions of all the medical societies under its auspices.

2-The society became an independent financial body with a treasurer and a private bank account.

3-The society introduced itself as an advocate of child health in Lebanon, by  becoming an official consultant to the Ministry of Public Health and WHO for national child health issues.

4-The society started decentralizing Continued Medical Education (CME) seminars, by holding them in different Mohafazat outside the major educational centers.

5-In August 15, 1996 and after several years of negotiations with Ministry of Public Health and in collaboration with WHO, the society finished and approved the current Individual Pediatric National Health Record.

6-In 1995, the society consisted of 89 pediatricians out of 425 pediatricians registered in the Lebanese Order of Physicians.

7-Finally, the society put the foundations for the 2nd Lebanese Pediatric Congress that was held in 1999.

March 1997, Dr Mariam Rajab was elected as president of the Society with a new six member cabinet Drs. Robert Sacy (Vice president), Ghassan Issa (Secretary), Raymond Kamel (Treasurer), Adel Rai, Aziz Koleilat, Chebl Mourani, & Mansour Hojeily. Their mandate extended until April 2000. The society pursued further its role in children advocacy.

1-In June 1997, the society consisted of 210 members.

2-The society started in November 27, 1997 a scientific periodical under the name "LPS newsletter" edited by Dr Ghassan Issa containing abstracts of important  papers published in the pediatric literature.

3-The society arranged several seminars including:

-Lectures by Prof. Claude Renier from Toulouse University, held in several lebanese districts, including North Lebanon, in March 1997.
-Renal Biopsy seminar in April,1997 at Dar A-Nakabah Hazmieh.
-Collaborative seminar with Pediatric Surgery in October,1997 at Dar A-Nakabah Hazmieh.
-Updates on anti infectious agents in December, 1997 at Dar A-Nakabah Hazmieh.
-A series of Lectures by Prof. Narcy, from France, arranged in collaboration with UNICEF, MOH and North Lebanon LOP, about ENT problems of children held respectively in Beirut, Saida and Tripoli during the month of January 1998.
-Pediatric Cardiology seminar in February 1998 at Dar ANakabah, Hazmieh.
-Eneuresis seminar in April 1998 at Dar A-Nakabah, Hazmieh.
-A series of lectures arranged in collaboration with Gastroenterology, Hepatology and Nutrition Club held in Beirut, south Lebanon, Kesserwan, Chouf, Tripoli and Bekaa during a period from February 2002 through June 2003.

4-The society participated actively in pushing MOH to withdraw human serum derived hepatitis B vaccine from MOH dispensaries in October1998, and reintroduce recombinant DNA derived hepatitis B vaccine into the National Lebanese Immunization agenda.

5-In December 1997, the society announced the establishments of subspecialty sections of the society referred to as Clubs where subspecialists can meet and put initiatives to improve the quality of their practices. Four clubs were effectively established; including Neonatology, Gastroenterology, School health, and Accident prevention. The society put bylaws for the functions of the clubs in June 1998.

6-The society represented Lebanon in XXIII UMEMPS CONGRESS in Nice,France 1997, and helped in arranging for transportation of the attending Lebanese pediatricians

7-The society arranged for the XXV UMEMPS Congress 1999, and the 2nd Lebanese Society Pediatric Congress, with Dr Mohamad Mikati as president in 1999.

8-In November 1998, the society assumed advocate roles on behalf of Lebanese Pediatricians when it conveyed their complaints to MOH officials about concerns from vaccines purchased and administered in pharmacies. It also conveyed their concerns to insurance companies about the validity of newborn ?Health Certificate? issued directly after birth. Finally, the cabinet approved the following form ?Baby Mrs ???.. enjoys a good health and is free of congenital abnormalities until now?

9-The society provided financial aids for two LPS members, 1500 US $ each, to start innovative projects in Lebanon directed toward:

a- Publication of a Perinatal Medicine Book containing guidelines and instructions to the care of the mother and her offspring by Dr Joseph Haddad, edited by Springerverlag- Paris.

b-Construction of a Database Network for collection of pre and post-natal materno-fetal health predictors from major Lebanese Hospitals covering the District of Greater Beirut region, through a National Collaborative Perinatal-Neonatal Network (NCPNN) directed by Dr Khaled Younis.

April 2000 Dr Robert Sacy was elected as president of the society with six cabinet members Drs Hassan Fakhoury (Vice president), Chebl Mourani(Secretary), Hanane Masri (Treasurer), Ali Fawaz, Ghassan Chehab, Naji Doumit,and Raymond Kamel. The cabinet confronted with several economic and professional challenges from general practitioners, family medicine physicians, and dispensaries leaving pediatricians in an economic crisis. Their mandate extended until October 2002. He and his cabinet fulfilled several achievements:

1-The cabinet could spare money from congresses, conferences and through donations from pharmaceutical companies to rent an independent office for the society with private secretarial services. The LPS cabinet meetings were held in that office until August, 2003 when it moved to its current location at Beit A-Tabib.

2-A Web page and e-mail address for the society were established via a fund from the French Cultural Bureau.

3-The society worked against the odds with several health authorities to improve the professional yields of pediatric practice. After several negotiations with health authorities the Pediatric Society was recognized as a full member in all national children health committees in the Lebanese Ministry of Health, UNICEF (after an agreement with Ambassador Ekrem Birerdink), and WHO (after an agreement with Ambassador Habib Latiri).

4-That period also witnessed the emergence of the first joint publications between UNICEF and Lebanese Pediatricians experts in fields of education, public health, and school medicine etc... available to the public in Arabic, English and French languages and issued under the supervision of the Lebanese Pediatric Society.

5-The Society established itself further as a Ministry of Health consultant regarding major health programs concerning Lebanese children e.g. vaccinations, school medicine, etc..

6-The Society collaborated with the Ministry of Social Affairs, the Higher Council of Children in Lebanon and with her Excellency First Lady Mrs. André Lahoud concerning the Bureau of the Women and Child Rights in Lebanon.

7-During its mandate, the Society was an agile representative of Lebanese Pediatricians internationally. It was an active member in the Bureau de l Association des Pédiatres de Langue Française, Dr Joseph Haddad was elected as a member and later he was elected as a vice-president of that association. Dr Robert Sacy was elected as a treasurer in the UMEMPS, and Dr Mariam Rajab was elected as an executive committee member in the Union of Pan-Arab Pediatric Societies.

8-The Society held a Nutrition and Environment Workshop in February 2000 in collaboration with Beech Nut pharmaceutical, to increase pediatricians and community awareness about impact of environment on infants nutrition.

9 -The Society held the 8th Pan Arab Pediatric Congress and the 3rd LPS congress in November 2000 president by Dr Mariam Rajab.

10-The Society held 33rd Congrès des Pédiatres de Langue Françiase, and the 4th LPS Congress with Dr Carlo Akatcharian as president in April 2002.

11-The Society issued its pediatric bulletin Pediatrica, edited by Dr Ghassan Chehab, describing the different activities of the society and containing medical alerts and articles related to daily pediatric practice.12-The Society published agenda with all addresses, e-mails and professional sub-specialties of all pediatricians affiliated to the Society.

October 2002 Dr Hassan Fakhoury was elected as the president of the society with a six members cabinet Drs. George Hage (Vice president), Salman Mroueh (Secretary), George Aramouni (Treasurer), Ghassan Chehab, Joseph Haddad, Hanane Masri, and Naji Doumit. Their mandate extended until July 2005. He and his cabinet fulfilled several achievements:

1-Six issues of Pediatrica were published during their mandate.
2-Communication with pediatricians working in Mohafazat and their Continued Medical Education was set as a priority issue.

8 workshops in collaboration with Abbott Laboratories were arranged for that purpose:

a. Alimentation de un enfent de 0-3 ans, & Eneuresie de la enfant. Saida, May 2003.

b. Asthme chez la enfant: actualites, & Soufle Cardiaque: quand prendre le avis de un cardiopediatre . Aley-Bhamdoun, June 2003.

c.Infants and Home accidents, Infectious diarrhea, & Retarded growth and use of growth hormone. Jeb Jenin, July 2003.

d.Updates on Periodic disease, Updates on Neonatal Respiratory Distress Syndrome, & Acute Diarrhea. Nabatieh, July 2003.

e.Interventional Pediatric Cardiology, Digestive tract Endoscopy in infants, & Lower Respiratory Tract infections. Zahle-Riyak, August 2003.

f.Obesity in infants, Prevention of bacterial endocarditis, & Asthma in infants. Baalback-Hirmel, September 2003.

g.Nutrition Management in Acute Diarrhea, Management of neonatal hyperbilirubinemia, & Feeding Low Birth Weight Neonates. Chouf, October 2003.

h.Asthma in infants, Neonatology Updates, Chronic diarrhea, & Digestive tract Endoscopy in infants. Tyr, November 2003.
3-Continued the collaboration of LPS with WHO and Ministry of Health.

4-Held an honoring ceremony for Lebanese Pediatricians working in the field for more than 40 years at Beit A-Tabib.

5-Dr Fakhoury succeeded with support of the Arab Societies Executive Committee in introducing a grant from his Excellency Sheikh Hamdan Bin Rashed for the best two young pediatric researchers in the Arab world.

6-LPS participated in the first North Lebanon Pediatric Congress and in the International Pediatric Associations Congress in Mexico in August 2004.

7-Despite the difficult situation following the grave assassination of his Excellency Prime Minister Rafic Hariri in February 14, 2005, Dr Fakhoury and his cabinet worked in a difficult setup to fulfill LPS obligations, and succeeded in convening the joint 12th Pan Arab societies Congress, the 8th Pan Arab Pediatric Gastroenterology & Nutrition Congress, the 5th Pan Arab Child Neurology association Congress and the 5th LPS Congress in Beirut in April, 2005. During that session Dr Fakhoury as president of the Congress, and the rest Arab members agreed to assign a session in forthcoming Pan Arab Congresses addressed for the memory of his Excellency Late Mr Rafic Hariri.

8-The society provided donations of 1500 US $ to each of Dr Joseph Haddad to publish a 2nd issue of his Perinatal Medicine Book, and to Dr Rola Suleiman for a Resident Research Project about the prevalence of positive PPD in Lebanese schools. That paper won the Sheikh Hamdan Bin Rashed Award for the best pediatric research in Arab countries during the 12th Pan Arab Societies Congress in Beirut.

July 2005- April 2008. Dr George Hage was elected as the President of the society with a seven cabinet member’s who were Doctors: Ziad Naja Vice president, Joseph Haddad General Secretary, Imad Chokr Treasurer, Ali Fawaz Clubs Coordinator, George Aramouni, Mohamad Itani, and Jamil Zogheib Executive Committee Members.

During that mandate LPS cabinet fulfilled the following achievements:

1-After its election the new cabinet held a general assembly in February 2006, where the results of questionnaires soliciting the impression of LPS members about the performance of the previous mandates and inspiring future means to solidify the performance of the society were discussed. A consensus to reduce LPS subscription fees from 50,000 LL per year to 30,000 LL was approved during the assembly. In addition a real need was felt to establish an interactive website that can work as link between the executive committee and the rest of LPS members.

2-LPS website became functioning in January 2007 with funds from pharmaceutical companies. It was coordinated by Dr Mohamad Itani and designed with the assistance of Dow group. The remaining funds were used for renovation office furniture of the society and to buy new computer.

3-Two new issues of Pediatrica Online were published during their mandate and posted at LPS website www.lpswebsite.org

4-Communication with pediatricians working in Mohafazat and their Continued Medical Education was set as a priority issue. A series of Mohafazat lectures (1 LOP-CME Credit each) were arranged by the LPS Clubs’ coordinator Dr Ali Fawaz, and in collaboration with Nestlé pharmaceutical company. The lectures were as follow:

a)Dietary factors  modulating the infant’s immune system. Hotel Phoenicia- Beirut  - February, 2006-presented by Dr. Erika Isolauri " Finland. Organized by LPS.

b)Probiotics for infant nutrition - Hotel Phoenicia- Beirut - February, 2006- presented by Dr. F. Rochat. Organized by LPS. 

c)Allergy  Prevention: the role of hydrolysates, probiotics and poly- unsaturated fatty acids. Hotel  Phoenicia- Beiru - April, 2006- presented by Dr. Yvan Vandenplas. Organized by LPS.

d)Pediatrics Update: outcome of neonates at risk- Allergy prevention through nutrition & intervention " Istirahit  Saida- April, 2006. Organized by LPS.

e)Passive smoking/Measles Update- May 2006, Rassoul Aazam Hospital. Organized by Community Ped. Club.

f)Dealing with Adolescent/ Autitussive Medications- March, 2006- Najem Hospital " Tyr. Organized by Community Ped. Club.

g)Management of Asthma in Children Ryaak Hospital " Bekaa- June 2006. Oragnized by Pulmonolgy Club.

h)Anemia/ Thrombocytopenia/ Neutopenia/ Coagulation Disorder/ Allergy Prevention through nutrition- January, 2007- Tripoli. Organized by Hemato-oncology Club.

i)Pediatric Pneumology: Update in Asthma/ Wheezing in Children/ Allergy Prevention through nutrition- May, 2007 " Tal-Chiha Hospital. Organized by Pulmonology Club.

j)Clinical cases in Neonatology " April, 2007 " St. Charles  Hospital. Organized by Neonatology Club.

k)Endocrino-Metabolic Prdiatric Club/ conduite à tenir devant une acidocétose diabétique/ Neonatal presentation of inherited metabolic disorders- May,2007- Ainwzein Hospital. Organized by Endocrinology Club.

l)Imaging of congenital Heart disease / Management by interventional catheterization  in Pediatric cardiology/ Association of cardiac and intestinal malformation- March 2007- Sahel General Hoapital. Organized by Cardiology Club.

5-LPS participation in Local events: LPS had the honor of representing its members in several national events related to child health including:

a)Society Journée  International de l’enfance/ L’enfant maltraité " Decembre 2007 " Hopital Hotel Dieu de France . Organized  by  HDF pediatric department.

b)The VIII Scientific Congress of Makassed General Hospital and the St. George Hospital.

c)The Children of French Doctors event. Organized by the Hotel Dieu Hospital in 27-28-29 - April 2006

d)The National Vaccination Campaign to eradicate Measles and German Measles for all the children in Lebanon aged 9 months through 15 years, Organized by MOH. 

e)The International Scientific Symposium on kidney diseases in children on March 13, 2008.  Dr. Jamil Zogheib presented the LPS in that meeting.

f)Dr George Hage held a joint press conference with LOP president Dr George Aftimos;  in July 12, 2008 explaining the facts about meningococcal outbreaks encountered in Lebanon during spring of 2008. A summary of that conference was posted on LPS website.

6-Financial support of medical research and other scientific projects: The society as part of its mission in promoting research provided financial support for two projects:

a)750$ to support the research project of Dr Amal Naous "  Senior Pediatric Resident at that time at Makassed General Hospital.

b)1000 $ to support the publication of a book about vaccination published in Arabic and can be used as a guide in dispensaries by General Practitioners.

7-LPS during July 2006 Israeli invasion: LPS represented by its president Dr Georges Hage took important initiatives both by providing financial and humanitarian supports to the displaced citizens. A sum of 3000 $ were provided through the LOP, and memos were sent to its members to remind them about their humanitarian responsibilities. Medical care was provided by the pediatricians in the different hospitals.

8-LPS participated in the IPA congress in Athens. Dr Mohamad Itani represented the society on behalf of Dr Hage. The society supported the application of two of its members Dr. Robert Sacy and Dr. Hassan  Fakhoury for the IPA membership post.

9-LPS arranged its 6th Congress April 17-19, 2008 at Beit Al Tabib. Its scientific program was put by the different LPS clubs.

References:

1-Records of Dr Philippe Chédid and remembrance of Dr Antoine Ferjallah.
2-Records of Pediatric Department at the American University Hospital of Beirut.
3-Dr Michel Tabet. Je voudrais vous raconter. Le Journal du Sacré Coeur. Autmne 2003; 2: 1-2.
4-Lebanese Order of Physicians Registry Records.
5-Remembrance of Dr Salim Ferzli and Dr Fuad Atiyeh.
6-Available records at the Lebanese Pediatric Society.
7-Remembrance of Dr Samir Najjar.
8-Remembrance of Dr Paul Haddad.
9-LPS newsletter plus remembrance of Dr Majd Ariss.
10-Minutes of LPS Cabinet meetings plus remembrance of Dr Mariam Rajab.
11-Minutes of LPS Cabinet meetings plus remembrance of Dr Robert Sacy.
12-Minutes of LPS Cabinet meetings plus remembrance of Dr HassanFakhoury.

Acknowledgement:
I would like to acknowledge all the previous LPS presidents for the valuable insight and comments, particularly Dr Samir Najjar for revising the manuscript and Drs Mohamad Mikati and Philippe Chédid (Jr) for provision of important details about Drs Nachman and Chédid records respectively.

Written by MOHAMAD H.ITANI MD

   
 


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