Psychological Distress, Fatigue, and Post‐Traumatic Stress Disorder Among Medical Staff Facing the Acute Watery Diarrhea Outbreak in Syria, Difficulties and Solutions: A Mixed‐Methods Study

Background: Cholera continues to be a significant public health threat, particularly in underserved regions with overcrowding and poor sanitation. The 2022-2023 cholera outbreak in Syria, particularly in Aleppo, overwhelmed medical staff, who faced extreme stress, extended work hours, and department closures. This cross-sectional study examines the association between this outbreak and the psychological distress, fatigue, and post-traumatic stress disorder (PTSD) experienced by healthcare workers. Methods: This cross-sectional study, conducted at Aleppo University Hospital between September 20 and October 20, 2022, adhered to STROBE guidelines. A total of 75 healthcare providers voluntarily participated by completing a structured questionnaire that assessed socio-demographic data and utilized standardized instruments to measure psychological distress, fatigue, and PTSD symptoms. In addition, qualitative data were collected to explore the challenges faced by healthcare workers during the outbreak and to gather their suggestions for better management in the future. Results: = 6) of participants indicating PTSD according to the PCL-5 questionnaire. Notably, the majority of medical staff perceived the cholera outbreak as less severe or more manageable compared to the COVID-19 pandemic. However, a smaller number acknowledged that learning from the previous pandemic conditions mitigated the impact of the cholera outbreak. In terms of challenges faced, inadequate hospital resources and medical staffing were frequently cited, alongside gaps in patient awareness regarding the seriousness of the disease. Suggested solutions emphasized the need for better resource allocation, focused medical staff training, and enhanced hygiene awareness campaigns. Conclusion: The cholera outbreak in Syria has exerted significant psychological and physical strain on medical staff, underscoring the urgent need for targeted interventions to support their mental health and well-being. Addressing these challenges is vital for sustaining an effective healthcare response during current and future public health crises.