Lebanon’s health system on life support as economic woes worsen

Lebanon’s crashing economy has piled pressure on hospitals, leaving them increasingly ill-equipped to face any new wave of COVID-19, with a decreasing supply of both medicines and skilled workers. (AFP)
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Updated 17 August 2021
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Lebanon’s health system on life support as economic woes worsen

  • Explosion’s adverse impact continues to be felt by nation’s medical professionals and patients alike
  • Health system creaks under the weight of medical supply shortages, COVID-19 and brain drain

DUBAI: Last August, millions around the world watched in horror as footage of the devastating Beirut port blast looped on TV channels and social-media feeds for days. For residents of the Lebanese capital, that month was like no other in recent memory.

Within hours of the explosion on Aug. 4, people began to pour into the city’s hospitals with all kinds of trauma, disfiguring burns and wounds caused by flying glass and masonry. But then, Beirut’s public-health infrastructure itself was one of the biggest casualties.

According to a World Health Organization assessment, four hospitals were heavily affected and 20 primary care facilities, serving approximately 160,000 patients, were either damaged or destroyed.

A year on, as Lebanon reels from the combined impact of economic chaos, medicine shortages, power cuts and repeated COVID-19 waves, the nation’s health system is on life support.

Furthermore, medical professionals report that they are not receiving sufficient protection while on duty as their workplaces lack the medical gear and the protocols necessary for dealing with the highly transmissible delta variant of COVID-19.

“The health situation in Lebanon is really dire,” Rabih Torbay, president and CEO of US-based humanitarian aid agency Project HOPE, told Arab News.




Lebanon reels from the combined impact of economic chaos, medicine shortages, power cuts and repeated COVID-19 waves. (AFP)

“It is a combination of the lack of electricity in hospitals, a lack of fuel for generators in hospitals and beyond, a lack of medicine for hospitals and clinics, the currency losing 90 percent of its value, doctors and nurses leaving and a rise in the number of COVID-19 infections.”

Lebanon took another jolt last week when the Central Bank announced that fuel subsidies had been halted. Already, according to CNN, many factories, including one that supplies the majority of Lebanon's intravenous lines to hospitals, have closed because of long power outages.

Nivine Bou Chakra, whose grandmother takes Nebilet for hypertension, said they have had to ration the stock of drugs they were able to buy last year. “You can’t find it now. And if you do, it’s expensive,” she told Arab News.

Bou Chakra’s father has run his own dental practice for more than 20 years. Many of his patients only visit if they have an emergency, “such as inflammation from an infected tooth,” she said.

“Since they can’t find antibiotics, they come to the dentist to take the tooth out. They do that because they can’t afford the alternative: Proper treatment.”

According to Ingrid Antonios, who is doing her residency at the anesthesiology and critical care department of the Hotel-Dieu de France hospital in Beirut, doctors and nurses are having to resort to cheaper, locally produced alternatives to imported drugs.

“A lot of products were, and still are, not available in the country for various reasons. From very basic stuff, such as painkillers and proton-pump inhibitors, to more specific medications for cancer, hypertension, diabetes and antibiotics,” she said.

Tony Noujaim, a master’s student, said it has become increasingly difficult to find diabetes and cholesterol medications for his father and aunt.

“We haven’t had the need to get them from across the border, at least not yet. But getting them involves a pharmacy treasure hunt in the north. Basically, we go from pharmacy to pharmacy until we eventually find what is a pretty basic and standard medicine,” Noujaim told Arab News.

And it is not just the people of Beirut who are struggling. About 19.5 percent of Lebanon’s population of 7 million are refugees from neighboring countries. Already living precariously in impoverished communities, few of them have the means or the connections to obtain vital medications at a time of scarcity.

It is hard to believe now that Lebanon’s health sector was in much better shape not so long ago, attracting patients from across the Middle East. But conditions began to deteriorate with the onset of the financial crisis in late 2019.

At the time, the New York-based Human Rights Watch warned that health professionals were struggling to meet the needs of their patients owing to the “government’s failure to reimburse private and public hospitals, including funds owed by the National Social Security Fund and military health funds, making it difficult to pay staff and purchase medical supplies.”

The steady depletion of foreign-currency reserves has made it difficult for Lebanese traders to import essential goods and “led banks to curtail credit lines” — a disaster for a nation that depends so heavily on imports.

“Lebanon imports 80 percent of its products — most of the country’s oil, medicine, meat, grain and other supplies come from abroad,” according to a report by Christian aid agency ACT Alliance.

“The pharmaceutical crisis has deepened in Lebanon as the central bank is unable to meet the cost of subsidized medicines.”




According to a World Health Organization assessment, four hospitals were heavily affected and 20 primary care facilities, serving approximately 160,000 patients, were either damaged or destroyed during the port explosion. (AFP)

The drastic devaluation of the currency has also made health insurance unaffordable for many Lebanese. “A challenge I faced at work was when a lady in her forties suffering from advanced cancer came to the emergency department in a critical condition following a severe infection,” Antonios, of the Hotel-Dieu de France hospital, told Arab News.

“She required admission to an intensive care unit, but she and her husband couldn’t afford to pay for admission. She had to be transferred to another hospital in a very unstable condition, which could have been life threatening.”

Amid Lebanon’s overlapping crises, electricity shortages have forced hospitals to rely on private generators to keep the lights on and their life-sustaining equipment functioning. But generators run on fuel, which is also now in short supply.

The American University of Beirut (AUB) Medical Center gave warning last week that its patients were in imminent danger owing to the fuel shortage.

“This means ventilators and other lifesaving medical devices will cease to operate. Forty adult patients and 15 children living on respirators will die immediately,” the AUB said in a statement.

Water has also become a finite commodity because of prolonged mismanagement, infrastructure decay and the unmet energy needs of pumping stations and treatment plants.




“The pharmaceutical crisis has deepened in Lebanon as the central bank is unable to meet the cost of subsidized medicines,” according to a report by Christian aid agency ACT Alliance. (AFP)

“A lot of the pumps are no longer in a position to supply water to homes, yet people can’t afford to buy bottled water,” said Torbay.

“It’s not just the lack of water. With lack of water comes infection outbreaks, diarrheal diseases and hygiene-related issues.”

Watching the health system beset by a lengthening list of problems, many medical professionals have made the difficult decision to leave the country. The trend started with the onset of the economic crisis and has only accelerated since the Beirut blast.

Amani Mereby, a Ph.D. candidate, said her physician now spends more time working in France, despite being in high demand in Lebanon.

“Because of the economic crisis, my physician, who was very successful in Lebanon, is having to divide his time between here and France,” she said. “The only reason he visits Lebanon once every two months is because he wants to help his patients.”




“A lot of products were, and still are, not available in the country for various reasons,” said Ingrid Antonios, who is doing her residency at the Hotel-Dieu de France hospital in Beirut. (AFP)

Among those who have been heading for the exits are colleagues of Antonios at the Hotel-Dieu de France hospital. “A large number of medical staff are leaving the country, from medical doctors to nurses, but also students,” he said. “It’s not just young people at the beginning of their careers. A lot of people in their thirties, forties and fifties are finding a way out where possible.”

For many, the reasons for departure are a mix of financial and emotional. “They can’t survive on the salaries they get paid,” said Torbay. “It’s also extremely difficult for a doctor or a nurse to take on a patient and not be able to heal them or give them the medicine they need.”

To many among the millions currently scraping by on their meager incomes, the remedy for Lebanon’s health system maladies lies either at the ballot box or the streets. They hold the same political elites blamed for the country’s deepening governance crisis, responsible for the unfolding health disaster.

“My friends call me delusional, but I have some hope,” Noujaim told Arab News. “After the Oct. 17, 2019, revolution, there was a huge political awakening in the country. My hope is confined to the next election.”


15 Turkish-backed fighters killed in north Syria clashes with Kurdish-led forces

Updated 6 sec ago
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15 Turkish-backed fighters killed in north Syria clashes with Kurdish-led forces

BEIRUT: At least 15 Ankara-backed Syrian fighters were killed Sunday after Kurdish-led forces infiltrated their territory in the country’s north, the Syrian Observatory for Human Rights war monitor said.
Fighters from the Syrian Democratic Forces (SDF), who controls swathes of the country’s northeast, “infiltrated positions of the Turkish-backed” fighters in the Aleppo countryside, said the Observatory, which has a network of sources inside Syria.
“The two sides engaged in violent clashes” that killed 15 of the Ankara-backed fighters, the monitor said.
An AFP correspondent in Syria’s north said the clashes had taken place near the city of Al-Bab, where authorities said schools would be suspended on Monday due to the violence.
The SDF is a US-backed force that spearheaded the fighting against the Daesh group in its last Syria strongholds before its territorial defeat in 2019.
It is dominated by the Kurdish People’s Protection Units (YPG), viewed by Ankara as an offshoot of the outlawed Kurdistan Workers’ Party (PKK) which claimed the attack on Ankara.
Turkish troops and allied rebel factions control swathes of northern Syria following successive cross-border offensives since 2016, most of them targeting the SDF.


Israel moving towards a ceasefire deal in Lebanon, Axios reports

Updated 16 min 2 sec ago
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Israel moving towards a ceasefire deal in Lebanon, Axios reports

BEIRUT: Israel is moving towards a ceasefire agreement in Lebanon with the Hezbollah militant group, Axios reporter Barak Ravid posted on X on Sunday, citing a senior Israeli official.
A separate report from Israel's public broadcaster Kan, citing an Israeli official, said there was no green light given on an agreement in Lebanon, with issues still yet to be resolved.

 


Russia plane evacuated in Turkiye as engine catches fire

Updated 25 min 13 sec ago
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Russia plane evacuated in Turkiye as engine catches fire

  • “Eighty nine passengers and six crew members on board were safely evacuated at 9:43 p.m. (1843 GMT) and there were no injuries”

ISTANBUL: More than 90 passengers and crew were evacuated from a Russian plane Sunday after one of its engines caught fire while landing at an airport in southern Turkiye, the transport ministry said.
The incident involved a Sukhoi Superjet 100 (SU95) operated by Russia’s Azimuth Airlines.
They plane had just landed at Antalya airport on Turkiye’s Mediterranean coast when a fire broke out in one of its engines, a ministry statement said.
“A SU95 type and RA89085-registered aircraft of Azimuth Airlines traveling from Sochi airport in Russia to Antalya airport had an engine fire during landing,” it said.
“Eighty nine passengers and six crew members on board were safely evacuated at 9:43 p.m. (1843 GMT) and there were no injuries.”
All further scheduled landings at the airport would be canceled until 3:00 am, it added, saying other planes waiting to depart would use the airport’s military runway for takeoff.
An airport official told Anadolou state news agency that the fire had affected its left engine but had been quickly extinguished.

 


War-hit Lebanon suspends in-person classes in Beirut area til end of December

Smoke billows over Beirut’s southern suburbs after an Israeli strike, seen from Baabda.
Updated 25 November 2024
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War-hit Lebanon suspends in-person classes in Beirut area til end of December

  • Education minister announced “the suspension of in-person teaching” in schools, technical institutes and private higher education institutions in Beirut
  • Suspension of in-person teaching also applies to parts of neighboring Metn, Baabda and Shouf districts starting Monday

BEIRUT: Lebanon has suspended in-person classes in the Beirut area until the end of December, the education ministry announced Sunday, citing safety concerns after a series of Israeli air strikes this week.
Education Minister Abbas Halabi announced in a statement “the suspension of in-person teaching” in schools, technical institutes and private higher education institutions in Beirut and parts of the neighboring Metn, Baabda and Shouf districts starting Monday “for the safety of students, educational institutions and parents, in light of the current dangerous conditions.”
Earlier on Sunday, Lebanese state media reported two Israeli strikes on Beirut’s southern suburbs, about an hour after the Israeli military posted evacuation calls online for parts of the Hezbollah bastion.
“Israeli warplanes launched two violent strikes on Beirut’s southern suburbs in the Kafaat area,” the official National News Agency said.
The southern Beirut area has been repeatedly struck since September 23 when Israel intensified its air campaign also targeting Hezbollah bastions in Lebanon’s east and south. It later sent in ground troops to southern Lebanon.


Legal threats close in on Israel’s Netanyahu, could impact ongoing wars   

Updated 24 November 2024
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Legal threats close in on Israel’s Netanyahu, could impact ongoing wars   

  • The trial opened in 2020 and Netanyahu is finally scheduled to take the stand next month after the court rejected his latest request to delay testimony on the grounds that he had been too busy overseeing the war to prepare his defense

JERUSALEM: Prime Minister Benjamin Netanyahu faces legal perils at home and abroad that point to a turbulent future for the Israeli leader and could influence the wars in Gaza and Lebanon, analysts and officials say. The International Criminal Court (ICC) stunned Israel on Thursday by issuing arrest warrants for Netanyahu and his former defense chief Yoav Gallant for alleged war crimes and crimes against humanity in the 13-month-old Gaza conflict. The bombshell came less than two weeks before Netanyahu is due to testify in a corruption trial that has dogged him for years and could end his political career if he is found guilty. He has denied any wrongdoing. While the domestic bribery trial has polarized public opinion, the prime minister has received widespread support from across the political spectrum following the ICC move, giving him a boost in troubled times.
Netanyahu has denounced the court’s decision as antisemitic and denied charges that he and Gallant targeted Gazan civilians and deliberately starved them.
“Israelis get really annoyed if they think the world is against them and rally around their leader, even if he has faced a lot of criticism,” said Yonatan Freeman, an international relations expert at the Hebrew University of Jerusalem.
“So anyone expecting that the ICC ruling will end this government, and what they see as a flawed (war) policy, is going to get the opposite,” he added.
A senior diplomat said one initial consequence was that Israel might be less likely to reach a rapid ceasefire with Hezbollah in Lebanon or secure a deal to bring back hostages still held by Hamas in Gaza.
“This terrible decision has ... badly harmed the chances of a deal in Lebanon and future negotiations on the issue of the hostages,” said Ofir Akunis, Israel’s consul general in New York.
“Terrible damage has been done because these organizations like Hezbollah and Hamas ... have received backing from the ICC and thus they are likely to make the price higher because they have the support of the ICC,” he told Reuters.
While Hamas welcomed the ICC decision, there has been no indication that either it or Hezbollah see this as a chance to put pressure on Israel, which has inflicted huge losses on both groups over the past year, as well as on civilian populations.

IN THE DOCK The ICC warrants highlight the disconnect between the way the war is viewed here and how it is seen by many abroad, with Israelis focused on their own losses and convinced the nation’s army has sought to minimize civilian casualties.
Michael Oren, a former Israeli ambassador to the United States, said the ICC move would likely harden resolve and give the war cabinet license to hit Gaza and Lebanon harder still.
“There’s a strong strand of Israeli feeling that runs deep, which says ‘if we’re being condemned for what we are doing, we might just as well go full gas’,” he told Reuters.
While Netanyahu has received wide support at home over the ICC action, the same is not true of the domestic graft case, where he is accused of bribery, breach of trust and fraud.
The trial opened in 2020 and Netanyahu is finally scheduled to take the stand next month after the court rejected his latest request to delay testimony on the grounds that he had been too busy overseeing the war to prepare his defense.
He was due to give evidence last year but the date was put back because of the war. His critics have accused him of prolonging the Gaza conflict to delay judgment day and remain in power, which he denies. Always a divisive figure in Israel, public trust in Netanyahu fell sharply in the wake of the Oct. 7, 2023 Hamas assault on southern Israel that caught his government off guard, cost around 1,200 lives.
Israel’s subsequent campaign has killed more than 44,000 people and displaced nearly all Gaza’s population at least once, triggering a humanitarian catastrophe, according to Gaza officials.
The prime minister has refused advice from the state attorney general to set up an independent commission into what went wrong and Israel’s subsequent conduct of the war.
He is instead looking to establish an inquiry made up only of politicians, which critics say would not provide the sort of accountability demanded by the ICC.
Popular Israeli daily Yedioth Ahronoth said the failure to order an independent investigation had prodded the ICC into action. “Netanyahu preferred to take the risk of arrest warrants, just as long as he did not have to form such a commission,” it wrote on Friday.

ARREST THREAT The prime minister faces a difficult future living under the shadow of an ICC warrant, joining the ranks of only a few leaders to have suffered similar humiliation, including Libya’s Muammar Qaddafi and Serbia’s Slobodan Milosevic.
It also means he risks arrest if he travels to any of the court’s 124 signatory states, including most of Europe.
One place he can safely visit is the United States, which is not a member of the ICC, and Israeli leaders hope US President-elect Donald Trump will bring pressure to bear by imposing sanctions on ICC officials.
Mike Waltz, Trump’s nominee for national security adviser, has already promised tough action: “You can expect a strong response to the antisemitic bias of the ICC & UN come January,” he wrote on X on Friday. In the meantime, Israeli officials are talking to their counterparts in Western capitals, urging them to ignore the arrest warrants, as Hungary has already promised to do.
However, the charges are not going to disappear soon, if at all, meaning fellow leaders will be increasingly reluctant to have relations with Netanyahu, said Yuval Shany, a senior fellow at the Israel Democracy Institute.
“In a very direct sense, there is going to be more isolation for the Israeli state going forward,” he told Reuters.