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

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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.”


Hundreds of thousands flee as Israel seizes Rafah in new Gaza ‘security zone’

Updated 03 April 2025
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Hundreds of thousands flee as Israel seizes Rafah in new Gaza ‘security zone’

  • Airstrike kills at least 27 Palestinians, including women and children, inside a school building

GAZA: Hundreds of thousands of fleeing Gazans sought shelter on Thursday in one of the biggest mass displacements of the war, as Israeli forces advanced into the ruins of the city of Rafah, part of a newly announced “security zone” they intend to seize.

A day after declaring their intention to capture large swaths of the crowded enclave, Israeli forces pushed into the city on Gaza’s southern edge, which had served as a last refuge for people fleeing other areas for much of the war.
Gaza’s Health Ministry reported at least 97 people killed in Israeli strikes in the past 24 hours, including at least 20 killed in an airstrike around dawn in Shejaia, a suburb of Gaza City in the north.

FASTFACT

The assault to capture Rafah is a significant escalation in the war, which Israel restarted last month after effectively abandoning a ceasefire in place since January.

Later on Thursday, an Israeli airstrike killed at least 27 Palestinians, including women and children, inside a school building that served as a shelter for displaced families in Gaza City, local health authorities said.
The Israeli military claimed the attack hit key Palestinian “terrorists.”
Medics said three missiles slammed into the Dar Al-Arqam school building in Tuffah neighborhood in Gaza City, and the Israeli military said it struck a command center that militants had used to plan and execute attacks against Israeli civilians and army troops.
Rafah “is gone, it is being wiped out,” a father of seven among the hundreds of thousands who had fled from Rafah to neighboring Khan Younis, said via a chat app.
“They are knocking down what is left standing of houses and property,” said the man.
The assault to capture Rafah is a significant escalation in the war, which Israel restarted last month after effectively abandoning a ceasefire in place since January.
In Shejaia in the north, one of the districts where Israel has ordered the population to leave, hundreds of residents streamed out on Thursday, some carrying their belongings as they walked, others on donkey carts and bikes or in vans.
“I want to die. Let them kill us and free us from this life. We’re not living, we’re dead,” said Umm Aaed Bardaa.
In Khan Younis, where a strike killed several people, Adel Abu Fakher was checking the damage to his tent: “There’s nothing left for us. We’re being killed while asleep,” he said.
Israel has not spelled out its long-term aims for the security zone its troops are now seizing.
Prime Minister Benjamin Netanyahu said troops were taking an area he called the “Morag Axis,” a reference to an abandoned former Israeli settlement between Rafah and Khan Younis.
Gazans who had returned to homes in the ruins during the ceasefire have now been ordered to flee communities on the northern and southern edges of the strip.
They fear Israel intends to depopulate those areas indefinitely, leaving many hundreds of thousands of people permanently homeless while Israel seizes some of Gaza’s last agricultural land and critical water infrastructure.
Since the first phase of the ceasefire expired at the start of March with no agreement to prolong it, Israel has imposed a total blockade on all goods for Gaza’s 2.3 million residents, recreating what international organizations call a humanitarian catastrophe.
Israel’s military said on Thursday it was investigating the deaths of 15 Palestinian aid workers found buried in a shallow grave in March near Red Crescent vehicles, an incident that caused global alarm.
The military said troops fired on the cars, believing they carried fighters.
Israel’s stated goal since the start of the war has been the destruction of the Hamas militant group, which ran Gaza for nearly two decades.
But with no effort made to establish an alternative administration, Hamas returned to control during the ceasefire.
Fighters still hold 59 dead and living hostages Israel says must be handed over to extend the truce temporarily; Hamas says it will free them only under a deal that permanently ends the war.
Israeli leaders say they have been encouraged by signs of protest in Gaza against Hamas, with hundreds of people demonstrating in north Gaza’s Beit Lahiya on Wednesday. Hamas calls the protesters collaborators and says Israel is behind them.
The war began with an attack on Israeli communities on Oct. 7, 2023 with gunmen taking more than 250 hostages, according to Israeli tallies.
Israel’s campaign has so far killed more than 50,000 Palestinians, Gaza health authorities say.
Rafah residents said most of the local population had followed Israel’s order to leave as Israeli strikes toppled buildings there.
However, a strike on the main road between Khan Younis and Rafah stopped most movement between the cities.
The movement of people and traffic along the western coastal road near Morag was also limited by bombardment.
“Others stayed because they don’t know where to go, or got fed up of being displaced several times. We are afraid they might be killed or at best detained,” said Basem, a resident of Rafah who declined to give a second name.

 


Lebanese leaders reach consensus on border demarcation to present to US envoy

Updated 03 April 2025
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Lebanese leaders reach consensus on border demarcation to present to US envoy

  • President Aoun tells top military officers: Lebanon’s interests are above everything else
  • Joseph Aoun: It is the state that protects Lebanon, not its sects

BEIRUT: Lebanese leaders have reached a unified position on border demarcation to present to Morgan Ortagus, the US envoy, who is scheduled to arrive in Beirut before the end of the week.

President Joseph Aoun, Parliament Speaker Nabih Berri, and Prime Minister Nawaf Salam, agreed that there “will be no negotiations with the Israeli side regarding (a) prisoner swap or withdrawal from the Lebanese hills still occupied by the Israeli Army,” a source in the government told Arab News on Thursday.

“However, Lebanon is open to discussing disputed land border points,” the source added.

“Regardless of the US envoy’s proposals, the Lebanese stance remains unchanged,” said the source, who clarified that the Lebanese Army “is fulfilling its duties by being deployed south of the Litani River and confiscating weapons in the border area, as acknowledged by the US side overseeing the ceasefire monitoring committee and the UNIFIL forces.”

The source said that the military had made significant progress on the issue, destroying weapons and ammunition seized from Hezbollah sites.

Aoun told top security officials on Thursday that Lebanon’s interests comes above anything else.

He was speaking during a visit to the leadership of the Internal Security Forces and the General Security Directorate.

“We have a great opportunity to seize at all levels, and we must show the people that we are mature enough to build the state and that we will build it,” he said.

The president called on security bodies to “remain unaffiliated with anyone, serve only Lebanon’s interests, and enforce the law,” noting that “the world is ready to help us, but we must first help ourselves.”

Aoun stated: “Lebanon’s interest comes above anything else. It is the state that protects Lebanon, not its sects. Parties and sects prioritize their interests, whereas your duty is to serve Lebanon.

“You must reject any demands or interference that might harm the nation’s interests and prompt people to respect the law, keeping in mind that no request outside the law will be tolerated.”

Also on Thursday, Maronite Patriarch Bechara Al-Rahi, the highest Maronite religious authority in Lebanon, said the time “has come to unify weapons in Lebanon, as stipulated in the Taif Agreement.”

He also told the Lebanese Editors Syndicate that the military “needs strengthening and support from other nations, but the solution now is diplomatic, as we are incapable of engaging in war, and no one can confront Israel.

“What has the resistance achieved with all its weapons against the Israeli war machine,” he asked, adding “now is not the time for normalization with Israel, as there are other issues that must be addressed first, such as border demarcation and disarmament.”

Israeli Defense Minister Israel Katz said Israel would not withdraw from the five positions it controls in Lebanon.

He was speaking during a visit to an Israeli military site in southern Lebanon — one of the five hills still occupied since the ceasefire declaration in November.

At the site, which is near the Israeli settlement of Margaliot, Katz stated Israel’s presence at the five locations will be determined not by time but by the situation on the ground.

“Only if Hezbollah disarms and withdraws from the border can we discuss the withdrawal of the Israeli Army from these positions, and this matter is being coordinated with the Americans,” he said.

Katz anticipated “an increase in activity among Palestinian organizations, including Hamas, in Lebanon and Syria.”

He stated: “We are working to prevent the arming of Hezbollah and Palestinian organizations. The challenge will begin and intensify.”

Katz claimed that Hezbollah “is not a protector of Lebanon.”

He added: “The Iranians now realize that it is no longer capable of defending them.”

Elsewhere, an Israeli drone targeted a vehicle on the main road between Bint Jbeil and Yaroun in the border area.

The drone struck the vehicle from behind, resulting in two injuries, the Lebanese Ministry of Health said.

The Israeli military conducted airstrikes around Naqoura and one strike in the town’s center, targeting pre-fabricated homes as replacements for the destroyed houses and facilities.

These pre-fabricated facilities were being used to meet citizens’ needs, serving as a substitute for the municipal building, destroyed by Israel following the ceasefire, said Naqoura Mayor Abbas Awada.

He highlighted that recent aggression occurring in proximity to UNIFIL headquarters falls “under the jurisdiction of the five-member ceasefire monitoring committee and UNIFIL forces.”

Hezbollah’s Islamic Health Authority reported that Israeli strikes destroyed a “newly established civil defense center and damaged ambulances and firefighting vehicles.”

Meanwhile, the Lebanese Armed Forces have taken proactive measures, with military units removing “engineering obstacles placed by Israeli forces inside Lebanese territory” near Al-Labouna in the Tyre region.

The military also closed an unauthorized dirt road created by Israeli units in the same area.

In an official statement, the Lebanese Army Command affirmed its ongoing commitment to “addressing Israeli violations through close coordination with the ceasefire monitoring mechanism and UNIFIL.”

The Army Command condemned Israel’s “persistent violations of Lebanese sovereignty and targeting of civilians across multiple regions.”

In another development, UNIFIL Western Sector Commander Gen. Nicola Mandolisi conducted his first meeting with Khirbet Selem Mayor Mohammed Rahhal.

Their joint statement highlighted “UNIFIL’s commitment to facilitating the safe return of displaced residents and supporting Lebanese military operations through strategic partnerships with the Fifth Brigade and the Second and Fifth Rapid Intervention Regiments, key components in regional stabilization efforts.”


South Sudan clashes kill 30: local official

Updated 03 April 2025
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South Sudan clashes kill 30: local official

  • The attack in northern Ruweng Administrative Area began earlier in the week
  • Local media reported that some of those killed were members of the armed groups

JUBA: At least 30 people were killed when a northern South Sudanese town was briefly overrun by an armed youth group, a local official said Thursday, following a cattle raid.
Clashes involving pastoralists and settled farming communities are common in the world’s youngest country, but this incident comes as tensions rise over South Sudan’s fragile political situation.
The attack in northern Ruweng Administrative Area began earlier in the week when a group of armed youth stole lambs before they were scared off by security forces, said Simon Chol Mialith, the local Minister of Information.
The following day, he told AFP, the group returned in greater numbers and attacked Abiemnom, and although “the youth and the security forces tried to defend the town, they were overrun by the Mayom armed youth.”
On Wednesday the South Sudan People’s Defense Force (SSPDF) drove the group from the settlement, Mialith said, where calm has now been restored.
“The number has risen to 30 people confirmed dead and over 40 persons wounded,” he said, without giving further details.
Local media reported that some of those killed were members of the armed groups, but AFP was unable to confirm this.
The incident comes as forces allied to President Salva Kiir and First Vice President Riek Machar clash across the country, sparking regional concern and threatening a fragile peace deal in 2018 that ended a five-year civil war.
South Sudan has been bedevilled by instability and insecurity since independence in 2011, and despite its natural oil resources remains deeply impoverished.


Palestinian Authority calls on Hungary to arrest Netanyahu

Updated 03 April 2025
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Palestinian Authority calls on Hungary to arrest Netanyahu

  • The governing body of the International Criminal Court voiced regret and concern over Hungary’s announcement that it was leaving the court, saying any departure harmed a “shared quest for justice”

RAMALLAH: The Palestinian Authority has urged Hungary to arrest visiting Israeli Prime Minister Benjamin Netanyahu under an International Criminal Court warrant over alleged war crimes in the Gaza Strip.
“The ministry calls on the Hungarian government ... to comply with the International Criminal Court’s arrest warrant by immediately handing Netanyahu over to bring him to justice,” the Ramallah-based Foreign Affairs Ministry said in a statement hours after Hungary announced it would withdraw from the ICC.
The governing body of the International Criminal Court voiced regret and concern over Hungary’s announcement that it was leaving the court, saying any departure harmed a “shared quest for justice.”
“When a state party withdraws from the Rome Statute (that established the ICC), it clouds our shared quest for justice and weakens our resolve to fight impunity,” the presidency of the Assembly of State Parties said in a statement.
The court is “at the center of the global commitment to accountability,” and the international community should “support it without reservation,” the statement added.
“Justice requires our unity.”
The governing body also extended an olive branch to Hungary, which earlier Thursday announced it was starting the one-year process to withdraw from the ICC.
Every court member “has the right to voice its concerns before the Assembly,” it said.
“The presidency strongly encourages Hungary to have a meaningful discussion on this issue.”
In the meantime, the body urged Hungary to “continue to be a resolute party to the Rome Statute.”
Budapest said it was quitting the ICC just as Prime Minister Viktor Orban hosted Netanyahu.

 


Israeli military says it holds special probe into Gaza aid worker deaths

Updated 03 April 2025
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Israeli military says it holds special probe into Gaza aid worker deaths

  • The military’s Southern Command had transferred the investigation to a general staff mechanism outside the chain of command
  • Israel has not directly addressed the accusation that its forces deliberately killed health workers

JERUSALEM: The Israeli military is conducting an investigation into an incident in Gaza in which a number of emergency and aid workers were killed, a military spokesperson said on Thursday, rejecting a description of the incident as an “execution.”
Lt. Col. Nadav Shoshani said the military’s Southern Command had transferred the investigation to a general staff mechanism outside the chain of command to establish what happened and “hold accountable people if we need to.”
Last month, the bodies of 15 workers from the Red Crescent, Palestinian Civil Defense and United Nations were found buried in a shallow grave at the southern end of the Gaza Strip, close to their wrecked vehicles.
Israel has not directly addressed the accusation that its forces deliberately killed health workers but the military has described an incident on March 23, when it said its troops fired on vehicles bearing Red Crescent markings near Rafah, killing nine members of militant groups.
“Our initial investigation found that there were terrorists in these cars, using those Red Crescent cars,” Shoshani told a briefing with journalists.
Asked how the troops knew that there were militants in the cars, he said: “It is based on different ways of intelligence and also based on the information gathered on the ground at the time of the event.”
He said troops later also fired on other unmarked vehicles that approached without emergency lights or prior coordination.
“I can’t go into the reasoning and what they did because this is under investigation,” Shoshani said. “We will investigate this incident and once we have the answers, we’ll put them out clearly and communicate everything we know and everything we’ve found,” he said.
The Palestinian Red Crescent, which said eight of its staff had been killed in the incident, said Israel had targeted the group and called for those responsible to be held accountable.
The medical team had been sent into Rafah as Israeli forces were advancing into the area after resuming operations in Gaza on March 18, following a two month-long truce, UN officials have said.
When the bodies were found, they were still in their medical uniforms and wearing gloves.
UN aid chief Tom Fletcher said the people had been killed by Israeli forces and demanded “answers and justice.”
Shoshani denied reports that some bodies in the grave had been found with hands tied, and rejected the term “execution” to describe what happened during what he called “an operational event.”
“Not an execution,” he said.