How political dysfunction precipitated Lebanon’s healthcare collapse

The damaged Wardieh hospital is pictured in the aftermath of the Beirut blast that tore through Lebanon's capital in August, 2020. (AFP/File Photo)
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Updated 20 February 2022
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How political dysfunction precipitated Lebanon’s healthcare collapse

  • Study says sector is in decay thanks to the problems that led to the 2019 economic collapse
  • International aid community needs to be incentivized to pour resources into the health system

LONDON: Lebanon’s health system is in a precarious state following wave upon wave of political and economic crisis. As the country reels from medical supply shortages, COVID-19 case surges and an exodus of skilled medical professionals, the urgency of the sector’s need for outside help is no longer a matter of debate.

In most countries, it might seem reasonable to look to the government to implement reforms to rescue the health system from collapse. But in Lebanon, where it is arguably politics itself that is making the nation sick, the embattled state is unlikely to offer solutions.

A new study led by King’s College London and the American University of Beirut suggests Lebanon’s health system is in decline thanks in large part to the same disastrous political decisions and systemic problems that led to the country’s 2019 economic collapse.

The study, “How politics made a nation sick,” conducted by the Research for Health in Conflict–MENA project (R4HC-MENA), shows how a series of politically driven disasters has created a crisis state that is unprepared to deal with a deepening public-health emergency.

Dr. Adam Coutts, one of the R4HC-MENA project leads, describes the health situation in Lebanon as “a slow moving trainwreck, which sped up in the pre-pandemic period when the economy collapsed in 2019.”

Ever since the end of Lebanon’s civil war in 1990, sectarianism, clientelism and corruption have dominated political life and driven the country into successive bouts of unrest and instability.

Corruption, hyperinflation and the 2019 banking sector collapse have plunged Lebanon into the worst economic crisis in its modern history. The arrival of millions of refugees from neighboring Syria has only compounded the strain on its creaking infrastructure.

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.




Protesting pharmacists (above) hold signs saying “no gasoline = no ambulance,” denouncing the critical condition facing the country’s hospitals while grappling with dire fuel shortages. (AFP)

Meanwhile, the drastic devaluation of the currency has made health insurance unaffordable for many Lebanese.

“The social and economic situation in Lebanon right now is dire,” said Dr. Coutts. “We have been working on health, economic and social issues in Lebanon for ten years and have never seen it this bad.”

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

Furthermore, patients have been left struggling to access appointments and surgeries as medical staff flee the country in droves.

According to the R4HC-MENA study, about 400 doctors and 500 nurses out of the country’s 15,000 registered doctors and 16,800 registered nurses have emigrated since the onset of the crisis.

To make matters worse, Lebanon’s chronic 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 perennially in short supply.

Despite the severity of the health care emergency, the Lebanese government has been unable to respond, lacking both the financial means and the willpower amid a multitude of overlapping crises.

“Health always seems to be viewed as the poor relation in development and early recovery compared to economic stabilization, education and security,” said Dr. Coutts. “The problem is if we continue to neglect health and health systems this leads to even bigger problems in the future.”

The COVID-19 pandemic arrived at the worst possible moment for Lebanon, further exposing the health system’s weakness and placing additional strain on the country’s battered economy.




A combination of images showing shuttered doors of pharmacies in Lebanon during a nationwide strike to protest against a severe shortage of medicine during 2021. (AFP/File Photo)

“As the COVID-19 pandemic shows, if you neglect health systems you cannot respond to health emergencies,” Dr. Coutts said. “Health is a top concern among people. It’s the street-level issue which affects everything in people’s day-to-day lives. Development needs to be about lives and livelihoods.”

While COVID-19 infections are currently falling in Lebanon, successive waves of the virus have exacted a devastating toll on Lebanon’s health system. In December 2020, for instance, about 200 doctors who lacked sufficient protective equipment to avoid infection were placed in quarantine.

The R4HC-MENA study found that successive peaks of the virus overwhelmed hospital capacity and resources, exacerbating shortage of staff, to say nothing of equipment such as ventilators and pharmaceuticals.

“Many private hospitals were reluctant to undertake COVID-19 care for fear of ‘losing’ income from more lucrative services, losing their physician and nursing staff, and lack of trust that they would actually be reimbursed by the government,” Dr. Fouad M. Fouad, R4HC-MENA project lead in Beirut, told Arab News.

Just when it seemed things could not get any worse for Lebanon’s health sector, the Beirut port blast of Aug. 4, 2020 leveled a whole city district.




The damaged Saint George hospital (left) in Beirut more than a week after the port blast of Aug. 4, 2020. Some 43,000 Lebanese emigrated in the first 12 days after the explosion, including skilled workers such as medical staff. (AFP/File Photo)

More than 220 people were killed in the blast, about 7,000 injured, and some 300,000 left homeless. Within hours of the explosion, people began to pour into the city’s hospitals with all kinds of trauma, disfiguring burns and wounds caused by flying glass and masonry.

However, the blast also shattered the city’s health infrastructure. According to a WHO assessment, four hospitals were heavily affected and 20 primary care facilities, serving about 160,000 patients, were either damaged or destroyed.

“The explosion generated multiple health and rehabilitation needs among survivors,” Rasha Kaloti, research associate on the R4HC-MENA project, told Arab News.

“It also caused many patients to miss routine care for a variety of conditions, including critical care therapy such as cancer treatments, with many having to move to other hospitals, which led to delays and a lack of continuity of care.”




Doctors have warned that Lebanon is losing its best and brightest medical staff amid the crisis. (AFP/File Photo)

Meanwhile, the mental health impacts of the blast have only now started to become apparent, with survivors experiencing anxiety, depression and post-traumatic stress disorder.

Embrace, a mental health awareness NGO in Lebanon, surveyed about 1,000 people aged 18 to 65-plus in the first 10 days after the blast. It found that 83 percent of respondents reported feeling sad almost every day, while 78 percent reported feeling very anxious and worried every day.

The blast has also accelerated the brain drain of skilled workers, including health staff. According to the R4HC-MENA study, 43,764 Lebanese emigrated in the first 12 days after the blast.

R4HC-MENA outlined several recommendations to help Lebanon salvage its health system. “The first thing that needs to happen is that clear political commitments are given to securing the health and wellbeing of the Lebanese and refugees,” said Dr. Fouad.




Despite the severity of the health care emergency, the Lebanese government has been unable to respond, lacking both the financial means and the willpower amid a multitude of overlapping crises. (AFP/File Photo)

“A new social contract needs to be created. Just signing a WHO declaration on Universal Health Care is not enough.”

Indeed, the causes of Lebanon’s health care collapse are largely political. For Dr. Coutts, a good first step might be to redefine the definition of “state failure” to incentivize the international aid community to pour resources into the health system.

“It is hard to see how Lebanon is not a failed state when the health system is on its last legs, half the population cannot afford to access the health system, three quarters of the population are on the World Bank poverty line, and a massive man-made explosion occurred in the middle of the capital city for which no one has been held accountable,” he said.

“If that is not state failure, then state failure needs redefining.”


Jailed Kurdish militant leader urges PKK fighters to disarm

Updated 2 sec ago
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Jailed Kurdish militant leader urges PKK fighters to disarm

ANKARA, Turkiye: The jailed leader of a Kurdish militant group renewed Wednesday a call for his fighters to lay down their arms, days before a symbolic disarmament ceremony is expected to take place as a first concrete step in a peace process with the Turkish state.
In a seven-minute video message broadcast on media close to the militants, Abdullah Ocalan, the leader of the Kurdistan Workers’ Party, or PKK, declared that the peace initiative had reached a stage that required practical steps.
“It should be considered natural for you to publicly ensure the disarmament of the relevant groups in a way that addresses the expectations of the (Turkish parliament) and its commission, dispels public doubts, and fulfills our commitments,” Ocalan said. “I believe in the power of politics and social peace, not weapons. And I call on you to put this principle into practice.”
In his video message — his first public appearance since being seen during his trial more than two decades ago — Ocalan, 76, also expressed his support for the establishment of a parliamentary committee to help oversee the peace initiative.
The PKK leader, who has been imprisoned on an island near Istanbul since 1999, first urged the PKK in February to convene a congress and formally dissolve itself. Responding to his call, the PKK announced in May that it would disband and renounce armed conflict, ending four decades of hostilities.
Ocalan’s call to end the fighting marked a pivotal step toward ending the decades-long conflict that has claimed tens of thousands of lives since the 1980s.
His message broadcast on Wednesday appeared to be aimed at convincing fighters who may still be hesitant about abandoning armed struggle. He delivered his message flanked by fellow inmates.
In a speech to lawmakers from his ruling party, Turkish President Recep Tayyip Erdogan said he expected imminent progress in the peace initiative, adding that once firmly established, the effort would benefit not only Turkiye but the broader region. Erdogan also expressed hope that the process would advance without attempts to sabotage it.
“Once the wall of terror is torn town, God willing, everything will change. More pain and tears will be prevented,” Erdogan said. “The winners of this (process) will be the whole of Turkiye — Turks, Kurds and Arabs. Then it will be our entire region.”
“We hope that this auspicious process will conclude successfully as soon as possible, without any road accidents, and without it being sabotaged by dark and corrupt circles,” he said.
In a first step toward the PKK’s disarmament process, a group of its fighters is expected later this week to lay down their arms in a symbolic ceremony to be held in Sulaymaniyah, in northern Iraq’s semi-autonomous Kurdish region. Aysegul Dogan, the spokeswoman for Turkiye’s pro-Kurdish Peoples’ Equality and Democracy Party said the symbolic laying down of arms would take place on Friday.
“We consider this to be a historic moment and a historic development,” she said, adding that representatives from the party would travel to Sulaymaniyah to witness the event.
Zagros Hiwar, a PKK spokesman, said that a group of 20 to 30 fighters would descend from the mountains and destroy their weapons in front of civil society organizations and invited observers.
The PKK has long maintained bases in the mountains of northern Iraq. Turkish forces have launched offensives and airstrikes against the PKK in Iraq and have set up bases in the area.
The Iraqi government in Baghdad announced last year an official ban on the separatist group, which has long been prohibited in Turkiye.
On Tuesday, Turkiye’s intelligence chief, Ibrahim Kalin, traveled to Baghdad to discuss the peace process and other security issues with Iraqi Prime Minister Mohammed Shia Al-Sudani and other officials, the state-run Anadolu Agency reported.

Israel army says launched ‘special, targeted operations’ in south Lebanon

Updated 12 min 35 sec ago
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Israel army says launched ‘special, targeted operations’ in south Lebanon

  • Israel has kept up its strikes on Lebanon, despite a November truce with Hezbollah
  • Israel's military claimed it carried out operations in Labbouneh and Jabal Blat

JERUSALEM: Israel’s military said Wednesday its troops entered southern Lebanon as part of targeted operations to dismantle infrastructure belonging to the Iran-backed militant group Hezbollah.
“Following intelligence information and the identification of Hezbollah weapons and terrorist infrastructure in several areas of southern Lebanon, the soldiers launched special, targeted operations to dismantle them and prevent Hezbollah from reestablishing itself in the area,” an army statement said.
The military did not immediately respond to an AFP request for comment on whether this was the first time Israeli troops had operated on the ground in Lebanon since a November ceasefire.
But the army shared a video captioned “footage from a targeted nighttime operation of the 9th Brigade in southern Lebanon,” showing troops walking on the ground.
AFP was unable to verify the footage, the time or location it was shot.
The army statement said the 9th Brigade was in the Labbouneh area, just over the border. Troops from the 300th Brigade operated in the Jabal Blat area further west, also within sight of the frontier.
Despite a November truce with Hezbollah, Israel has kept up its strikes on Lebanon, mainly saying it is targeting the group’s sites and operatives but also occasionally members of their Palestinian ally Hamas.
The November 27 ceasefire sought to end more than a year of hostilities with Hezbollah, including two months of all-out war that left the group severely weakened.
Under the ceasefire deal, Hezbollah was to pull its fighters back north of the Litani river, about 30 kilometers (20 miles) from the Israeli border, leaving the Lebanese army and United Nations peacekeepers as the only armed parties in the region.
Israel was required to fully withdraw its troops from the country but has kept them in five places it deems strategic.


Armenia, Azerbaijan to meet for peace talks in UAE Thursday

Updated 09 July 2025
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Armenia, Azerbaijan to meet for peace talks in UAE Thursday

  • The announcement came a day after US Secretary of State Marco Rubio expressed hope for a swift peace deal between the Caucasus neighbors

BAKU: The leaders of Armenia and Azerbaijan will meet on Thursday in the United Arab Emirates for peace talks, two days after the US expressed hope for a swift deal.
Baku and Yerevan fought two wars over the disputed Karabakh region, which Azerbaijan recaptured from Armenian forces in a lightning offensive in 2023, prompting the exodus of more than 100,000 ethnic Armenians.
The arch foes agreed on the text of a comprehensive peace deal in March, but Baku has since outlined a host of demands — including amendments to Armenia’s constitution to drop its territorial claims for the Karabakh — before signing the document.
On Wednesday, the Armenian government said Prime Minister Nikol Pashinyan and Azerbaijani President Ilham Aliyev will meet the following day in the UAE capital, Abu Dhabi, “within the framework of the peace process between Armenia and Azerbaijan.”
The Azerbaijani presidency issued an identical statement.
The announcement came a day after US Secretary of State Marco Rubio expressed hope for a swift peace deal between the Caucasus neighbors.
Aliyev and Pashinyan last met on the sidelines of the European Political Community summit in Albania in May.


Iraq’s Kurdistan enjoys all-day state electricity

Updated 09 July 2025
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Iraq’s Kurdistan enjoys all-day state electricity

  • The region’s electricity minister, Kamal Mohammed, said residents were now enjoying “uninterrupted, cleaner, and more affordable electricity”

Irbil: More than 30 percent of Iraq’s autonomous Kurdistan region now has 24-hour state electricity, authorities said Thursday, with plans to extend full coverage by the end of 2026.
The northern region of Kurdistan has long promoted itself as a haven of relative stability in an otherwise volatile country.
Despite Iraq’s vast oil wealth, the national grid struggles to meet demand, leaving most areas reliant on imported energy and subject to frequent power cuts.
“Today, two million people across the Kurdistan region enjoy 24-hour electricity... that’s 30 percent of the population,” including the cities of Irbil, Duhok and Sulaimaniyah, said regional prime minister Masrour Barzani.
In 2024, the Kurdistan Regional Government launched “Project Runaki” to deliver round-the-clock power in a region where, like much of Iraq, residents often turn to costly and polluting private generators.
The region’s electricity minister, Kamal Mohammed, said residents were now enjoying “uninterrupted, cleaner, and more affordable electricity.”
“Rollout to other areas is expected to be completed by the end of 2026,” he told AFP.
As part of the transition, roughly 30 percent of the 7,000 private generators operating across Kurdistan have already been decommissioned, he said, a move that has contributed to an estimated annual reduction of nearly 400,000 tons of CO2 emissions.
The project also aims to lower household electricity bills, offering a cheaper alternative to the combined cost of grid power and private generator fees.
However, bills will still depend on consumption and are likely to increase during peak summer and winter months.
Mohammed said the project’s success hinges on the introduction of “smart” meters to curb electricity theft, as well as a new tariff system to promote responsible usage.
“More power has been added to the grid to support 24/7 access,” he said.
Kurdistan has doubled its gas production in the past five years, and most of the power supply comes from local gas production, Mohammed said.
Despite Iraq’s abundant oil and gas reserves, years of conflict have devastated its infrastructure.
The country remains heavily reliant on imports, particularly from neighboring Iran, which frequently interrupts supply. It also imports electricity from Jordan and Turkiye, while seeking to boost its own gas output.
“We stand ready to offer our technical support and assistance” to the federal government, Mohammed said.
In Irbil, resident Bishdar Attar, 38, said the biggest change was the absence of noisy and polluting generators.
“The air is now clear,” he said. “We can now use home appliances freely... as needed.”


40 Palestinians killed in Gaza as Netanyahu and Trump meet over a ceasefire

Updated 09 July 2025
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40 Palestinians killed in Gaza as Netanyahu and Trump meet over a ceasefire

  • Israel’s offensive in Gaza has killed more than 57,000 Palestinians, more than half of them women and children
  • Many Palestinians are watching the ceasefire negotiations with desperate for an end to the war

DEIR AL-BALAH: At least 40 Palestinians were killed in Israeli airstrikes in the Gaza Strip, hospital officials said Wednesday, as international mediators raced to complete a ceasefire deal.
Israeli Prime Minister Benjamin Netanyahu had a second meeting in two days with US President Donald Trump at the White House on Tuesday evening. Trump has been pushing for a ceasefire that might lead to an end to the 21-month war in Gaza. Israel and Hamas are considering a new US-backed ceasefire proposal that would pause the war, free Israeli hostages and send much-needed aid into Gaza.
Nasser Hospital in the southern city of Khan Younis said the dead included included 17 women and 10 children. It said one strike killed 10 people from the same family, including three children.
The Israeli military did not comment on specific strikes, but said it had struck more than 100 targets across Gaza over the past day, including militants, booby-trapped structures, weapons storage facilities, missile launchers and tunnels. Israel accuses Hamas of hiding weapons and fighters among civilians.
Struggle to secure food and water
Many Palestinians are watching the ceasefire negotiations with trepidation, desperate for an end to the war.
In the sprawling coastal Muwasi area, where many live in ad-hoc tents after being displaced from their homes, Abeer Al-Najjar said she had struggled during the constant bombardments to secure sufficient food and water for her family. “I pray to God that there would be a pause, and not just a pause where they would lie to us with a month or two, then start doing what they’re doing to us again. We want a full ceasefire.”
Her husband, Ali Al-Najjar, said life has been especially tough in the summer, with no access to drinking water in a crowded tent in the Middle Eastern heat. “We hope this would be the end of our suffering and we can rebuild our country again,” he said, before running through a crowd with two buckets to fill them from a water truck.
People chased the vehicle as it drove away to another location.
Amani Abu-Omar said the water truck comes every four days, not enough for her dehydrated children. She complained of skin rashes in the summer heat. She said she was desperate for a ceasefire but fears she would be let down again. “We had expected ceasefires on many occasions, but it was for nothing,” she said.
The war started after Hamas attacked Israel on Oct. 7, 2023, killing around 1,200 people and taking 251 hostage. Most of the hostages have been released in earlier ceasefires. Israel’s offensive in Gaza has killed more than 57,000 Palestinians, more than half of them women and children, according to Gaza’s Health Ministry.
The UN and other international organizations see its figures as the most reliable statistics on war casualties.
Netanyahu and Trump meet again
Netanyahu told reporters in the Capitol on Tuesday that he and Trump see “eye to eye” on the need to destroy Hamas. He added that the cooperation and coordination between Israel and the US is currently the best it has ever been during Israel’s 77-year-history.
Later this week, Trump’s Mideast envoy, Steve Witkoff, is expected to head to the Qatari capital of Doha to continue indirect negotiations with Hamas on the ceasefire proposal.
Witkoff said late Tuesday that three key areas of disagreement had been resolved, but that one key issue still remained. He did not elaborate.
After the second meeting, Netanyahu said he and Trump also discussed the “great victory” over Iran from Israeli and American strikes during the 12-day war that ended two weeks ago.
“Opportunities have been opened here for expanding the circle of peace, for expanding the Abraham Accords,” said Netanyahu, referring to normalization agreements between Israel and multiple Arab nations that were brokered by Trump in his first term. Washington has been pushing for normalization between Saudi Arabia and Israel.