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.”


Kurdish fighters leave northern city in Syria as part of deal with central government

Updated 04 April 2025
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Kurdish fighters leave northern city in Syria as part of deal with central government

  • The fighters left the predominantly Kurdish northern neighborhoods of Sheikh Maksoud and Achrafieh
  • The deal is a boost to an agreement reached last month

ALEPPO, Syria: Scores of US-backed Kurdish fighters left two neighborhoods in the Syrian Arab Republic’s northern city of Aleppo Friday as part of a deal with the central government in Damascus, which is expanding its authority in the country.
The fighters left the predominantly Kurdish northern neighborhoods of Sheikh Maksoud and Achrafieh, which had been under the control of Kurdish fighters in Aleppo over the past decade.
The deal is a boost to an agreement reached last month between Syria’s interim government and the Kurdish-led authority that controls the country’s northeast. The deal could eventually lead to the merger of the main US-backed force in Syria into the Syrian army.
The withdrawal of fighters from the US-backed and Kurdish-led Syrian Democratic Forces came a day after dozens of prisoners from both sides were freed in Aleppo, Syria’s largest city.
Syria’s state news agency, SANA, reported that government forces were deployed along the road that SDF fighters will use to move between Aleppo and areas east of the Euphrates River, where the Kurdish-led force controls nearly a quarter of Syria.
Sheikh Maksoud and Achrafieh had been under SDF control since 2015 and remained so even when forces of ousted President Bashar Assad captured Aleppo in late 2016. The two neighborhoods remained under SDF control when forces loyal to current interim President Ahmad Al-Sharaa captured the city in November, and days later captured the capital, Damascus, removing Assad from power.
After being marginalized for decades under the rule of the Assad family rule, the deal signed last month promises Syria’s Kurds “constitutional rights,” including using and teaching their language, which were banned for decades.
Hundreds of thousands of Kurds, who were displaced during Syria’s nearly 14-year civil war, will return to their homes. Thousands of Kurds living in Syria who have been deprived of nationality for decades under Assad will be given the right of citizenship, according to the agreement.
Kurds made up 10 percent of the country’s prewar population of 23 million. Kurdish leaders say they don’t want full autonomy with their own government and parliament. They want decentralization and room to run their day-to day-affairs.


King Abdullah, Bulgarian president co-chair Aqaba Process meetings in Sofia

Updated 04 April 2025
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King Abdullah, Bulgarian president co-chair Aqaba Process meetings in Sofia

  • Initiative aims to bolster cooperation on security, counterterrorism issues
  • King held separate talks with several regional leaders on sidelines of event

LONDON: King Abdullah II of Jordan and Bulgarian President Rumen Radev co-chaired the third round of the Aqaba Process meetings in Sofia on Friday, bringing together international leaders to address pressing security challenges in the Balkans and beyond, the Jordan News Agency reported.

The Aqaba Process Balkans III forum, jointly organized by Jordan and Bulgaria, tackled issues such as regional security, counterterrorism efforts, online radicalization and illegal migration. The participants also explored opportunities for greater international cooperation, including intelligence sharing and strategic partnerships in combating extremism.

Attending the event were heads of state, government officials and security representatives from Serbia, Albania, North Macedonia, Montenegro, Slovenia, Kosovo, Bosnia and Herzegovina, Croatia, Spain, Greece, Italy, France, the UK, US and Japan.

Prince Ghazi bin Muhammad, King Abdullah’s personal envoy and chief adviser on religious and cultural affairs, was among the attendees, while several international organizations, including the EU, Interpol, Global Internet Forum to Counter Terrorism and the Organization for Security and Cooperation in Europe, were also represented.

On the sidelines of the forum, King Abdullah held meetings with several regional leaders, including Slovenian President Natasa Pirc Musar, Albanian President Bajram Begaj, Kosovan President Vjosa Osmani-Sadriu, North Macedonian President Gordana Siljanovska Davkova, Montenegrin President Jakov Milatovic and Serbian President Aleksandar Vucic.

Launched by the king in 2015, the Aqaba Process is designed to enhance coordination between regional and international actors in the fight against terrorism and extremism. It fosters military, security and intelligence cooperation, focusing on counterterrorism strategies and the exchange of expertise.

Previous meetings have been hosted by Jordan, Albania, Brazil, Indonesia, the Netherlands, Nigeria, Norway, Rwanda, Singapore, Spain, the US and the UN General Assembly.

Discussions have covered diverse regions such as East Africa, Southeast Asia, Latin America, West Africa and the Sahel.


It’s not enough for audiences just to feel ‘sad,’ says Oscar-winning director of ‘No Other Land’

Updated 04 April 2025
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It’s not enough for audiences just to feel ‘sad,’ says Oscar-winning director of ‘No Other Land’

  • ‘People need to use their voices to influence their governments and to hold Israel accountable for violating international law,’ Palestinian filmmaker Basel Adra tells Arab News
  • Adra, who addressed the UN in New York this week, says that the Oscar recognition was a moment of pride but has not resulted in any tangible changes for Palestinians

NEW YORK CITY: Basel Adra, the Palestinian co-director of the Oscar-winning documentary film “No Other Land,” has garnered global attention for his compelling portrayal of the hardships faced by Palestinians in the West Bank, particularly his home region of Masafer Yatta.

The film chronicles the ongoing violence against, and forced displacement of, Palestinians at the hands of Israeli forces and settlers in an area designated a restricted military zone by Israel since the 1980s.

Despite all the accolades for the film over the past year, including the Oscar for Best Documentary Feature at the Academy Awards last month, Adra’s message remains one of urgency and resistance.

The filmmaker spoke with Arab News in New York about the continuing suffering of the Palestinian people, and underscored the fact that the situation has worsened despite the international recognition of his work.

“No Other Land” has sparked intense emotional responses from audiences worldwide but Adra believes the film should do more than just evoke feelings of sadness, it should inspire action.

“Audiences feel emotionally connected to the people of Masafer Yatta, to the land and to the cause,” he said. “But it’s not enough to just feel sorrow for them. People need to use their voices to influence their governments and to hold Israel accountable for violating international law.”

Adra, who had been invited to New York speak at the UN by the Committee on the Inalienable Rights of the Palestinian People, continues to call for international pressure on Israel to end its occupation of Palestinian territory.

During his speech, which followed a screening of his film that received a lengthy standing ovation from a full house, Adra made an impassioned plea: “I wanted the world to know that we live in this land, that we exist, and to see what we face on a daily basis — this brutal occupation.”

His film reveals the harsh realities of Palestinians who face violent evictions, the demolition of their homes and attacks by Israeli settlers, all under the protection of the Israeli military.

After a prolonged legal battle over the expulsion of residents from eight villages in Masafer Yatta, in 2022 the Israeli Supreme Court ruled in favor of the Israeli army and allowed the evictions to proceed.

Adra said that the recognition of the film by the Academy Awards, though a moment of pride, has not resulted in any tangible changes on the ground for Palestinians.

“Even after winning the Oscar, we went back to the same reality,” he lamented. In fact the situation has only gotten worse. While attacks by Israeli settlers in the West Bank had long been escalating, the situation has reached new heights of violence since the start of the war between Israel and Hamas in Gaza.

Last week, one of Adra’s co-directors, fellow Palestinian Hamdan Ballal, reported he had been attacked by Israeli settlers for winning the Oscar, and was detained by Israeli police for “hurling rocks,” during which he suffered a beating and “brutality.”

In a somber reflection, Adra acknowledged the growing risks to Palestinian communities in Masafer Yatta and reiterated the urgent need for the world to act.

“There’s no time to wait,” he said. “The international community needs to take serious action now. Otherwise, Israel will continue with its aggression.”

Though widely acclaimed, the documentary has sparked mixed reactions from some, particularly regarding the involvement of Yuval Abraham, one of two Israeli co-directors of the film (the other is Rachel Szor), a figure some critics felt represented a form of “normalization” of Israeli policies.

Adra firmly rejected this suggestion and said such criticism makes him “very sad,” adding: “The last thing I want is to normalize the occupation. Everything I do with Yuval is activism, to change this and to end the occupation.”

Despite the challenges, Adra said his bond with his co-director remains strong.

“Now, we are allies and we are activists. We will continue to fight,” he added, affirming their shared mission to end the occupation and the system of apartheid Israel operates in the Palestinian territories.

Looking ahead, Adra said his work continues to be driven by the hope of a better future for his people. He plans to return to Palestine soon, and his message to the Palestinian people remains consistent: “To keep standing strong, not to give up, and to hold on. We have to keep being alive.”

Despite the critical acclaim, Oscar recognition and other awards it has received, “No Other Land” has has found it difficult to secure widespread distribution, particularly in the US.

In a world where the cost of inaction is high, Adra said he will continue to work tirelessly for justice in an attempt to compel audiences and governments around the world to reflect on their role in the ongoing conflict and take responsibility for the lives that are affected.


In Tunisia, snails inch toward replacing red meat as people turn to cheaper protein

Updated 04 April 2025
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In Tunisia, snails inch toward replacing red meat as people turn to cheaper protein

  • Snails have been consumed in Tunisia for more than seven millenia
  • Low in fat and high in iron, calcium and magnesium, snails offer both nutritional value and economic relief

AKOUDA, Tunisia: In fields outside their hometown in central Tunisia, an increasing number of unemployed young men are seeking a new way to make a living, picking snails off of rocks and leaves and collecting them in large plastic bags to take to the local market to be sold.
More and more people, they say, are buying the shelled wanderers as the price of market staples remains high and out of reach for many families.
“They’re profitable, beneficial and quite in demand,” said Karim, a 29-year-old snail seller from the village of Akouda said.
Snails have been consumed in Tunisia for more than seven millenia, according to research published last year in the journal Archaeological and Anthropological Sciences. In today’s world considered mostly a bistro delicacy, they’re again gaining traction in Tunisia as a practical alternative to red meat — a protein-rich substitute that pairs perfectly with salt, spices, and bold seasonings.
The snails are a lifeline for some in Tunisia, where youth unemployment now hovers above 40 percent and inflation remains high, three years after spiking to its highest levels in decades. A lack of opportunity has fueled social discontent throughout the country and, increasingly, migration to Europe.
Low in fat and high in iron, calcium and magnesium, snails offer both nutritional value and economic relief. In a country where unemployment runs high and median wages remain low, they cost about half as much as beef per kilogram and often less when sold by the bowl.
“Snails are better for cooking than lamb. If lamb meat costs 60 dinars ($19.30), a bowl of snails is five dinars ($1.60),” a man named Mohammed said at the Akouda market.
As the price of meat and poultry continues to rise, more Tunisians are turning to affordable, alternative sources of protein. Beyond their economic appeal, these substitutes are also drawing interest for their environmental benefits. Scientists say they offer a more sustainable solution, producing far fewer carbon emissions and avoiding the deforestation linked to traditional livestock farming.
Wahiba Dridi, who serves snails at her restaurant in Tunis, cooks them in a traditional fashion with peppers and spices. She said they were popular throughout this year’s Ramadan, which ended last week. Though Tunisian Muslims traditionally eat red meat at the meals during which they break their daily fasts, a kilogram of snails costs less than 28 Tunisian dinars ($9) compared to beef, which costs 55 dinars per kilogram ($18).
“If people knew the value of snails they would eat them all year long,” Dridi said.


Israel kills Hamas commander in Lebanon strike

Local residents walk past debris in front of an apartment building following an Israeli strike in Sidon on April 4, 2025. (AFP)
Updated 53 min 47 sec ago
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Israel kills Hamas commander in Lebanon strike

  • PM Nawaf Salam condemns targeting of civilians in Sidon, violation of Lebanon’s sovereignty

BEIRUT: Israel killed a commander of Hamas on Friday in a pre-dawn strike in the Lebanese port city of Sidon that also killed his two children.

Lebanese Prime Minister Nawaf Salam described the strike as a “blatant violation of Lebanese sovereignty” and a breach of the ceasefire established on Nov. 27 with Israel.

He urged for maximum pressure on Israel to stop ongoing attacks that target various districts, many of which are residential areas, affirming that all military operations must cease.

The Ezzedine Al-Qassam Brigades, the military wing of Hamas, confirmed the death of Hassan Farhat, also known as Abu Yasser.

According to a statement from his media office, Salam said: “Targeting Saida (Sidon) or any other area in Lebanon is a blatant violation of Lebanese sovereignty and a clear breach of UN Resolution 1701, as well as the security arrangement agreement regarding the cessation of hostilities.”

Lebanese state media had reported the 3:45 a.m. (0045 GMT) strike in Sidon.

A drone attacked a residential apartment, resulting in two explosions that caused a fire and significant damage, the National News Agency reported.

Sidon Mayor Hazem Badih stated that the raid resulted in the deaths of a father, his son Hamza, and his daughter Jinane.

It also destroyed the apartment and its contents, damaging neighboring apartments and buildings.

Media reports from Sidon indicated that the husband’s daughter was associated with the “Islamic Group in Lebanon.”

The Israeli raid caused damage to nearby buildings, shops, and parked cars, resulting in panic among residents.

Sidon is located less than 50 km from the southern border and 45 km from Beirut.

It is home to the Ain Al-Helweh camp, the largest Palestinian refugee camp in Lebanon.

Over the decades, many of its residents have opted to live in the city rather than in the overcrowded neighborhoods of the camp.

Israeli army spokesperson Avichay Adraee stated that the military carried out an operation directed by the Northern Command and the Intelligence Directorate.

Adraee said the objective was to target Farhat, the commander of the Western Sector of Hamas in Lebanon, who is based in the Sidon area of southern Lebanon.

The army claimed that Farhat orchestrated multiple attacks on Israeli soldiers and civilians during the hostilities that followed the outbreak of war in Gaza in October 2023.

Adraee also stated that Farhat had promoted plans against Israel in recent months, posing a threat to the country and its citizens. This included the rocket fire on the Israeli town of Safed on Feb. 14, 2024, which resulted in the death of an Israeli soldier, according to the military.

Hamas stated that Farhat was “assassinated by an Israeli military drone in his apartment on the fourth floor of a seven-story building in a neighborhood of Saida, southern Lebanon. He was killed along with his two children by two guided missiles while they were sleeping.”

The Palestinian movement stated that the target was a commander of the Ezzedine Al-Qassam Brigades, and his son was a member of Hamas’ military wing.

This is the second Israeli assassination in a matter of days, following the killing of a Hezbollah official at his apartment on the second day of Eid Al-Fitr in the southern suburb of Beirut.

Also on Friday, Lebanon’s prime minister met with a delegation of mayors from border villages that were destroyed by the Israeli army during its conflict with Hezbollah, preventing residents from returning.

Salam reiterated his support for the residents in their efforts to secure essential assistance from the government to rebuild their destroyed homes and emphasized that the government was continuing its efforts to end the Israeli occupation of southern Lebanon.

He stated that the initial phase of the reconstruction process will prioritize repairing infrastructure, including roads, and ensuring the provision of water, electricity, and communication services.

A plan is being developed with the World Bank to ensure fairness among different villages and towns.

Salam highlighted the importance of maintaining stability, which requires implementing measures to ensure the safety and dignified existence of citizens.

Qassem Al-Qadri, the mayor of Kfar Shouba, stated that the border villages were facing difficult conditions, with a severe lack of security.

Al-Qadri claimed that the presence of the state in “our villages is still very limited” and that the government had not yet assessed all the damages nor reached every village.

He stated that the assistance at present primarily included food aid, while “we urgently require electricity, water, and infrastructure.”

Former Prime Minister Fouad Siniora said that the recent Israeli airstrike on Sidon constituted a clear violation of Lebanese sovereignty.

He said that if UN Resolution 1701 is to be enforced, it should be emphasized that Israel is the main violator of both the resolution and the agreement that established it.

The countries sponsoring this agreement, namely the US and France, must urge Israel to stop its attacks on Lebanon, he added.

In the border town of Kafr Kila, residents found flyers posted on the walls of their damaged homes amid ongoing Israeli military actions.

The flyers warned that their homes would be targeted if members of Hezbollah used them, stating: “Do not allow Hezbollah members to return to their homes or the area. Hezbollah is putting you and your family at risk. The choice is yours.”