Doctors, sweaty and drenched, check patients on stretchers at the reception of Lebanon’s largest hospital. To save fuel, air conditioners are not turned on except in storage units and operating rooms.
After the hospital ran out of saline, medics had to scramble for other options. The medical staff is exhausted and the shortages are severe. The hospitals in Lebanon are now at breaking point due to a surge in coronavirus cases.
Lebanon’s health sector is suffering from multiple crises that have thrown it into a downward spiral. These include a financial and economic collapse, corruption, and a pandemic that’s not going away.
This is especially dramatic because only a few short years ago, Lebanon was the leader in Arab medical care. This small Mideast nation of six million was home to the region’s wealthy and famous, for everything from major hospital procedures to plastic surgery.
THE NEW NORMAL
Ghaidaa Al-Saddik is a second year resident. She just returned from a week-long vacation after an exhausting year. After being back on duty for a week she had already intubated two critically ill patients in the emergency department, both in their 30s.
Because of the scarcity of supplies, she has difficulty admitting new patients. She is afraid to make mistakes and is unsure if her efforts are being effective. Patients are often asked to bring their own medicine, such as steroids. Some patients are discharged too quickly, often to homes with power outages lasting for days.
Al-Saddik said, “You feel trapped.”
Because she doesn’t have electricity at home, the 28-year old spends more time in staff dorms than she does at home. To save money on rent and transport, she moved into an apartment near the hospital where she shares it with two others. Her salary lost almost 90% due to the crisis and collapse of the currency in Lebanon.
She now has to do rounds for 30 patients instead of 10, as there are fewer residents. Her mentor, a senior virusologist, left Lebanon. This is just one example of the brain drain that has afflicted medical professionals.
She said, “I want my people to be helped.” “But at the exact same time, how about me being better doctors?”
Rafik Hariri University Hospital, Lebanon’s largest and most prestigious public hospital, is also the No. The number 1 hospital for coronavirus patients. Nearly 590,000 cases of infection and more than 8,000 deaths have been reported in Lebanon.
The hospital was dependent on the state power company for its power, and had to start relying on generators at least 12 hours per day. The generators have been running non-stop since Monday last week, and they are the only source of electricity. The black market sells most of the hospital’s diesel at five times the official cost. It is donated by international aid groups or political parties.
Some rooms use only electric fans to save fuel in the summer heat. Some hospital elevators do not work. The ER has a limited capacity and can only accept life-threatening cases.
Firas Abiad, the hospital’s director, said that it is always in crisis, which has made the hospital constantly at the edge of collapse. There is a shortage of “almost everything”.
He struggles every day to get more fuel. The hospital can only store a maximum of two days’ worth. There are no shelves for medicines, even for dialysis patients or cancer patients. The new shipment of blood serum aid will only last for a few days.
Jihad Bikai (head of the ER) said, “We can hardly make it by.” Because he doesn’t have a vascular surgeon, he had to transfer a critically ill patient to another hospital.
The financial crisis in Lebanon, which was rooted in years and decades of corruption and poor management, reached the streets in late 2019 with protests and calls for accountability. Since then, political leaders have failed to agree on a recovery plan or a new government — leaving previous one in a perpetual but unfulfilled caretaker role.
According to the World Bank, the crisis is among the most severe in more than a century. Within two and a quarter years, the majority has fallen into poverty, and the country’s currency is in ruins. Foreign reserves are also low.
For years, power outages have forced people to depend on generators privately. But this summer, the crisis reached new heights when fuel and diesel became scarce. This disrupted the work of many businesses, including bakeries, hospitals, and internet providers.
Last August saw a huge explosion at Beirut’s port. It was caused by hundreds of tons improperly stored ammonium-nitrate. This caused destruction of entire neighborhoods and resulted in the deaths of 214 people. Many were hurt, flooding hospitals that lost staff members and had to be shut down temporarily.
Nurse Mustafa Harqous (39), tried to ignore the commotion outside the Rafik Hariri ER. Patients with oxygen masks waited for a bed, families pressing to see sick relatives, and others arguing about out-of-stock medications.
In the 25-bed room, he went about his business. The patients, except for the baby who was a month old, were mostly men in their 30s or 40s.
He said, “Some people understand that the shortages are not our fault.” “But many don’t.”
He is worried about how he will get his car filled up for the hour-and-a-half drive home. He said that the government is “leaving people at sea without a rescue boat.”
There is no way out
According to reports, at least 2,500 nurses and doctors have fled Lebanon in the last year. At Rafik Hariri, more than 30% of doctors and 10% of nurses have left Lebanon, including five in one day. Private hospitals that provide 80% of Lebanon’s medical services are closing down due to lack of resources, or refusing patients who cannot pay.
Bikai, a 37-year-old ER chief was offered a job as a translator in a neighbouring country. His son’s dental bills will barely be covered by his salary. His wife, a physician, is also at his side in the ER.
He said, “There’s a time when you push hard to climb a mountain and get to a point where you can’t move.” “I worry that we will get there.”
Abiad, hospital director, is unable to keep his staff happy.
He said, “Our country is falling apart in front of our eyes ,””.” “The hardest part is that we don’t seem to have a way to stop this deterioration.”