BEIRUT (AP): Drenched in sweat, doctors check patients lying on bunks in the reception area of Lebanon’s largest public hospital. Air conditioners are turned off, except in operating rooms and storage units, to save fuel.
Doctors are fighting to find alternatives to saline solutions after the hospital is over. The shortage is overwhelming, the medical staff exhausted. And with a further increase in coronavirus cases, hospitals in Lebanon are at a breaking point.
The country’s health sector is a victim of the many crises that have plunged Lebanon into a downward spiral: an economic and financial thaw, exacerbated by a total failure of the government, runaway corruption and a pandemic that does not go away.
The collapse is even more dramatic, as just a few years ago Lebanon was a leader in health care in the Arab world. The rich and famous of the region came to this small Middle Eastern nation of 6 million for everything from major hospital procedures to plastic surgeries.
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THE NEW NORMAL
Ghaidaa al-Saddik, a second-year resident, had just returned from a week off after a grueling year. Back on duty for a week, he has already intubated two critical care patients in the emergency room, both in their thirties.
She struggles to admit new patients, knowing how little supplies the hospital has, is afraid of being blamed for mistakes and wonders if she is doing her best. Many patients are asked to bring their own medications, such as steroids. Others are discharged too soon, often in homes where power outages last for days.
“You feel trapped,” al-Saddik said.
The 28-year-old spends more nights in student dormitories because she has no electricity at home. He moved to an apartment closer to the hospital that he shares with two more people to save on rent and transportation. With the collapse of Lebanon’s currency in the midst of the crisis, its salary has lost almost 90% of its value.
With fewer and fewer residents, he now has to do the rounds for about 30 patients, instead of 10. His mentor, a senior virologist, has left Lebanon, one of many in a brain drain from medical professionals.
“I want to help my people,” he said. “But at the same time, what about me being a better doctor?”
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OPERATING IN A VACUUM
Rafik Hariri University Hospital is the largest public hospital in Lebanon and the number 1 in the country for the treatment of coronavirus patients. To date, Lebanon has recorded nearly 590,000 infections and more than 8,000 deaths.
The hospital, which depended on the state power company, had to start relying on generators for at least 12 hours a day. Since last Monday, generators have been the only source of non-stop power. Most of the hospital’s diesel, sold on the black market at five times the official price, is donated by political parties or international aid groups.
To save fuel, some rooms run on electric fans only in the hot summer heat. Not all hospital elevators work. Bed capacity has been reduced by around 15% and the emergency admits only life-threatening cases.
It is a perpetual crisis that has left the hospital always on the edge, says its director, Firas Abiad. There is “scarcity of almost everything.”
Every day he struggles to get more fuel: the hospital has a maximum supply of two days at any one time. Shelves are scarce in medications, including patients with cancer and dialysis. A new shipment of blood serum will take a few days.
“We can hardly get out,” said Jihad Bikai, chief of emergency services. He recently had to send a critical care patient to another hospital because he no longer has a vascular surgeon on staff.
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WHAT HAPPENED?
Lebanon’s financial crisis, rooted in years of corruption and mismanagement, took to the streets in late 2019, with anti-government protests and demands for accountability. Political leaders have failed to agree on a recovery program or even a new government, leaving the previous one in a perpetual but shattered janitor role.
The World Bank has described the crisis as one of the worst in more than a century. In just two and a half years, the majority of the population has been plunged into poverty, the national currency is collapsing and foreign reserves have dried up.
Power outages have forced dependence on private generators for years, but the crisis took on new dimensions this summer, as fuel and diesel were scarce, which disrupted the work of hospitals, bakeries, suppliers of ‘Internet and many other companies.
Last August, a massive explosion in the port of Beirut, when hundreds of tons of improperly stored ammonium nitrate were ignited, destroyed entire neighborhoods of the city and killed 214 people. Thousands of injured flooded hospitals, some of which lost staff members and were forced to close temporarily.
One recent afternoon at Rafik Hariri Hospital, 39-year-old nurse Mustafa Harqous tried to ignore the rubbish outside the ER coronavirus: patients with oxygen masks waiting for a bed to be released. , families pressing to visit sick relatives, others discussing drugs in stock.
He devoted himself to his work in the 25-bed room. Except for a one-month-old baby, the patients were mostly men in their 30s and 40s.
“There are those who understand that scarcity is not our fault,” he said. “But many don’t.”
He worries about how he will fill his car to go home, an hour and a half away. The government, he said, “leaves people in the middle of the sea without any rescue boats.”
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NO OUTPUT
At least 2,500 doctors and nurses have reportedly left Lebanon this year. At Rafik Hariri Hospital, at least 30% of doctors and more than 10% of nurses left, most recently five in one day. Many private hospitals, which provide 80% of Lebanon’s medical services, are closing for lack of resources or to keep patients away who cannot pay.
Bikai, the 37-year-old emergency chief, was offered a job in a neighboring country. Your salary is barely enough to cover your child’s dentist bills. His wife, also a doctor, works alongside him in the emergency room.
“There’s a time when you’re pushing to get over a mountain and you get to a place you can’t move,” he said. “I’m worried we’re getting there.”
Abiad, the director of the hospital, struggles to be positive for his staff.
“Our country is disintegrating before our eyes,” he said. “The hardest part is … it looks like we can’t find a way to stop this deterioration.”