On August 4, 2020, a devastating explosion occurred in the port of Lebanon’s capital city, Beirut. The explosion left over 200 people dead, 6,500 injured, and 300,000 displaced from their homes. The explosion destroyed and damaged health facilities in Beirut. Now, the ongoing economic and political crisis continues to leave the people of Lebanon facing daily hardship. MedGlobal’s Lebanon Program Manager, Dr. Tania Baban, and Lebanon Logistics and Procurement Coordinator, Radiah Saleh, answered questions about the situation ahead of the one year anniversary of the Beirut port explosion.

1. It’s been a year since the Beirut port explosion. Can you describe the impact of the explosion on the city and for people in Lebanon in general?

Radiah Saleh: The blast took place amidst a political, economic, and public health crisis. It escalated the lack of confidence in governmental institutions and the public sector in general. The people felt betrayed by their own government for storing such toxic material in the port which is located in Beirut’s hub and adjacent to residential areas. Health care institutions were overwhelmed and over flooded by patients due to the closing down of major hospitals that were destroyed in the blast. And with the rising cases of COVID patients, things were getting out of control.

Dr. Tania Baban:

The explosion happened at a time when the Lebanese people had already been emotionally and physically drained.

The humanitarian impact of the blast was and remains very daunting. Lebanon had already been facing an economic meltdown, an influx of refugees, and a new spike in COVID-19 cases. It came in the throes of the worst economic crisis in recent Lebanese history, which has only been exacerbated by the COVID-19 pandemic.

Around 33% of the country’s population lived at or below the poverty line September 2019 — that number is now estimated to be approximately 77%.

The country’s unemployment rate is now just above 50%. The  massive explosion in Beirut led to a more immediate emergency: more than 300,000 people were left homeless, and over 6,000 injured. These injuries come on top of the pandemic, placing additional stress on the country’s medical and healthcare resources as well as the population’s emotional breakdown.

2. The blast damaged major hospitals and destroyed primary health centers. Can you describe how people accessed health care directly after the explosion, and throughout the past year?

Radiah Saleh: Right after the explosion, emergency rooms were flooded with the injured and hospitals couldn’t accommodate the huge number of injuries. Some patients had to be treated in ambulances or outside hospital doors because hospitals were full and their staff outnumbered. 

Days after the explosion, COVID cases started skyrocketing due to the lack of measures and the chaos the country was going through. This is where MedGlobal saw it best to intervene to help ease the suffering of the Lebanese people in such unprecedented times. We started by distributing PPE material in the area that the blast took place in and then proceeded with the distribution of hygiene kits. We then set up a medical tent nearby the port area that offered first aid, medical assistance, and mental health consultations to more than 3,000 patients. Our work continued later on during the coming months to provide PPE and medications to several hospitals in the Beirut area and then expanded to distribute winterization and hygiene kits to refugee camps in Arsel, in addition to oxygen concentrators and medical equipment to hospitals in Beirut and the north of Lebanon. Our Elderly Program in collaboration with Lobnaneyon was a huge success due to the lack of home care in Lebanon, especially for the elderly.  We also received a lot of positive feedback for the implementation of the dental program in collaboration with MAPS in the north of Lebanon.

Dr. Tania Baban:

Lebanon is facing multiple overlapping emergencies that have had dire consequences.

The country’s ongoing economic crisis has made private healthcare prohibitively expensive, leaving more people reliant on the public health services. COVID-19 and the Beirut blast put additional strain on the already stretched public health system. As one healthcare official told the press the day after the explosion, “We need everything to hospitalize the victims, and there is an acute shortage of everything.”

The explosion destroyed three of the city’s main hospitals and damaged many other health facilities, forcing many patients to be evacuated and creating an increased demand for beds in other nearby facilities. Two more hospitals suffered severe damage, with one hospital managing to continue functioning by setting up a field hospital in its parking lot. Some medical supplies were already in short supply due to the coronavirus. Beirut had the highest concentration of confirmed cases of COVID-19 in the country. The port of Beirut also handled 80% of Lebanon’s medical imports, which meant that getting supplies into the country to where they were most needed involved contingency plans, such as delivering through the smaller port of Tripoli in the north (approximately 90 minutes away by car). Before the explosion, hospitals were already near capacity, coping with a spike in COVID cases. After the explosion, the situation deteriorated even more rapidly, with more than 300 new cases of COVID identified on a daily basis. It became harder for people to protect themselves from the virus while living in damaged homes without electricity and running water, or sharing shelters with other families. The health system was stretched to breaking point as medical facilities in the capital had to treat thousands of patients for severe burns and blast injuries. Many facilities reported an urgent need for more medications and medical equipment as well as medical staff to treat all those in need of care.

3. The mental health impact of the blast for many people in Lebanon will surely be long-lasting, and we know that anniversaries of traumatic events can sometimes reactivate particularly difficult thoughts and feelings for survivors. Can you describe some of the mental health and psychosocial support services that are available?

Radiah Saleh: Mental health awareness has been a rising topic in Lebanon the past couple of years due to the socio-economic situation in the country and unstable political situation. The blast alongside the pandemic reinforced the need for such care. MedGlobal’s first initiative in this field was in the medical tent that was set up in collaboration with a local NGO. A psychiatrist was brought on board and there were daily consultations and follow ups for over 200 patients. We then collaborated with Embrace, a local NGO aiming to raise mental health awareness whose mission is ‘to ensure that mental health and access to care is positioned as a basic human right that must be met for all persons, through awareness, advocacy, and dignified mental health services across the spectrum of care.’ 

Dr. Tania Baban:

Lebanon’s recent history combined with this explosion created a mental health challenge for hundreds of thousands of Beirutis, including an estimated 100,000 children.

While many affected by the blast may not have sustained physical injuries, the long-term effects of explosions are shown to include post-traumatic stress disorder. Left untreated, PTSD from these experiences could lead to chronic conditions including anxiety, depression, or addiction, as well as negative coping mechanisms. These conditions can seriously limit a person’s potential or quality of life. Although the number may not be exact, many people were separated from their loved ones in the aftermath of the blast. Many, including children, witnessed first-hand the destruction of their homes, the death of family members, and hospitalization of close friends. Hundreds of people are still recovering from physical injuries a year after that ominous day. And those without physical wounds are suffering from the psychological effects of what happened. The people still need substantial emotional and psychological support to help us try to “come to terms” with the disaster and the suffering that we continue to see around us.

4. Now we are seeing economic collapse lead to another dire crisis throughout Lebanon. Can you describe the daily challenges people are facing?

Radiah Saleh: Despite the lack of trust in leadership in Lebanon, community solidarity still stands. This is evident in the rising number of volunteers in response to the explosion, either through physical labor or through donating to local NGOs. The main challenge is that people do not feel that the money allocated for recovery, coming from the outside, will be spent equally, transparently, and fairly. People are reluctant to invest in anything public because of the corruption rates. They are pessimistic about the future and the quality of life a couple of years from now.

There is a growing shortage in medicine and fuel to keep hospitals and generators running, in addition to the fact that most of our renowned doctors are leaving the country.

Some food items have become a luxury to most Lebanese because of the inflated prices and devaluation of the Lebanese currency. 

Dr. Tania Baban: The country now faces a growing shortage of medical supplies and essential medicines, such as those used to treat chronic diseases and mental health, leaving the most vulnerable people at risk. Lebanon also hosts the largest number of refugees per capita in the world, which means that many of the displaced people living here have already endured traumatic experiences. Since late 2019, Lebanon has been grappling with its worst economic crisis in decades, as well as social unrest and political turmoil. These overlapping crises, along with COVID and the blast, have exacerbated people’s vulnerability and pushed thousands into poverty. All this comes in addition to a protracted situation for displaced people. Now the cost of basic goods, including food, is more and more difficult to afford for many. Medical fees have also become prohibitive for vulnerable groups in the country, and this context is expected to worsen people’s health conditions and access to care. We have already started to witness signs of deterioration. Over the past year, we have observed an increase in vulnerability among patients. Many of them are experiencing financial issues related to the country’s economic situation, which for some are having an impact on their ability to properly follow their treatment. The toll on people’s psychological well-being is also noticeable and is a major concern.

5. What are the greatest needs you see now for the population in Lebanon? Among Lebanese, as well as Syrian and Palestinian refugees, migrants, and others?

Radiah Saleh: The ability to provide basic necessities to their families is the main concern to most Lebanese or refugees residing in Lebanon.

What once was a necessity is now a luxury to most.

Clean water, fuel, electricity, food, and medicine are very difficult to acquire. A basic standard of living has become so hard to maintain, causing distress, anxiety, and depression among many people. Unemployment rates are rising by the day and maintaining a safe space for families to live is becoming impossible. These truly are unprecedented times and every donation and helping hand makes a difference. MedGlobal and our field team in Lebanon are trying to reach as many vulnerable communities as possible with the limited resources we have, and praying for better days for this beautiful, once vibrant country. 

Dr. Tania Baban: For many people in Lebanon, whether they are Lebanese, refugees, or migrant workers, the current economic crisis and the deteriorating living conditions come on top of traumatic events and stressful experiences they have already had to face, such as conflict or displacement. These stress factors have contributed to disrupting people’s psychological well-being. Many people in Lebanon show symptoms related to emotional distress, depression, anxiety and hopelessness. As one blow follows another, people’s coping mechanisms are weakened and, for many, keeping their head above the water is becoming harder. The MedGlobal Lebanon team is trying to help as much as we can in such a complex context and we are committed to continuing to do so, but our capacities are also limited and we can’t respond to all the needs. It is disheartening to see people’s vulnerability increasing and more people requiring more and more medical support.

We have become a nation on edge with limited access to anything and everything: medical equipment and medications, fuel and electricity, food and water.