The one-year anniversary of the horrific Aug. 4 Beirut Port blast is upon us. On that day, when 2,750 tons of ammonium nitrate exploded, Beirut’s largest academic medical centers and hospitals were so damaged that some had to evacuate their patients and turn away injured blast victims. Since then, Lebanon’s health sector has struggled to recover and now faces severe medicine shortages, electricity blackouts and mass migration of medical staff. As the country’s financial crises deepen, its health care system is heading into collapse and irreparable damage as it teeters on the edge of a precipice, barely able to provide basic care for people in their greatest hour of need.
In July, an otherwise healthy 38-year-old mother of three arrived at one of Beirut’s most reputable hospitals after falling and hitting her head. A year ago, her routine injury would have been handled by one of many neurosurgeons at a peripheral hospital near her home. This time, the woman’s family had to travel from one town to another, trying to find a hospital still equipped to handle her case, and ended in a medical center that recently lost a quarter of its physicians. The medical center had to scavenge for a neurosurgeon from yet another hospital to perform the life-saving procedure.
Once the medical capital of the Middle East, Lebanon’s world-class health care system has been stripped to the bones, ravaged by the country’s multiple political, financial, economic and health care crises.
Since October 2019, Lebanon has faced a severe financial and economic crisis that sent its economy and banking sector into a downward tailspin. The U.S. dollar, which was equivalent to 1,507 Lebanese pounds (LBP), recently peaked at 24,000 LBP in the secondary market — effectively a 94 percent devaluation.
Hyperinflation and severe shortages in goods and supplies, including medicines, gas and electricity, have forced a flight of the country’s medical talent. Many top U.S.-trained physicians who moved back a few years ago were once regarded as evidence of Lebanon’s success in reversing the civil war’s brain drain. However, dire conditions are forcing some of them to leave their country once again. Nurses who lived comfortably on a monthly salary of $1,000 now struggle to make ends meet, as their income plummets to less than $2 a day.
Lebanese health care workers were touted as heroes for their unique success in keeping the COVID-19 pandemic at bay for a while, though the explosion changed that. Despite the catastrophic circumstances the country has been facing, Lebanon has not experienced the same levels of disaster seen in India. Thanks to its once prosperous infrastructure, the country’s health care system was able to absorb multiple COVID-19 shockwaves and the heavy burden of the Beirut blast. It is estimated that 40 to 50 percent of doctors have made the difficult decision to emigrate.
The pharmaceutical sector also has been hit hard because of the scarcity of foreign currency (92 percent of medications are imported). This crisis has resulted in major shortages of critical drugs such as anesthesia, insulin and chemotherapy medications.
Patients are suffering as a result — for example, a 9-year-old girl whose adrenal insufficiency had been controlled on hydrocortisone but now needs attention at a hospital emergency department in full-blown adrenal crisis because her parents cannot find steroids in the empty-shelved pharmacies.
The U.S. — the world’s leader in medicine, research, innovation and health — has stood by Lebanon, and today more than ever, funding initiatives are needed to save Lebanon’s health care sector.
The U.S. can gain a significant advantage by granting Lebanon’s health system higher priority on its foreign policy agenda, thereby preventing shady entities from exploiting the crises. The U.S. and American citizens can help stop the brain drain and save the health care sector from collapse by supporting the private hospital systems that have been the driving force behind health care excellence in the country. These are the hospitals that attracted back the talent pool of the Lebanese diaspora and raised the bar for quality, safety and patient experience. Funding patient medicine access programs is also necessary to ensure access to basic, lifesaving and innovative medicines and vaccines.
Lebanon is in a deep crisis. Only the United States and the Lebanese diaspora have the capacity, resources and power to save it. If urgent aid fails to arrive soon, what was once a flagship sector in the Middle East unfortunately will become a tragic story of loss and suffering.
Petra M. Khoury, Pharm.D., a health professional expert leading Lebanon’s COVID-19 response team and chairing its COVID-19 vaccine executive committee. She obtained her degree from the Lebanese American University and completed her pharmacy residency program at Massachusetts General Hospital-Harvard University in Boston. Follow her on Twitter @petra_khoury.