Eps. 4: Lebanese health sector is deteriorating in light of outbreak of Coronavirus; patients complain of lack of medicine and neglect

BY

Wed, 13 Jan 2021 - 02:24 GMT

The situation in Lebanon's hospitals is terrible

The situation in Lebanon's hospitals is terrible

Headlines

 

- "The Land of heartbreak", Lebanon's health in "intensive care" ... the health sector is facing the challenges of the Covid-19 pandemic outbreak, the economic crisis, and the emigration of doctors ... patients complain of drug shortage and neglect ... A Citizen told us: "My father waited for his turn in the hospital until he died." Leader of Hospitals Syndicate: 85% of services are threatened with suspension, and the situation is catastrophic and leads to collapse if the government does not put in place an urgent rescue plan.. Resolution 573 of the Banque du Liban, is a fatal blow threatening to stop receiving patients in hospitals soon ... and the Ministry affirms work to improve conditions.

 

- Patients are among the crimes of negligence and the fire of high prices ... Citizens suffer from a shortage of basic medicines in the market...and the Lebanese Minister of Health confirms: The pharmaceutical mafia collapses soon, and pharmacies involved in smuggling are closed. Hamad Hassan: Taking measures to ensure a fair distribution of medicines to all citizens. Lebanon is waiting for Covid-19 vaccine in early 2021

 

- Patients and families who died of “Covid-19" complain: Negligence led to death.. Daughter of one of the deceased Covid-19: They left my mother in an inhuman room without food or medicine, and hours later she died. Ahmed Al Mahdi from Tripoli: My father died because he waited his turn to get an intensive care room, and we do not have hospitals equipped to receive Covid-19 patients... the Ministry of Health responds: The matter requires investigation...There is a team from the "World Health Organization" to enhance the capabilities of hospitals that receive covid-19 patients ... and the Ministry is still working to equip government hospitals and encourage the private sector to receive patients.

 

- A patient in Akkar governorate: I went to the hospital to have a gallbladder operation, and they cut off half of my liver.

 

- The state is unable to pay US$ 300 million dues to hospitals

 

- The lack of beds for Covid-19 patients in several regions, the insufficiency of respirators, the poor equipment of hospitals, and the shortage of foreign currency ... increase concerns about the ability of the health sector to cope with the epidemic.

 

- Head of Medical Syndicate: The number of people who emigrated from the end of August until mid-October reached nearly 300, and the rate of emigration is between 7 and 8 doctors per week

 

-Minister of Health: We will take measures to arrest drug monopolists while the citizens suffer from a shortage of medicine in the market. Hamad Hassan: 2 shipments of smuggled medicines have been seized at the airport ... and warehouses that store huge quantities of essential medicines for the citizen and infant formula...We will take measures to arrest drug monopolists while citizens suffer from a shortage of medication in the market.

 

 

 - Confronting the operations of the drug smuggling mafia and its monopoly ... closing pharmacies in the Zahle region in the Bekaa district with red wax that used to smuggle medicines abroad

 

- The dollar crisis, the state’s inability to pay hospital dues, and the emigration of doctors. The continuous blackout ... the explosion disaster and the outbreak of the Covid-19 epidemic ... crises driving the health sector to the brink of an abyss

 

- Director General of Health: We are preparing for the next period to convert a number of public government hospitals into private hospitals for Covid-19.

 

- Director General of Health: The economic disaster forces the state to ease the lockdown measures. Lebanon does not have the elements to withstand all these disasters, so we asked for the support of friendly and brotherly countries.

 

- A UN official to Egypt Today: The organization is working to support the public health sector in Lebanon, providing 14 major hospitals with essential drugs and supplies to support 2,600 surgeries.

 

- A UN official stated: The World Health Organization has been working to support the health system intensively since the beginning of the escalation of the economic crisis...some international institutions provided initiatives and programs to support this sector, including the United Nations...the organization is working to secure funding for a plan for the rehabilitation and reconstruction of hospitals and clinics affected by the Beirut explosion.

 

- Leader of Hospitals Syndicate to Egypt Today: Poor preparedness of hospitals, insufficient breathing equipment, and a shortage of foreign currency. It increases concerns about the health sector's ability to confront "Corona" ... We have warned the Ministry of Health and the Bank of Lebanon against the step of canceling the subsidies ... The bank responded that there are not enough foreign exchange reserves to continue with the support.

 

- Leader of Hospitals Syndicate: The health sector losses ranged from 80 to 100 million dollars, and no organization came to help hospitals to rehabilitate. 2,500 employees and doctors have been laid off so far.

 

 

- Secretary General of the "Red Cross" of Lebanon: The health conditions in Lebanon are not reassuring, affected by the explosion and the economic situation ... There are important hospitals that have been destroyed, and some of them need 40 million dollars to be rehabilitated .. The Corona pandemic situation is extremely worrying ... Chronic disease patients face difficulty in obtaining medicines due to lack of availability and high prices.

 

- The Coronavirus pandemic situation after the port explosion has become very worrying due to contact and the infection rate has quadrupled.

 

 

- Director General of the Ministry of Public Health of Lebanon: We have a plan for the coming period to encourage the national pharmaceutical industries.

 

- Leader of Hospitals Syndicate: The Covid-19 pandemic and the Beirut port explosion have emptied hospitals of their stockpile, the subsidy cancellation, and the state’s failure to pay hospital dues threatening it to stop receiving patients. The Director General of Health Lebanon replies: The state is obligated to pay, and hospitals use “pressure" to get their dues faster.

 

- Director General of Lebanon Health: The medical sector crises will only be solved by the formation of the new government and the start of economic reforms.

 

- Director of Hariri Hospital: International medical aid played an important role in supporting hospitals to continue their role.

 

- Director of the Saint George Hospital University Medical Center: The government pricing is unfair for hospitals. $ 15 for a room, including accommodation, nursing, and meals ... The hospital sector appealed to the state represented by the Ministry of Health and the guarantors, but unfortunately, "the state is sleeping" and officials are taking advantage of the weak people.

 

- Director of the Saint George Hospital University Medical Center: The Hospital Syndicate decided to stop receiving patients who belong to the Social Security for a temporary period ... Hospitals have lost their ability to accommodate all patients, and therefore the patient is affected.

 

Egypt Today is inside the Covid-19 isolation unit at Rafik Hariri Hospital ... Unit official states: The capabilities we have are insufficient compared to the large numbers of Corona patients ... Many patients do not have the ability to purchase the necessary medication for home treatment.

 

- An official at the Covid-19 isolation unit at Rafik Hariri Hospital: There are patients suffering from chronic diseases such as kidney failure and they are in need of dialysis. We cannot provide places for them and other hospitals do not receive them.

 

- A Lebanese security official for Egypt Today: The health situation in Roumieh prison is critical, and efforts are made to limit the spread of “Covid-19".

 

- Head of Internal Medicine and Chest Diseases Department at  Saint George Hospital University Medical Center: Covid-19 represents a major crisis in Lebanon, specifically due to the limited capabilities.

 

- President of the Medical Syndicate: Winter is a health disaster for Lebanon if we do not adapt our health system ... Expectations of a widespread outbreak of the epidemic in conjunction with the wave of doctors' emigration.

 

- Director General of Health in Lebanon: The medical sector has been greatly affected by the rise in the dollar’s exchange rate.

 

- Breathtaking moments inside Lebanese hospitals to save the victims. Accounts of heroes on the first line of defense: We used to stitch wounds in the streets and garages. We made the young men removed their clothes to tie the wounds and used the sheets to bring the patients down from the upper floors .. People asked for help, we could not save them.. Nurse Pamela, who saved 3 newborns: I carried them and ran for 5 km in the rubble and over the glass...The next day we returned to clean the hospital from the rubble

 

 

- Director of Rafik Hariri Hospital: The Ministry of Health warned us about the seriousness of the situation, and if it continues, government hospitals will not be able to provide services to citizens, especially as the pressure on them increases after the increase in the percentage of those below the poverty line

 

- Head of the epidemiological surveillance program at the Lebanese Ministry of Health for Egypt Today: Lebanon is facing a fierce wave of the epidemic, which has reached its peak

 

 - UNICEF official stated to Egypt Today: We were able to deliver awareness messages to 300,000 affected people about the Corona pandemic

 

- Minister of Health Hamad Hassan: We are approaching the European scene regarding the Covid-19 situation and closing is the last opportunity

 

- PM Misbah Al -Ahdab: Northern hospitals lack the minimum requirements of medical equipment...the Ministry of Health's attention is focused on hospitals in Beirut and Hezbollah areas

 

- A UN official to Egypt Today: We are currently working to support about 14 government hospitals with the necessary medical equipment to take care of Covid-19 patients

 

- Head of the Doctors Syndicate in Tripoli: 25% of the total health sector workers are expected to emigrate

 

- The health sector crisis in numbers

 

 - 118,664 thousand total Corona injuries and 934 deaths since February 21 until November 26 (according to Ministry of Health statistics)

 

- 100 million dollars in losses to the health sector due to the Beirut bombing (according to the Hospital Syndicate)

 

- 15 hospitals are about to be closed (Hospital Syndicate)

 

- 80% of the hospital sector in Lebanon is private hospitals that provide 85% of health services in Lebanon (Hospital Syndicate)

 

- US $ 30 million, the cost of treating the injured in the explosion

 

- 450 billion pounds of debt owed by the Lebanese state to hospitals during the period from 2012 to 2018

 

- Almost 300 doctors emigrated from the end of August to mid-October (Doctors Syndicate)

 

- 40 hospitals were damaged in the explosion, including 3 hospitals that were completely destroyed (Hospitals Syndicate and the Ministry of Health)

 

- Approximately 3 years for the medical sector to recover from the crisis, and its conditions cannot be addressed in isolation from the conditions of the country as a whole

 

- 140 private hospitals and 30 government hospitals .. are the entirety of the medical sector in Lebanon

 

- 7,000 doctors work in the private hospital in Lebanon

 

- From 1000 to 1500 cases of Covid-19 per day in Lebanon (Lebanese Ministry of Health)

 

- 2,500 employees and doctors have been laid off so far

 

Lebanon: With unfocused eyes and a trembling voice, Nawal Al-Saadi, a 55-year-old diabetic, stuttered, then asked: Are we going to be deprived of medicine too?! .. A question that Nawal directed at the officials when we met her while she was walking down Hamra Street in central Beirut, summarizing the concerns of patients in light of their suffering due to the current conditions in Lebanon. The question was repeated vehemently on the tongues of many Lebanese in conjunction with the government preparing a new strategy for support, which it has not yet been approved.

 

"Hospital of the East" is the title that Lebanon has won since the 1990s for the distinction of the health sector, but with the deterioration of its conditions, it has become in "intensive care"!

 

 "Canceling drug subsidies" is not the only crisis in the Lebanese health sector. There is an outbreak of the “Covid-19" pandemic, in light of the weak capabilities of the medical sector, which prompted the country in mid-November to completely close for 15 days, while the Minister of Health in the caretaker government, Hamad Hassan, announced a glimmer of hope. About an agreement signed with "Pfizer” company, for Lebanon to receive the vaccine in the first quarter of 2021.

 

On the other hand, patients are screaming about negligence, high prices and the absence of oversight, at the same time hospitals complain about the accumulation of their financial dues with the state, threatening to close their doors to patients, especially in light of the economic crisis that places restrictions on the import of medical supplies due to the lack of foreign currency and the restrictions on hospitals to withdraw from their bank accounts, which puts them at the gates of an unprecedented crisis.

 

All of this comes at a time when the hospital sector is still exhausted, suffering as a result of the losses resulting from the Beirut port explosion.

 

Between officials, patients and medical staff ... we discuss in this file the crises and fate of the health sector in Lebanon.

 

We met a number of patients and their families (15 male and female patients) in different cities to convey their suffering, among them Hajjah Mona Ibrahim, 70 years old from Beirut, who spoke restlessly from the severity of pain, as she suffers from kidney failure, accompanied by her husband on the treatment trip: «I suffer from kidney and heart diseases and high blood pressed, my husband pays all his pension and borrows money to buy medicines, and sometimes charitable people help me, but the prices are rising every day, and there are some types of medicine that we don’t find. They are not available in the ministry’s distribution center. I did two catheterization operations earlier and now I need a third operation. that I cannot afford, if they cancel the subsidies on medicines I would die!

 

Patients are torn between manipulation and neglect

 

 In a faint voice suffocated by the bitterness of pain and need, Shimole Barbine says: “I was injured in the Beirut explosion and I am still receiving treatment. I need several operations for my arms and back, and I don’t have money to afford for the many expensive medicines. I’m unable to buy them. I don’t know what to do? "

 

Aisha Muhammad, 55 years old from Akkar governorate, continues talking about the suffering of patients. She says: “I suffered a tragedy after entering a hospital, to have a gallbladder operation, and they accidentally cut half of my liver. No one told me the truth. My health condition kept worsening, until I discovered the calamity after I undertook a scan at another Hospital! ».

 

Al Hajjah Aisha barely finished recounting her story, saying: “My late husband, may God have mercy on him, had symptoms of a stroke and was dying, but in the hospital they told him to go home you are fine. After he arrived home within hours his condition got worse and we took him to a hospital, so they informed us that he is suffering from a stroke and they couldn’t save his life... My husband is victims of neglect, and there are many others like us...Who can get us our rights back?

 

Nader Ahmed, from Sida in the south, a father of three, added: “We are suffering from a crisis due to the hospitals’ manipulation of prices in the absence of oversight. After my wife gave birth under social insurance coverage. The hospital asked me for a big amount of money as a cost difference that was not paid by the ministry but it was much higher than the declared rates, I had no money and they kept us in the hospital until I got the money from friends of mine...the prices are high and at the same time the services are bad."

 

The suffering with very high prices is also the complaint of Abdul Qadir Ater, a resident of North Lebanon, who told us: “The patients suffer great suffering, and no one helps those who get sick except God. Who does not have an insurance can’t afford the prices of hospital and who goes to hospital at the expense of the Ministry of Health suffers great deal of neglect and needs to know someone so he can be accepted in the hospital?”

 

 Ater adds: As for medications, many types of them are hidden from the market, and if they are found, their prices are beyond our affordability. I spend almost all my income on medicines. Diabetes medicine costs 60,000, and nerve medicine costs 70,000. I have to buy it one strip at a time. If the subsidies are canceled, how will we be? !

 

He continued, saying, “After the Corona pandemic, suffering doubled because hospitals did not have services for regular diseases, and medical staff became at the lowest levels of efficiency.”

 

Medication Mafia

 

 While the citizen suffers from a shortage of basic medicines, pharmacies withdraw essential medicines for patients and infant formula from the market and store them in warehouses to smuggle them abroad or sell them for several times their price, as revealed by campaigns carried out by the Ministry of Health recently. Two shipments of smuggled medicines were also seized at the airport. On that note, the Minister of Health called for dealing with the drug mafia and its smuggling, stressing the start of its collapse and taking measures to ensure the fair distribution of medicines throughout Lebanon and to control those who monopolize them while the citizen suffers from their shortage.

 

Hospitals are at stake

 

"The situation is catastrophic and will end in collapse if the government does not put in place a rescue plan." This is how Dr. Harun Suleiman, the head of the Hospitals Syndicate, describes the situation in the health sector in Lebanon, and in details he said that the sector is still suffering as a result of the losses incurred by the port explosion, amounting to about US$100 million. Forty hospitals were destroyed, concentrated in the areas of Beirut, Baabda and the northern coast, including 3 hospitals with total destruction in addition to losses in medical devices. So far, no party has come forward to help these hospitals to rehabilitate.

 

 Suleiman added that the dollar crisis led to an insane increase in the prices of medicines and medical supplies, about 80% of which are imported, and despite the fact that the drug subsidy reaches 85%, but many patients are unable to pay after the deterioration of the price of the lira, so how will the situation be after canceling the subsidies? ! Certainly, the citizen will be unable to buy medicines, and hospitals will not be able to perform surgeries because of the cost of medical supplies, especially since the Corona pandemic and the explosion have emptied hospitals of their stock, so the Ministry of Health and the Bank of Lebanon warned us of the danger of canceling it, and the response of the bank was that it does not have sufficient foreign exchange reserves to continue to subsidies.

 

Haroun explained that the cost of treating the injured in the blast exceeds US$ 30 million, according to initial estimates by the Syndicate. The hospital sector fully bears it, as the Ministry of Health has not paid its share, and many hospitals are threatened to stop receiving patients and 15 hospitals are on the verge of closure if the crisis is not resolved.

 

He pointed out that private hospitals, which represent 80% of the hospital sector in Lebanon, are suffering due to their worsening debts in conjunction with the banking sector crisis, in addition to the weakness of their resources, and these hospitals, which constitute 85% of the health services in Lebanon, are afraid to close their doors, explaining that the problem is chronic However, this has been further exacerbated by the accumulation of debts owed by the Ministry of Health and the guarantors, including the army and internal security, and the value of the debt is 450 billion pounds during the period from 2012 to 2018.

 

Dr. Suleiman added that in the face of this amount of debt, the medical services provided to citizens were reduced, and a number of hospital departments were closed, which resulted in the layoff of some employees. The strength of the private hospital sector in Lebanon is 25 thousand employees and technicians, in addition to 7 thousand doctors. 2,500 employees and doctors.

 

Suleiman added that the circular issued by the Central Bank No. 573 obliging the importing companies to pay the amounts due to them to the banks in cash, which is estimated at 52 billion pounds, is a fatal blow to hospitals and threatens to stop them from receiving patients soon, in light of the companies' inability to provide cash and thus stop import What creates a major crisis between these companies and hospitals, and Soliman stressed that if the Banque du Liban does not exclude the health sector from this decision, we are going for the worst, and the exorbitant bill will be borne by the patient.

 

Hariri Hospital is facing danger!

 

Another aspect of the suffering of the medical sector is explained by Dr. Edgar JoJo, director of the Saint George Hospital University Medical Center in Beirut, saying that the situation became more difficult after the drop in the price of the Lebanese pound, although the Bank of Lebanon set a special dollar price for medicines and some medical supplies, but the devices and spare parts remain at the black-market price.

 

Dr. Firas Al-Abyad, director of the Rafik Hariri Governmental Hospital in Beirut, which is the largest government hospital in Lebanon, agreed with him, stressing that the exchange rate has become the main problem facing the health sector, which has affected the hospital equipment, indicating that the economic conditions that Lebanon is going through made the state. It stopped paying its debts to hospitals, which are estimated at 200 million dollars to government hospitals, and we have addressed the ministries of health and finance several times, to no avail, and if the situation continues, we will not be able to provide services to citizens, especially since the pressure on government hospitals increased after the increase in the percentage of those below the poverty line.

 

Al-Abyadh added that Hariri Hospital is facing a lot of pressure due to the difficult economic conditions, especially with the imperative to equip it to receive cases of Corona while it did not receive the required support for this equipment.

 

Edgar JoJo, director of the Saint George Hospital University Medical Center, pointed out that the price of social security after the collapse of the Lebanese pound has become "ridiculous" and unfair. What the insurance pays is equivalent to approximately $ 15 per room, including the patient’s accommodation, nursing and meals, and the operations cost more than the value of the insurance, in such case hospitals bear the difference, he added: “ Unfortunately, the state is unaware, and officials are taking advantage of the poor people. ”

 

Dr. JoJo adds, and as a result of all these problems, the Hospital Syndicate decided to temporarily stop receiving cases paying via Social Security.

 

Health conditions in the north

 

North Lebanon suffers double the suffering in the health sector due to the negligence of the Ministry of Health in the governorate, according to what the resigned MP, Misbah Al-Ahdab, confirmed. Hospitals lack the simplest medical equipment.

 

“Rooms are crowded with patients’ beds, and the bed is dirty, down to the floor dirtier with debris.” This is how FirasRigby in northern Lebanon, the father of the child Daniela, described to us the scene of the room that received his daughter after her birth, and added: “I work as a truck driver despite our living conditions my wife gave birth in a private hospital because the governmental hospital looms with certain death. It does not contain the minimum level of care or equipment, and even the private hospital capabilities are at the minimum and without any supervision“.

 

He continues, saying: “After giving birth, the child got sick, so they put her in a room with 3 elderly patients, even a thermometer was not available. After 3 days they told us that she is fine even though she was suffering from infections that we do not know the cause of, after 12 hours she had a relapse so we went to another hospital where we discovered that her condition is difficult and she has acute infections due to a rotavirus infection from the maternity hospital ... unfortunately the health situation is shameful!

 

How did the explosion affect the sector?

 

Dr. Edgar JoJo, Director of the Saint George Hospital University Medical Center, says that the explosion has seriously affected the health sector that has been already in suffering for years. Our losses resulting from the explosion are estimated at about $ 40,000, and parts of it are still under repair, in addition to the high cost of treating the injured at the expense of the state that haven't been paid it yet.

 

International support for the health sector

 

 Dr. Firas Al-Abyad said that international medical aid has played an important role in supporting hospitals, and that we have partnerships with several international organizations to provide medical services to citizens.

 

Dr. Najat Rushdie, the United Nations Humanitarian Coordinator in Lebanon, explained that the United Nations is working to support the public health sector in Lebanon. Fourteen major hospitals have been provided with essential drugs and supplies to support 2,600 surgeries, explaining: “The health sector in Lebanon, especially the public healthcare sector, has been suffering for years of structural challenges. So we have worked tirelessly to support the health system, and with the worsening of the Covid-19 epidemic and the acute crisis left by the explosion, we have been keen to respond quickly to these crises and distribute medical and surgical supplies to hospitals. The United Nations is working to secure the necessary funding for the reconstruction of health facilities affected by the explosion.».

 

Emigration of doctors

 

Doctors in Lebanon also bear some of the suffering. Dr. Salim Bin Saleh, head of the Doctors Syndicate in Tripoli, expressed it to “The Seventh Day”, saying that “the suffering of doctors and nurses pushed them to the unprecedented turnout for immigration, which threatens a vacuum in competencies in the medical sector, as the number reached approximately 300 doctors have immigrated from the end of August until mid-October, and the emigration rate is between 7 and 8 doctors per week. It is expected that the percentage of immigrants will reach 25% of the total workers, and this comes in light of the termination of contracts for some and the reduction of the salaries of others. The delay in receiving salaries for more than 6 months after deducting between 45% and 50% of its value, and all this is due to the poor management level of the Ministries of Health and Finance.

 

Dr. Salim continues: The suffering of doctors increased after the decrease in the value of examination fees, to become equivalent to only 5 dollars instead of 23 dollars..

 

Dr. Salim continues: We addressed the Ministry of Health about the doctors ’suffering, and it replied:“ There is no increase in doctors ’fees and it is not possible to speed up the payment process”!

 

Dr. Rahim Dunia expressed this suffering, saying: “I decided to emigrate to Dubai. I cannot continue in light of the deteriorating situation of the medical sector. Hospitals cannot provide sufficient funds.

 

Trading Our Way Out of the Crisis

 

 Regarding the solution to the hospital crisis, Dr. Suleiman Haroun said that recovering from the crisis takes about 3 years, and the health sector situation cannot be addressed in isolation from the conditions of the country as a whole, and the beginning of the solution is for state agencies to pay the dues, but this is currently difficult, so the solution is external support, otherwise We are on the verge of disaster, and he added, "Negotiations are currently underway with the World Bank to approve loans of $ 500 million with a grace period of 3 years and repayment over a period of 5 years."

 

The ministry responds

 

In the context of his response to what we have conveyed about the complaints of patients we met, especially those who do not have insurance or social security that they will not be able to bear the costs of treatment and surgeries, Dr. Faddy Sinan, Director General of the Ministry of Health in Lebanon, confirmed to “Egypt Today", that the Ministry does not cover the expenses of examination by doctors in clinics and this problem appeared as a result of the increase in the number of people below the poverty line, as for the costs of hospitalization and some surgical operations, the Ministry covers them for any citizen who does not have insurance. He further confirmed that the prices of medicines are subsidized, and we have a center in every governorate for the distribution of medicines for some chronic diseases with high cost, stressing that the medical sector in Lebanon is better than other countries undergoing similar conditions.

 

  Dr. Sinan added that the medical sector has been affected by the high exchange rate of the dollar, especially since the ministry's pricing for hospitals and medical services is in pounds, while hospitals import their medical supplies in dollars, which has resulted in large losses for them, and this gap is the cause of problems between the Ministry of Health and hospitals.

 

As for the dues of public and private hospitals, Sinan said that their total is equivalent to approximately US$ 300 million, according to estimates by the House of Representatives, which approved their payment months ago, and we are examining the mechanisms of payment because the amount is not available in the state budget, but it will be provided by borrowing and we are working to finish it as soon as possible. On the reason for the accumulation of debts, he said this crisis occurs every 6 or 7 years because it is money in excess of the funds allocated to hospitals, and then the House of Representatives issues laws for the solution.

 

 Sinan added that Lebanon has 140 private hospitals, 30 government hospitals and a large group of insurers. The Ministry of Health is considered the largest and checking bills takes a long time, especially since hospitals sometimes exceed the financial ceiling for accreditation, but the state is obligated to pay.

 

Sinan added that the medical sector crises are a reflection of the economic crisis in Lebanon, and the solution will come with the formation of the new government, the start of economic reforms and the solution of the exchange rate problem.

 

Sinan stressed that medical services are provided at a high level, and the medical sector was affected only by the explosion, which damaged a number of hospitals, and that they will be restored and reopened in early 2021. On the plans to develop the health sector, Sinan said, firstly, to revitalize hospital tourism, as it is one of the most important sources of income in Lebanon, especially as it is characterized by important medical specialties such as cancer and cosmetology, but Lebanon lacks political stability, so without stability, success cannot be achieved in any field.

 

He pointed out that there is a plan reorganize the health sector and encourage national pharmaceutical industries. There are currently 7 private sector factories that will be expanded.

 

On the role of the Ministry of Health in containing the repercussions of the explosion, he said, "We have contributed to treating the injured, and some cases still require surgery, and whoever does not have an insurer, the ministry handles his treatment."

 

"Covid-19 and the preparedness of the Medical Sector

 

The "Corona pandemic" has a special impact in a country burdened with crushing crises, and although the state is still able to some extent to deal with the crisis, the rapid spread of it - as the total number of infected people from February 21 until now reached 118,664, and 934 deaths, (according to the Statistics of the Ministry of Health) - Amidst many crises that threaten the viability of these hospitals, especially with the possibility of hospitals refraining from receiving more non-critical cases, in light of the shortage of medical supplies and medicines.

 

In this context, the head of the Hospitals Syndicate stressed that there are insufficient ventilators, poor hospital readiness, and a shortage of foreign currency, which increases concerns about the health sector's ability to cope with the epidemic. Meanwhile, Hamad Hassan, Minister of Health in the caretaker government, warned of an imminent disaster due to the increasing number of Corona cases in Lebanon in the second wave of the epidemic in front of a dangerous turning point.

 

Hariri Governmental Hospital is the largest hospital that receives Corona cases, and since the beginning of the pandemic it has performed 45,000 corona examinations, according to the statements of Dr. Firas Al-Abyad, director of the hospital, adding: “We have 122 beds, an intensive care room and 23 respirators.

 

Dr. Firas Al-Abyad added that Lebanon is still in a very worrying stage (the peak), and the inability to impose long-term closures due to the economic situation worsens the situation. As for Lebanon's preparations for the pandemic, he said, there are 220 intensive care beds for Corona patients, and the extent of their sufficiency depends. On the scale of the epidemic.

 

For his part, George Kettaneh, Secretary-General of the "Red Cross" in Lebanon, affirmed that the health conditions in Lebanon are alarming, and that there is difficulty that some patients with chronic diseases and cancer face in obtaining medicines due to their unavailability and high prices. The suffering will increase after the support is lifted and we try to contribute to solving the crisis, especially the explosion led to the loss of a large part of the stockpile of medicines, and also destroyed important hospitals. Some hospitals need US$ 40 million to rehabilitate them.

 

The isolation unit at Hariri Hospital

 

Among the waiting patients hoping to enter, and their faces appeared to be very tired, we made our way to the Covid-19 Patient Isolation Unit at Rafik Hariri Hospital to closely touch the health reality. Inside we found a limited number of beds and respirators, and loud voices for the patients' moans accompanied by continuous coughing and their throats echoing the phrase, «Oh Lord », one of them is sitting on a chair barely breathing, and doctors rush to try to rescue him and find a respirator for him .. While others are knocking on the door.

 

"The load on the hospital is great and the numbers that arrive daily exceed 600 cases, and the hospital does not bear this amount, so we are forced to keep some patients in the emergency until places become available." At home, adding that the capabilities inside the unit are not sufficient for the number of patients, and there are patients who suffer from chronic diseases such as kidney failure and need dialysis, and we cannot provide places for them and other hospitals do not receive them.

 

Among the problems, Kansu added, many patients do not have the means to provide the drugs required for treatment at home, so we try to describe the minimum or focus on vitamins, especially since there are many patients suffering from malnutrition. He continues, saying: "We need ventilators, and we also have a shortage of blood oxygen measuring devices (StirMometer) for patients who suffer from shortness of breath. We need more protective clothing, and also medical personnel. We have about 40 doctors, and this is not enough."

 

The disaster of Winter!

 

The head of the Doctors Syndicate in Tripoli adds that winter represents a health disaster for Lebanon under our current health system. There are expectations of a greater outbreak of the pandemic, especially in light of the wave of doctors 'migration abroad, and the reluctance of some private hospitals to receive Covid-19 cases, which creates a crisis of unavailability of beds for  patients, he adds. : "At the same time, the Ministry of Health and other ministries are running randomly, without clear plans."

 

Covid-19 patients ... are suffering neglect leading them to death

 

Amid fears that Covid-19 will get out of control, patients and their families complain of neglect in providing the necessary medical care for Covid-19 cases inside hospitals, especially in the north.

 

Kamila Al-Atr, from the Danniyeh region in northern Lebanon, died due to negligence. Her daughter recounts the story, saying: “My mother died because of neglect. When she got sick we took her to Abdullah Al Raas governmental hospital. The scan for Covid-19 came out positive so they held her in the hospital. We couldn’t contact her for 3 days. So we ran to the hospital to check on her. We found her lying on the ground dying from shortness of breath and the room is inhuman, without ventilation or hygiene. The nurse refused to help her, so I entered with my brother and she could barely describe her condition to us, she was without food or medicine, even though she was sick with heart and diabetes conditions. At home, we discovered that blood oxygen was 57%, and she was supposed to stray in the hospital...My mother died within hours, and we could not transfer her to another hospital. There is no conscience, I advise people not to go to hospitals so that they would not die! ”

 

Ahmed al-Mahdi, in Tripoli, in the north, adds: “The health situation is dire even before Corona. The numbers of cases and deaths we have are frightening. My father died because he was ill and it took us days to find a hospital, and finally after 5 days a hospital agreed to receive him, but unfortunately it was not equipped for Covid-19 cases. My father was left in a room without any equipment, when we objected, they told us: that’s what is available, otherwise take him home! .. He needed a room for intensive care and had to wait his turn, but unfortunately he could not bear the wait and he died .May Allah avenge for him ”Al Mahdi concluded:“ My father is not the only case, there are many cases that died due to negligence. ”

 

Dr. Salim bin Saleh, head of the Doctors Syndicate in Tripoli, says, "We asked the responsible authorities for a quick support plan for the northern regions, and the response was:" There is no budget! "

 

Ministry of Health: An investigation is required

 

In response to these accusations, Dr. Nada Ghosn, head of the epidemiological surveillance program at the Lebanese Ministry of Health, said that this matter requires investigation, but currently, a team from the «World Health» is strengthening the capacity of hospitals that receive patients with COVID-19 19, especially that we are in a critical period. But, until now, the level of health preparedness is better than other countries, and the ministry still supports equipping government hospitals, in addition to the agreement announced by the ministry to oblige private hospitals to receive cases of "Corona".

 

Ghosn confirmed that Lebanon is facing a fierce wave of the epidemic, which has reached its daily peak between 1000 to 1500 cases a day.

 

Fatima Mohamed, from Beirut, was afflicted with Covid-19, narrating her experience: “There were no apparent symptoms. I was just feeling short of breath, and after the examination the result was positive, I retired, but the problem was the lack of medicines, and each doctor prescribed a different treatment, and what was in it Medical follow-up during the treatment period, as well as there are no clear instructions to the Ministry of Health about the protocol for the isolation period, so I began to ask those who had gone through the experience before me, and in the Ministry they told me what was necessary to repeat the test, after 10 days if symptoms subsided, return to your normal life! But I insisted on repeating the test until I was sure that it was negative before contacting people. ”

 

Regarding the difficulties facing Corona patients in Lebanon, Dr. Edgar JoJo, Director of the Roman Hospital in Beirut, said that most medical insurance companies refuse to cover the cost of Corona treatment for subscribers, and they are a large proportion of patients and therefore private hospitals refuse to receive them, as insurance companies have suffered major problems since the explosion, and insurance contracts do not cover epidemics. The state is the one that takes care of the treatment, and in light of the state’s failure to play its role, the patient is the first victim.

 

Have the close down restrictions loosened a little?

 

The frightening situation of Covid-19 prompted the Lebanese state to take a decision to completely close for 15 days that will end next Sunday, this measure that caused restlessness in economic circles, but the health authorities considered it an imperative measure to prevent the health system from collapsing, especially since the beds and intensive care units are full of patients, and the authorities did not hide Its fear of repeating the Italian model, something that Lebanon cannot tolerate, neither demographically nor health.

The Prime Minister’s medical advisor, Petra Khoury, warned of a fierce outbreak of the epidemic, saying: “We are on our way to a terrible storm if we cannot control.”

 

Are the lockdown measures for numbered days sufficient to confront the fierce pandemic, or is it necessary to draw an integrated strategy for confrontation?

 

Petra Khoury says that the closure strategy requires more tests and tracking campaigns to ensure compliance, while the Minister of Health described the "closure" as the last opportunity for Lebanon not to replicate the miserable European scene, and MP Assem Araji, head of the Parliamentary Health Committee, warned of a significant increase in the infection rate in the coming period.

 

Dr. Faddy Sinan, Director General of Health, told “Egypt Today", "Lebanon has become on the red line of the pandemic, and thus the problem of the shortage of respiratory equipment has appeared, but we are trying to fill this deficit."

With regard to the closure policy, Sinan said that the economic disaster compels us to reduce the period of closure, as Lebanon does not have the resources to withstand all these disasters, so we asked for support from friendly countries, and we received a huge volume of medical aid, and Egypt was one of the first supporting countries.

Sinan described the current stage as "extremely dangerous", calling on countries that can provide field hospitals for Corona cases to help Lebanon. There is also a plan to convert public government hospitals into private hospitals in Corona, so far there are 12 government hospitals that treat Corona, in addition to the first category hospitals, about 30 A hospital, and Lebanon quickly booked a batch of Corona vaccine.

 

The health situation in prisons

 

Of course, the health situation inside prisons is more dire, in light of the widespread spread of Corona, attention may have turned to Roumieh prison - the largest in Lebanon - after the circulation of leaked videos last September, which showed overcrowded rooms with prisoners sleeping on the floor close together, while the head of the Beirut Bar Association, Melham Khalaf, warned that Covid-19 is a bomb inside prisons, he called on the government to take immediate action to confront the crisis.

 

 According to the statements of an official source in the Lebanese Internal Security, for the seventh day, the health situation in Roumieh Central Prison has become critical, due to the accumulation of inmates, whose number is close to 5,000 inmates.

 

 He explained that the injuries in "Roumieh" exceeded 377 cases, and to counter this, special places were established in a number of hospitals to treat severe cases. The source indicated that work to isolate the elderly, and about 200 corona examinations are conducted daily, in addition to preparing places for isolation of the injured with teams of nurses.

 

The source added that mixing helped speed the transmission of the virus, and one of the preventive measures that have been taken is to prevent receiving new prisoners since last February, except after they are quarantined in private places for a period of 14 days, stressing that all the infected people are in stable health and the highest levels of follow-up are being conducted for them in cooperation with "World Health" .

 

UN support in facing the pandemic

 

 In terms of supporting Lebanon, the United Nations had a role in supporting the health sector to cope with the pandemic, according to the statement of Dr. Najat Rushdie, the UN coordinator in Lebanon, who said: “We support epidemiological surveillance with laboratory tests and human cadres in order to implement the decisions of the Corona surveillance unit in the regions, and we support isolation centers with crews. Nursing, in addition to supplying 12 government hospitals with the necessary medical equipment for the injured.

Ted Cheban, UNICEF Regional Director, said, we were able to reach 300,000 people affected by the explosion with awareness messages about Corona, in addition to rehabilitating 15 health care centers that were destroyed.

The Regional Director of the World Bank in the Middle East, Saroj Kumarja, indicated that $ 45.5 million has been reallocated to support the Lebanese government's plan to deal with the pandemic and its impact.

 

White Army heroes under the cedar trees

 

The White Army or medical teams are the heroes of the two crises of the Covid-19 Pandemic outbreak and the “Port Explosion”, between the injured and the rescuers of those seeking help as brave warriors in the fields of work. Pamela recalls those difficult moments, saying: " At the moment of the explosion I fell on the ground and the doors fell above me, but I thought that I would save the children, so I gathered my strength and removed the rubble and tried to pave the way through the rubble to reach the children. I ran right away; we were on the fourth floor and we had 4 children in the nurseries. I carried Ali, Sidra and Nawar, and my colleague carried the fourth child with the help of our colleagues, they opened a small hole for us to reach the stairs, there was a darkness and a glass and rubble above it while I was carrying children, I hardly reached the first floor and there I saw the biggest calamity, all the medical staff were bleeding and trying to help the sick, and no one was able to help me, so I went out with the children to the road, and went to other hospitals but they were unable to receive them, so I ran with them a distance of 5 km, people started giving me their clothes to cover the children, until we reached Abu Jawdeh Hospital and I stayed with them until their parents came, and immediately the next day my colleagues and I went to clean the hospital and get the rubbles out.

Pamela added:” There was an underestimation of the status of medical staff, but after the crises of Covid-19 and the explosion, everyone began to appreciate the importance of the role of these teams.

Pamela was not the only heroic story, but there are many stories that confirm that these were the first line of defense in the face of the repercussions of the disaster. "The most painful thing in the scene is that people sought help from us, and we cannot save them," but they agreed at the same time that no matter how big the losses are, they will be able to rebuild Beirut.

“I work in the emergency department and at the time of the explosion, everyone around us was running and screaming, and people asking for help, I would not find anything to wear on my feet to walk on the glass, there was no aid material in the hospital. We started to make young men get off their clothes to tie the wounds.” This is how Rita Najem, a nurse, described the scene on the day of the explosion, adding: "We tried to collect medical materials from the middle of the rubble, and we were treating the wounded in the street, where a lot of people died in my hands, 4 of which were our colleagues in the hospitaland the nurses, despite their injuries, carried children and ran with them to save them."

Rita added, "The story does not describe the great pain in our hearts ... We will not forget it all our lives, the fear is beyond description within us, and any sound scares us, but we will not let what happened defeat us and we will come back stronger. "

Rola Itani, head of the emergency department at Rafik Hariri Hospital, added: I was home at the time and I was keen on being there with my colleagues in the hospital since early moments of the explosion, although most of our houses were destroyed but we left everything and ran to rescue the victims. At that that night, we received about 250 injured people and divided the patients into critical cases and less critical cases, and all the hospitals that were affected send their patients to us because the hospital here was less affected and we received 17 people who died on the spot.

Regarding the suffering of the psychiatric medical team, Rola said, the hospital recently started organizing sessions with psychologists to provide psychological support to the medical teams.

Despite the important role of nurses, they have many problems in Lebanon, and their material and moral rights are still incomplete despite the sacrifices they make and what they have continued their rights, thus through a number of nurses in different hospitals, including Pamela, Rita and Rola, demanding that more rights be given in terms of salaries and appreciation and that the nursing assignment be based on The same level of other professions, as a large number of nurses were laid off, and the salaries of others were reduced and the number of working hours and shifts decreased. Some shifts were reduced from 15 to 12 per month, and the incentives were also reduced by nearly half.

 In general, the health sector needs more attention because it is one of the most important sectors in the country and it cannot continue with this many problems it suffers from.

Dr. George Falakian, at the Rum University Hospital, said, “We are still suffering from the psychological and physical effects of the explosion, and despite my and many of my colleagues at the time of the explosion, we only thought about saving the patients on the upper floors, so we carried them to broken doors and put them down with sheets after the elevators stopped.”

In general, the health sector needs more attention because it is one of the most important sectors in the country and it cannot continue with this many problems it suffers from So would those in charge pay attention before it is too late?!

 

This article is part of a series of articles on Lebanon by Iman Hanna. Hanna has taken a 30-day trip to monitor the crises in Lebanon and  the suffering of the people.

 

 

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