Demise of a Legend – The Lebanese Medical Sector
On June 7 in an interview with The National, the Lebanese Minister of Health, Dr. Firas Abiad remarked that “Lebanon’s healthcare sector [is] a bomb waiting to explode.” Healthcare workers were reaching a breaking point, lashing out at doctors and administrators, going on strike, and emigrating out of Lebanon. Six months later, nothing has changed for the better. The government is an average of 22 months bn its payments to doctors and hospitals alike, owing close to $2 billion to those institutions. More than half of the country’s professional healthcare staff have chosen to emigrate, if they have not done so already, seeking better earnings so that they may feed their families and send their children to school.
This has been the situation since the Beirut Port blast and the economic implosion that has left Lebanon dependent on international aid and remittances from overseas. Even if the government begins a process of paying its arrears, most hospitals are refusing to admit patients knowing that the country is bankrupt and neither the availability nor affordability of medical care will change soon.
As an article in Cureus commented, “Currently, Lebanon remains in the depth of political and socioeconomic uncertainties. A tense political state ready to erupt into chaos at any moment, a continuously failing economy, and a relatively staggering COVID-19 morbidity and mortality rates have all left the country’s healthcare system in limbo.”
Cureus reports that “The shortage in medical supplies including medications, non-invasive therapy (NIH) machinery, nebulizers, dialysis machines, surgical kits, vital sign monitors, and oxygen tanks has left the healthcare system paralyzed as it attempts to fight against both a pandemic and a fragile economy. Even with the international donations that the country received over the past months, the lack of fuel and electricity renders supplies like NIH useless at homes, thus resulting in exacerbation and decompensation of chronic cardiopulmonary cases.” Even at ATFL, we are once again receiving requests for even the most basic medications and medical equipment. Basic cancer treatments and specialty medicines are almost impossible and as the world’s attention turns elsewhere, there are few options for those who are suffering or their families.
It is ironic that in 2018, Bloomberg ranked Lebanon as 23rd in the world, after Sweden, in healthcare efficiency. I remember Jordan and Egypt trying to expand their medical facilities during the civil war in Lebanon in order to replicate the success of Lebanon’s medical tourism. Both countries did not wind up succeeding, as Lebanon’s patient care and expertise were unrivaled in the region. Just four year later, however, Lebanon’s healthcare system is now on life support. As Al-Monitor pointed out, “Lebanon’s health-care sector is fighting for survival amid an economic collapse, with the lives of patients at risk as critical care facilities have been falling apart and for the majority of the population affording essential medicine has become a luxury.”
This challenge will not just fade away. “It is not only the medical staff who are in crisis. An economic depression is leading large numbers of health workers to quit for better opportunities abroad, forcing medical centers to close departments and turn away the needy.” What part of the population can afford to travel abroad for medical care? Certainly not those whose deposits are being held by the commercial banks, nor is it those who have felt the dramatic drop in the value of the lira, are unable to find even common medications in mostly empty pharmacies, and are unable to procure medications abroad.
Stopping the brain drain and restoring credibility and effectiveness to the public health care sector will require the Lebanese government to grapple with the IMF reforms that will give the country a chance to breathe again, which will not be achieved with the printing of more Lira. Lebanon is in disarray, and the Lebanese emigrant community is ready to help beyond the level of providing medicines and equipment. As the head of the Lebanese Order of Physicians made clear, “The health sector suffers from challenges that we may not be able to get out of unless efforts are combined, and we move quickly to save what can be saved, as the sector is on the verge of collapse in light of the emigration of the veteran generation of doctors in search of a decent life and lost dignity.”
At ATFL, we are looking at alternatives for assisting the public health sector by focusing on primary healthcare centers as the first line of defense in supporting the Lebanese people. We are working with Lebanese-American doctors and healthcare professionals to craft a strategy that we hope will attract necessary US government support and contribute to a gradual strengthening of the sector. We are not giving up; too much is at stake.
Disclaimer: The views and opinions expressed in these articles are those of the author and do not necessarily reflect the position of the American Task Force on Lebanon, a non-profit, nonpartisan leadership organization of Lebanese-Americans.