Lebanon’s worsening health sector leaves patients suffering

BEIRUT — Throughout Beirut and other regions, adults and children struggle for survival in a country crippled by poverty and debts, who share one thing in common — their fight against illness and a struggle to stay alive.

“It’s mentally, morally and physically exhausting,” is how breast cancer patient Rima Khodr described her days to Al-Monitor. “Cancer can be treated, but the economic collapse in Lebanon is turning it into a death sentence.”

Most Lebanese diagnosed with cancer cannot afford to start treatment or get their hands on medicine that are imported and sold at high prices.

Khodr said that she skipped her last two chemotherapy sessions, as she was unable to cover the costs. Her health insurance, which is fully covered by the Ministry of Health as her husband is a lieutenant in the army, has been denying her requests for a discounted treatment rate.

It is not just cancer patients who are suffering; it has almost become an impossible mission to find aspirin in Lebanon.

“I want to speak on behalf of all diabetic patients. This is simply genocide against us; they’re indirectly ending our lives. Medicine is either available but we cannot afford it, or it is unavailable altogether,” said Lama Eid, a 32-year-old patient with diabetes and mother of three from Beirut.

According to Eid, Lebanon’s multi-crisis has affected her mental health and her treatment, which in turn has worsened her diabetes and increased her blood sugar levels.

The rising cost of medicine in Lebanon has forced her to skip certain medications and treatments several times.

“Even affording the insulin resistance diet that my doctor has advised has become a challenge, because it is all quality food. And having three children also means that I have to prioritize their needs first,” Eid noted.

Lebanese health-care workers have warned for months of declining stocks of vital medical supplies, and there is little fresh dollar currency to buy medicine and supplies.

At present, 80% of health-care service facilities are private and the public sector has long been neglected and underfunded, and for now, international assistance from international organizations is what is keeping Lebanon on life support. 

Thousands of cancer patients have received help from the Barbara Nassar Association, a nonprofit and nongovernmental organization that provides support for cancer patients in Lebanon. Over the past six years, the group has provided medicines worth around $1.5 million. 

Hani Nassar, the organization’s founder, told Al-Monitor, “The colostomy bags used by colon cancer patients cost more than 2 million Lebanese pounds [$50] per box, and they need a few boxes of these per month, so some people are having to wash the bags to reuse them.”

Some cancer patients are forced to skip chemotherapy sessions, risking the spread of the disease.

“When someone is diagnosed with cancer, treatment needs to begin immediately to increase the survival rate, but in Lebanon it is the opposite for many,” Nassar noted, adding that it is like being sentenced to death for those who delay their treatment because of the financial barriers that limit their access.

The country used to rank high in the region for medical care, but standards have now plummeted along with an exodus of health-care staff and acute staff shortages that have added to the list of problems.

Al-Monitor reached out to Rola Itani, head nurse at Rafik Hariri Hospital. She said, “Nurses at the hospital are always overwhelmed and exhausted and the situation outside the hospital is adding extra stress to their daily routine and the constant pressure they face when dealing with patients.”

According to Itani, there is a shortage of nurses, and those working at the hospital have to take extra shifts to provide needed cover amid a shortage of staff.

Changes and reforms by the government seem like a far-fetched dream, and more doctors and nurses are leaving the country for opportunities abroad.

Reluctant to practice her profession in Lebanon, Maya Saab, a 25-year-old medical intern at Mount Lebanon Hospital, told Al-Monitor, “At first I was surrounded by top doctors with a lot of experience from whom I could gain skills, but every month I hear someone is leaving.”

With plummeting wages and stressful working conditions, Saab would no longer be able to practice her medical profession in her own country if no changes are implemented.  

She said that she will work at hospitals in Lebanon in the near future, but she believes the country is no longer a place where she can fulfill her dreams.

Dwindling supplies in Lebanon are also being reflected in health-care services, as the country is running out of cash to pay for imported products.

The declining value of the Lebanese lira has lowered the purchasing power in the country, with the medical sector severely suffering as a result.

President of the Medical Committee at Rafik Hariri Hospital Nawfal Nawfal told Al-Monitor, “The existing economic crisis directly impacts the way hospitals operate, because we receive our funding in Lebanese pounds and we pay for supplies in dollars.”

Nawfal said that fuel is one example of the many commodities that are adding an extra financial burden on hospitals, as it must be paid for in fresh dollars. Private hospitals have dollarized their services to cope with the cost of such commodities.

What this means for patients is unaffordable health-care services and sometimes it is a choice between life or death.

Almost everyone with a medical issue is facing problems. Pharmacists say that suppliers are often giving them as little as one to two packets of essential medicine in each consignment, so they have to be selective as to whom they are selling to and whether customers are in desperate need of the medicine or are just stockpiling it.

Nour Ghanem, owner of a pharmacy in Aley district in Mount Lebanon, told Al-Monitor, “Prices of medicine have soared despite being essential and life-saving, and patients are increasingly struggling to afford them.”

Ghanem said that she has customers wanting to buy medicine to treat their cholesterol, diabetes or blood pressure, but the high cost of the prescribed drugs leaves them empty-handed.

“Sometimes I have to sell customers the medicine by individual tablets based on the amount of money they have,” she noted. “It is honestly daunting and heartbreaking to witness the financial barriers that harm patients and deteriorate their health.”

Social media platforms are now used by the Lebanese in need of medicine or those willing to share what they don't need themselves.

Doctors now fear a surge in deaths that could have been avoidable as drugs are no longer subsidized, and for the majority of patients they have become out of reach.

Lebanon began gradually lifting subsidies on drugs in July 2021, and subsidies on drugs for chronic diseases were partially lifted in November 2021; now they include drugs used for chronic diseases, too.

Activists are demanding the country should produce more generic medicines to be available at lower prices in the market.