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    One year after the Beirut blast, the situation in Lebanon has got much worse

    refugee camp

    The Arsal refugee camp © Tariq Keblaoui/MSF 

    Fawziyya Al-Sahili stands in her kitchen in north-eastern Lebanon stirring a vegetable stew. “My neighbours brought me this meal yesterday, otherwise we wouldn't have any fresh vegetables,” she says. “We haven't eaten meat for a year. With my son's salary we can only afford bread, beans and lentils. That's the way it is now.”

    The 64 year old woman has high blood pressure and diabetes, and needs to eat a healthy diet with lots of fruits and vegetables. But these foods are often out of reach for her and her family. One of her sons works in a shop where he earns 10,000 Lebanese pounds each day – less than US$1 at today’s informal exchange rate. Her other son is unemployed. The three of them live together in an unfinished house that they can’t afford to complete.

    For the past two years she visits the Doctors Without Borders clinic near her house in the north Lebanese town of Hermel, for regular check-ups and to collect the medications and insulin she needs for her treatment.

    Fawziyya Al-Sahili

    Fawziyya Al-Sahili

    Fawziyya Al-Sahili in her kitchen stirring a vegetable stew. © Tariq Keblaoui/MSF 

    Fawziyya Al-Sahili, 64, suffers from high blood pressure, diabetes (and osteoporosis). She regularly visits the MSF clinic in Hermel where she is examined and given the right medication.

    Fawziyya has seen many crises in Lebanon. Despite the really difficult situation at the moment, she has hope that one day things will improve again. Sticking together and being patient is her motto. She is grateful for the aid she receives via the Doctors Without Borders clinic. © Tariq Keblaoui/MSF 

    Fawziyya Al-Sahili

    Fawziyya Al-Sahili with social worker. © Tariq Keblaoui/MSF 

    Fawziyya Al-Sahili, 64, suffers from high blood pressure, diabetes (and osteoporosis). She regularly visits the MSF clinic in Hermel.

    Fawziyya Al-Sahili being examined in the Doctors Without Borders clinic in Hermal after she fell. © Tariq Keblaoui/MSF 

    After the explosion

    Fawziyya and her family are part of the half of Lebanon's population now living in extreme poverty. Since 2019, this small country on the eastern coast of the Mediterranean has been hit hard by an economic crisis, rising inflation, political instability, and COVID-19 pandemic.  On top of all these came the explosion which rocked the capital, Beirut, on 4 August 2020.

    The huge explosion in the port area had devastating effects: close to 200 people were killed, more than 6,000 were injured and tens of thousands lost their homes. It also destroyed a number of public facilities, including hospitals, and badly damaged the central warehouse of the health authority, disrupting access to medicines, especially for elderly people and patients with chronic diseases.

    In the wake of the explosion, Doctors Without Borders teams donated first aid kits to the Lebanese civil defense and medical supplies and masks to the Lebanese Red Cross. Doctors Without Borders teams in three locations – Karantina, Mar Mkhayel and Khandak – treated more than 1,800 patients with wounds caused by the blast and 4,500 patients with chronic diseases who needed medical support.

    Doctors Without Borders teams also went door-to-door in affected areas to assess people’s needs. They installed water tanks and distributed water purification and hygiene kits; they also scaled up psychosocial support.

    In the weeks following the explosion, several public hospitals were almost at capacity due to high numbers of patients with COVID-19. People injured in the explosion rushed to reach hospitals without taking preventative measures, as coronavirus was the least of their worries.

    With numbers of COVID-19 patients rocketing, Lebanon was put under lockdown for several weeks. Even before the pandemic, the public health system faced regular bottlenecks in drugs and medical supplies as a result of the economic crisis. Post-pandemic, the situation grew even worse.

    Shortages of medicines

    One year after the Beirut explosion the people’s need for medical and psychological help is still enormous. At the same time, a visit to the doctor has become a luxury for many people due to the cost of private healthcare. “The health system in Lebanon is highly privatised so more and more people cannot afford medication or see a doctor,” says Hammoud al-Shall, Doctors Without Borders assistant project coordinator. “People have to decide whether to spend their money on food or drugs. The prices of both are up to five times what they used to be."

    Fawziyya needed pain medication but found it impossible even to get hold of even the most basic drugs, like paracetamol “I fell and then I had such a headache,” she says. “I wanted to buy paracetamol, but the pharmacist didn't have it. We tried three other pharmacies, but it was nowhere to be found. The drug is no longer available in Lebanon.”

    Such shortages of medications are challenging, even for organisations like Doctors Without Borders. It is difficult for local companies to import medicines into the country, so Doctors Without Borders teams now import the most essential ones themselves. The escalating fuel crisis has increased transportation costs, affecting both stocks of medical supplies and patients trying to reach medical care.

    An uncertain future

    Many people in Lebanon – both Lebanese and refugees – already struggle with stress and psychological trauma connected with war or displacement. Now, deteriorating living conditions are proving an additional burden and impacting their mental health. Numerous patients who seek psychological help from Doctors Without Borders suffer from depression, anxiety or despair.

    Fawziyya Al-Sahili worries about her family’s future. She’s particularly concerned about her son who is out of work. He also attends the Doctors Without Borders clinic in Hermel, where he receives psychosocial support.

    The meal now ready, Fawziyya sits on the carpet with plates of rice, white bread and vegetable stew in front of her. Her anxiety about the future is ever-present, but she has not lost all hope yet. There is solidarity amongst the Lebanese people and she feels supported by her community – not just the neighbours who bring her food, but the social workers and the doctors in the Doctors Without Borders clinic where her family gets the free medical, psychosocial care and medications they need.