As Israel’s overtwo-month military campaign in Lebanon against Hezbollah continues, Lebanon’s medical system is under strain, facing resource shortages, mass displacement, staff exhaustion, delayed treatments, and the closure of dozens of health facilities, leading one medical professional to describe the situation to Newsweek as “under siege.”
In late September, Israel pushed northward, launching a ground military operation into Lebanon, which has led to mass displacement, instability, and civilian injuries and deaths in the country. The ground and air military operations come as Israel seeks to return thousands of displaced Israelis to their northern communities and dismantle Hezbollah, a militant group that has deep ties with Hamas.
On October 7, 2023, Hamas, a Palestinian militant group, attacked Israel and killed around 1,200 people and took 250 hostages. Hezbollah supported the group’s attack and has engaged in rocket fire and border clashes with Israel over the past year. In late-September, Israeli forces took out longtime Hezbollah leader Hassan Nasrallah.
The past year of war has had a significant humanitarian toll across the region. In Lebanon, Israel has killed more than 2,574 people and over 12,000 have been wounded, according to the country’s Health Ministry. Upwards of 1.2 million people are displaced, the majority from southern Lebanon where the clashes are most frequent. It is unclear how many Israelis Hezbollah has killed, with the group’s latest statement, which does not offer a time frame, saying more than 70 Israeli troops.
President of the American University of Beirut (AUB) Dr. Fadlo Khuri told Newsweek in a phoneinterview last Saturday that “every aspect of the educational, health, and municipal systems are under siege right now” in Lebanon.
He added: “But so far, the health system overall is holding, albeit under duress. The system would collapse were they to hit one of the big Beirut hospitals.”
Dr. Khuri’s comments came just days before Israel struck near Rafik Hariri University Hospital in Beirut. Israel said the hospital was not affected by the strike, while the hospital’s director noted that debris had caused damage to the center, according to Reuters.
Newsweek has reached out to several medical centers in Beirut as well as humanitarian organizations and the Lebanese Ministry of Health for comment via email. Newsweek has also reached out to the Israel Defense Forces (IDF) and Israel’s prime minister’s office for comment via email on Sunday.
IBRAHIM AMRO/AFP via Getty Images
The Strain on the Lebanese Medical System
The conflict has had an immense impact on the medical system, with the United Nations’ World Health Organization (WHO) noting earlier this month that a growing number of health facilities in Lebanon have been forced to close due to intense bombardment and insecurity, reporting that “out of 207 primary health care centers and dispensaries in conflict-affected areas, 100 are now closed.”
On October 25, Director-General of the WHO, Tedros Adhanom Ghebreyesus, reported that the organization has “documented 53 attacks on health care in Lebanon over the past year, including the deaths of 99 patients and health workers.” He added that “health care facilities and providers must be safeguarded at all times.”
Dr. Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean, said in a press release in mid-October: “The situation in Lebanon is alarming. Attacks on health care debilitate health systems and impede their ability to continue to perform. They also prevent entire communities from accessing health services when they need them the most.”
With medical staff and civilians displaced, hospital staffing has become increasingly difficult in some southern areas. Dr. Khuri noted that staff exhaustion and limited resources are also straining the health system.
Hospitals lack sufficient stockpiles of supplies, with Dr. Khuri highlighting that “sutures and items for complex operations on eyes, hands, etc., are not things that hospitals typically stock up on for months and years,” andwith the increased demand, supplies are limited.
Dr. Khuri also noted the added difficulty of treating displaced patients who arrive without medical records.
The International Rescue Committee (IRC) Lebanon director Juan Gabriel Wells said in a press release earlier this month, “We are witnessing alarming gaps in health care, with critical shortages of medication and limited access to services affecting the elderly, children and those with chronic conditions.” The humanitarian group has mobilized a medical team in the country.
Mass explosions and strikes can greatly hit the system. Last month’s booby-trapped pager explosions across Lebanon in what is believed to be an Israeli operation targeting Hezbollah members had a “tremendous” impact on the health system and marked the highest patient influx at AUB’s medical center Dr. Khuri told Newsweek last week.
Israel has not publicly claimed credit for the pager attacks or denied responsibility, however, a U.S. official, speaking on condition of anonymity, told the Associated Press that Israel briefed the U.S. on the operation.
He recalled waves of people with “injuries that the medical system doesn’t have familiarity with” were flooding in, and while the attack targeted Hezbollah members, he said “quite a few people who seemed to have had those pagers in their hands at the wrong time,” including women and children. Many were killed and maimed, with common injuries including hand and eye trauma from looking at the pagers.
Routine Medical Care: ‘Delay in Treatment’
One of the biggest hospital and population health concerns is that patients needing routine care are not coming to the hospital for their regular treatments due to the conflict.
People are “being only treated for acute medical care. We don’t have the ability to keep up with their routine medical care and non-emergency medical care,” Dr. Khuri said, referring to cancer, cardiovascular disease, stroke, neurological disease, diabetes, hypertension, among others. Acute care often refers to short-term yet severe surgeries or treatments.
“So even among our pain patients, people are afraid to come to the hospital at this time and to care for their diseases,” he explained. “The cancer patients and cardiovascular patients are choosing to stay at home and wait it out. Which is of course, very serious. Heart disease is the number one killer in the world, cancer is the second biggest killer.”
When asked by Newsweek whether he believed the hospital would be targeted by Israel, Dr. Khuri said, “The large teaching hospitals have not yet been targeted. I hope it stays that way.”
In addition, to the health concerns of patients not receiving their routine care, the health system “loses resources on emergent care, urgent care and makes up for it on elective care, even if that elective care is lifesaving or prolonging.” Emergency room treatments, especially with new, unidentified patients are at a “massive financial loss,” for the system.
