The Washington PostDemocracy Dies in Darkness

Lebanon was famed for its medical care. Now, doctors and nurses are fleeing in droves.

Medical staff outside the American University of Beirut Medical Center in March. (Anwar Amro/AFP/Getty Images)
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BEIRUT — Lebanon was long known for producing some of the Middle East’s best health-care workers and became a popular destination for foreigners seeking medical treatment.

But over the past two years, life has become unbearable for many Lebanese, prompting doctors and nurses to leave the crisis-stricken country in droves.

The World Health Organization estimated in September that nearly 40 percent of Lebanon’s doctors and 30 percent of nurses had departed since October 2019. The majority of the nurses who left did so this year, according to Lebanon’s Order of Nurses.

And Charaf Abou Charaf, head of Lebanon’s Order of Physicians — which, like the nurses group, is a national organization of medical professionals — said that nearly all recent medical school graduates have taken jobs abroad.

Compounding the medical meltdown, Lebanon is running desperately short on drugs and other supplies. Instagram stories are awash with pleas for blood for transfusions and basic medications, such as painkillers. The shortage is so pronounced that the DHL shipping company has offered 40 percent off medical shipments, and Emirates Airlines has granted travelers to Beirut an extra baggage allowance so they can carry more medicine back to Lebanon on their own.

The country has been rocked by cascading crises, with an economy in collapse and a currency rapidly becoming worthless. But it was the massive explosion on Lebanon’s waterfront in August 2020 — which killed more than 200 people and wrecked large parts of the capital — that was the final straw for many medical professionals.

“The level of risk we endured by living in Lebanon was beyond my ability to tolerate for my family,” said a doctor who left for Qatar this summer. “The winds coming [in] through the shattered glass windows after August 4th woke me up to a cold reality. I took my daughter and fled.”

The doctor, who spoke on the condition of anonymity to protect his personal safety, said he had come to realize that Lebanon’s leaders were putting a higher priority on getting rich than on people’s well-being.

Many doctors and nurses have been moving to Egypt, Iraq and Persian Gulf countries like the United Arab Emirates, and they are accepting salaries that would have been considered laughably low two years ago. One hospital in Dubai took 50 nurses just from the American University of Beirut Medical Center (AUBMC), one of Lebanon’s biggest hospitals.

Older medical professionals, who lived through the country’s civil war four decades ago and the political turmoil that followed it, are finally leaving, hoping for a better life for their families.

Lebanon’s troubles began accelerating in 2019, when a financial crisis led banks to limit the number of dollars depositors could withdraw. (Dollars and the Lebanese pound traditionally have been used interchangeably.) But the crisis worsened and protests erupted. Then came the coronavirus pandemic.

Just when it seemed Lebanon couldn’t get worse, it did

After the economy began its slide, medical professionals avoided panicking and tightened their belts, believing daily life would recover eventually, said Joseph Otayek, the director of the AUBMC.

Aug. 4, 2020, changed all of that, he said. The failure of Lebanese investigators to uncover who was responsible for the explosion of 2,750 metric tons of ammonium nitrate, which was negligently stored for years on the edge of downtown, moved many health-care workers to despair.

“We know this from the psychology of the staff,” said Hisham Bawadi, the AUBMC’s nursing director. “After the blast, they changed. When they saw that nothing happened, it made them become hopeless.”

At the same time, the AUBMC has been running perilously short of medical supplies, lacking more than 500 critical items, Otayek said. The hospital now rations chemotherapy tubes, antibiotics, catheters, gauze, antiseptics and CT-scan dye, according to Otayek and Badawi. At one point, there were only three available pacemakers in all of Lebanon.

As a result, many Lebanese are delaying treatment, leading to a higher risk of infections and prolonged hospital stays once patients are admitted. The lack of antibiotics in the market means patients often cannot be discharged. And overnight electricity cuts are so routine due to fuel shortages that patients on ventilators cannot use them at home.

In Beirut, pharmacy shelves are nearly empty, the few medicine boxes no longer stacked but spread out to cover as much of the as possible. In one pharmacy, near a major hospital, a sign is stuck on the glass: “Our dear customers, in order to continue to serve you, please do not ask for more than one box.”

When asked what medicine is in high demand and low supply, the two pharmacists behind the glass defeatedly repeated, “Everything.” One wrote down names of medications missing, filling page after page in tiny pink cursive.

The situation is so bleak that patients are washing and reusing colostomy bags, said Hani Nassar, head of the Barbara Nassar Association for Cancer Patient Support.

“In the future, they will say of cancer patients dying at home one after the other, ‘Oh, poor them, they died because they had cancer,’ ” Nassar said. “No. They died because you did not give them their cancer treatment.”

Alain Abu Suleiman, a cancer patient on his final round of chemotherapy, has been planning to receive a bone-marrow transplant — if he can find the lifesaving vials. He said he worries about their cost and how to cover the $100,000 surgery. But right now, he is focused on finding the final three vials he needs.

“This treatment has a 100 percent recovery rate,” he said, “but there is no medication.”

He holds the country’s leaders responsible for failing to address Lebanon’s many crises.

“They are telling us, ‘Go, die; you’re better off that way.’ ”

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