Lebanon’s state hospitals placed on life support
▶ Collapse of currency and power cuts happen at same time as surge in Covid-19 cases
Health professionals in Lebanon say hospitals are falling apart because of the economic crisis at the same time that the country is experiencing a surge in Covid-19 cases.
The 166 new cases on Sunday broke the daily record set on Saturday, when 86 infections were reported. With only 36 deaths and 2,419 cases, Lebanon has been relatively spared up to now.
But hospitals, already suffering from the country’s ninemonth economic crisis, worry that they will not be able to cope if there are more sharp increases in the number of cases.
“We cannot afford rampant coronavirus in this country because our capabilities are low,” Firass Abiad, director of Rafik Hariri University Hospital – where most Covid-19 cases are treated – told The National.
Dr Abiad said the recent increase in power cuts “almost crippled the healthcare industry in Lebanon”.
Electricity cuts, which normally last between three and eight hours a day, increased in recent weeks because of a fuel shortage. Rafik Hariri hospital, Lebanon’s largest public healthcare centre with 430 beds and 10 operating theatres, had to cope with daily power cuts of up to 18 hours.
State electricity company Electricite du Liban usually gives preference to hospitals by switching power off for only one to two hours a day, Dr Abiad said.
“When you have severe cuts from the power grid, then you have to resort to your generators,” he said. “But without fuel, those generators cannot run indefinitely, and without generators, a hospital can simply not function. That is why we had to cut our fuel use to be able to continue.”
From July 2 to July 7, the hospital turned off the air conditioning for administrative staff – but not patients – despite the sweltering heat and humidity.
It also closed two of its operating rooms and postponed non-urgent surgery.
Fuel importer Total Liban donated diesel for the hospital’s generators last week but Dr Abiad said the situation was far from stable.
“We are working on reopening the last [operating room],” he said. “We are scheduling cases and I think we can clear the backlog.”
But the hospital is rationing fuel as much as possible.
“This problem might come back again,” Dr Abiad said.
An increase in Covid-19 cases is expected after the reopening of Beirut’s airport at the beginning of the month, he said.
“The question is, will this increase stay within capacity? Or will you see a surge that spirals out of control? This is the main question.
“You see a lot of people not wearing masks and not respecting social-distancing rules. A lot of restaurants are functioning at 100 per cent capacity. All of these are bad omens.
“You put them all together with the surge of new cases, and this is how the disease spread in other countries.”
Lebanese hospitals struggle to import medical supplies because of the collapse of the local currency and restrictions on access to US dollars.
Despite a partial subsidy mechanism set up by the central bank, the cost of supplies has rocketed for hospitals.
They have to buy supplies with dollars bought on the black market, where the US currency is traded for nearly 8,000 Lebanese pounds instead of the official exchange rate of 1,507.5.
Because of the increasingly high running costs, about 60 per cent of private hospitals have reduced their operations, with some admitting only emergency cases.
“The whole system is falling apart slowly,” said Sleiman Haroun, head of the Syndicate of Private Hospitals.
This is affecting patient care at private hospitals, which treated 85 per cent of Lebanon’s patients before the pandemic.
“Quite a few hospitals are not admitting oncology patients because they cannot afford to buy the drugs,” he said. “Some hospitals are not doing orthopaedic surgery because the actual prices of implants are higher than the official prices.”
To make matters worse, the healthcare system is in crisis just when the Lebanese need it most. Dr Abiad said public hospitals “are seeing a surge in patients outside the coronavirus” pandemic. This is because hundreds of thousands of people have lost their jobs in the past months, and along with it their private health insurance and social security cover.
“Because of that, they are now all coming to the public hospitals to be treated,” he said.
“What is interesting – or worrying – is that we are also seeing an increase in the number of critical patients.
“These patients are delaying their visit to the doctor. They may not have access to basic medication, or delay coming to the hospital for fear of the costs that they will incur.”
Quite a few hospitals are not admitting oncology patients because they cannot afford to buy the drugs SLEIMAN HAROUN Head, Syndicate of Private Hospitals