Public health on the brink of collapse in Lebanon


Lebanon has suffered from a serious economic crisis for two years. The lack of foreign exchange made it difficult for pharmaceutical companies to pay their suppliers, which resulted in a severe shortage of drugs. Lebanon owes more than $ 600 million to pharmaceutical suppliers and is unable to pay its debt.

Drug importers have said they are running out of many essential drugs. Authorities, on the other hand, blame importers for the shortages. They claim that importers are hoarding drugs to sell them later at higher prices.

Some drugs can be found on the black market at higher prices. However, the economic crisis has drastically impoverished many Lebanese and many of them cannot afford to buy essential drugs for their treatment at black market prices.

Poverty is on the rise

According to the United Nations Economic and Social Commission for Western Asia (ESCWA), more than 70% of the Lebanese population lives below the poverty line. In addition, 82% of the population has limited access to health, public services and education.

The minimum wage in Lebanon has dropped to around $ 35 per month. A pack of plain water that contains 9 liters of water costs $ 1.5, and 1 liter of milk costs $ 1.2 in Beirut. From this information, it can be deduced that an adequate and balanced diet for a minimum wage worker is impossible in Lebanon.

In this atmosphere, it is difficult to obtain vital medicines for many Lebanese. About 10% of cancer patients do not have access to treatment, according to Dr Joseph Makdessi, head of the hematology and oncology department at Saint George Hospital.

Nearly empty shelves seen in medical storage at the government-run Rafik Hariri University Hospital in Beirut, Lebanon on August 11, 2021 (AP Photo)

While patients cannot find their drugs, the Lebanese military seized thousands of expired cancer drugs from two drug warehouses on August 24. Medicines in warehouses were waiting to be evaluated on the black market.

Lebanese authorities seize hundreds of thousands of stored drugs every week. However, these operations are not efficient enough and are akin to breeding cats. Instead of extinguishing illegal motives for profit, trying to stop the black market with limited authority will not be effective.

The Lebanese central bank subsidizes many drugs. Some chemotherapy treatments become more than 10 times cheaper with the subsidies. However, the central bank is short of foreign currency and cannot pay suppliers. Importers suffer from central bank drug price regulation. All of these factors lead groups to sell their drugs on the black market.

Removing subsidies may solve the black market, but it also means leaving low-income patients to a slow death.

According to some officials of non-governmental organizations (NGOs), the central bank intends to remove the subsidies and the health ministry wants the subsidies to continue. However, the solution is above both. Structural problems must be solved, and it is almost impossible without an effective government.

Fuel shortage in the center

The severe economic crisis has affected many interdependent sectors. The devastating explosion in Beirut and the numerous failures in forming a government for more than a year accelerated the sectoral crisis. Lebanon suffers from a fuel shortage, which affects almost all sectors. It is impossible to refuel a private car without waiting, people wait hours to buy fuel.

General view of a gas station on the main highway that connects the capital Beirut with southern Lebanon as cars come from all directions to try to fill their gas tanks, in the coastal town of Jiyeh, to the south from Beirut, Lebanon, on September 3, 2021. (AP Photo)

General view of a gas station on the main highway that connects the capital Beirut with southern Lebanon as cars come from all directions to try to fill their gas tanks, in the coastal town of Jiyeh, to the south from Beirut, Lebanon, on September 3, 2021. (AP Photo)

Storing fuel for sale on the black market is very popular because of the subsidies. Fuel is sold below market price due to subsidies, which encourages smuggling and storage. In order to alleviate this shortage and avoid illegal markets, the authorities have decreed a partial reduction in subsidies.

In addition to the central bank’s efforts, the problem persists and needs to be addressed. Authorities seize millions of liters of illegally stored oil every week. However, the root of the problem is similar to the drug shortage, and these raids bring only limited relief.

Drivers have to wait in fuel queues for hours every day. I met a taxi driver who told me he had to wait at least six hours a day just for fuel.

Besides its illegality and extreme prices, drivers are also reluctant to use black market fuel as many hoarders mix the fuel with other liquids. It seems more logical for them to wait in the queues instead of having engine problems.

The fuel shortage is not limited to the endless lines of cars in front of gas stations. It also affects hospitals, agriculture and the manufacturing sector.

Hospitals are suffering from fuel shortages at the highest level. Patients who need ventilators, dialysis machines, and many other devices are at risk. Currently, many hospitals are unable to use air conditioners except in critical rooms in order to save fuel. Hospitals have to use their own power generators due to long power cuts.

Public health at risk

According to a UNICEF report in July, more than 70% of the Lebanese population is at risk of losing access to safe drinking water. On August 21, UNICEF Executive Director Henrietta Fore warned that more than 4 million people would face severe water shortages or blackouts if urgent action is not taken.

Tap water is not considered safe to drink in many parts of Lebanon and people generally depend on bottled water. The water reserves in the markets are not as full as they used to be. What’s more, the prices of bottled water have almost doubled in dollars in just six months.

Storing food also becomes more difficult with power cuts. Since refrigerators also shut down due to blackouts, storing perishable foods like meat and cheese is impossible for small businesses. In mid-August, E.coli contamination was detected in a popular type of cheese. In one district of Beirut, E.coli per gram in a cheese sample exceeded 79 times the upper limit. The cases of food poisoning do not seem to decrease in this situation.

Patients are treated inside the emergency room at the government-run Rafik Hariri University Hospital in Beirut, Lebanon, August 11, 2021. (AP Photo)

Patients are treated inside the emergency room at the government-run Rafik Hariri University Hospital in Beirut, Lebanon, August 11, 2021. (AP Photo)

According to local sources, the supply of infant formula and diapers is also declining. Current prices are not affordable for low income families. The Lebanese people face poverty, malnutrition and drought among all other problems.

Who is to blame?

I recently attended an interesting discussion about Lebanese expats and their behavior abroad. According to my colleagues, Lebanese expatriates do not distinguish between their sects and adopt a comprehensive Lebanese identity outside the country. However, upon their return, sometimes even on the flight home, they begin to question the other person’s subidentity.

Lack of government authority, sectarianism, favoritism, corruption, rival groups, national disasters, outside powers, etc. It’s easy to tie the current situation in Lebanon to all of these excuses, but focusing on the why is more important.

Losers and winners in politics are no longer important in Lebanon. The political winner has not yet been determined, but the loser is certain: the Lebanese people. They have become impoverished, do not feel sure of their future and are also losing their health.


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