Temporarily installed on the top floor of the Lebanese Geitaoui Hospital, since the area reserved for the administration was blown up during the explosions of August 4, 2020, the co-directors of the establishment, Sister Hadia Abi Chebli, and Professor Pierre Yared can only recall daily and visually that murderous and devastating day.

And for good reason: the windows of their substitute office overlook the epicenter of the tragedy.

Before their eyes stretches the port of Beirut, its gigantic gutted grain silos and the crater where hangar number 12 was located, where the 2,750 tons of ammonium nitrates at the origin of the explosions were stored.

The hospital, located in the densely populated district of Geitaoui, in the east of the capital, had been severely damaged while housing 120 patients that day.

In the midst of a health crisis, its Covid-19 unit was notably destroyed. 

The establishment had even been declared out of service for 48 hours the next day, even if the medical teams had been able to treat and operate, on the evening of August 4, dozens of wounded in the few spaces deemed sufficiently secure.

One of the rooms of the hospital photographed the day after the explosions of August 4.

© Lebanese Geitaoui Hospital

"That day, caregivers and many patients were affected, we only had a few minutes to regain our senses before a flood of people injured by the explosion poured in, recalls the doctor precisely. Naji Abi Rached, medical director of the hospital and head of the cardiac resuscitation service We had to react very quickly, when the 8 floors of the university hospital center and its logistical capacities had suffered damage, using all the areas we had reach and transforming the emergency car park into a care space ".

One year after the cataclysm, the establishment, which has a capacity of 260 beds, continues to rebuild, like the two hospitals located in the same area.

"We have miraculously been able to repair about 80% of the damage in almost 8 months, and now most of the floors are functional, explains Professor Pierre Yared. So far, we have had to settle a bill of $ 7 million, and this is not finished since there are still repairs to be made, in particular in the emergency department and that of the reception of the patients ".

The sum was financed by many actors - donors, private companies, NGOs, international groups and even the Vatican, all of whom came to the bedside of this private non-profit hospital, attached to a religious institution, the Congregation of the Maronite Sisters of the Holy Family.

"We did not receive any cent from the Lebanese state when commissions were sent to assess the damage, but we have not heard from them again, even a year after the explosion," said the man ironically. Professor Pierre Yared, specialist in visceral surgery, while the total cost of the damage to the hospital is estimated at $ 15 million.

Management hopes to reopen all of the hospital's departments at the end of September and thus allow it to regain 100% of its capacity.

"I am calling for help, an SOS"

But during the repairs, Lebanon continued to sink into the multiple crises that have plagued the country for two years and whose consequences have been added to those of the explosions of August 4.

These crises, which give each day cold sweats to the two co-directors of the Lebanese Hospital Geitaoui, are linked to the disastrous economic situation of the country of the Cedar and to the vertiginous fall of its currency which pushes doctors and nurses, to the like many Lebanese, going abroad.

The co-directors of the hospital, Sister Hadia Abi Chebli, and Professor Pierre Yared.

© Samia Metheni, France 24

"I appeal for help, an SOS, to European countries, and especially to France, which represents our cultural and French-speaking space, to help us stop this bleeding which will cost us dearly," said the professor with an air. serious. Because there is no point in having a hospital with the best equipment if there are no more doctors to use them ".

For her part, Sister Hadia Abi Chebli, a nurse by training, calls for resistance to what she describes as an "exodus".

The Geitaoui hospital is no exception: 30 caregivers who worked there have gone abroad in the past two years.

"We must not leave, we must resist, Lebanon is our country, who are we going to leave it to? We must hold on!"

From his stronghold of the cardiac care unit, which had also been destroyed in a few seconds by the explosions, Doctor Naji Abi Rached responded to this call for resistance, even if he does not hide his dismay at the situation. 

"Unfortunately, the departures are increasing, since more than 1,000 doctors have already left Lebanon and around 1,500 are asking to leave, deplores the cardiologist, while keeping an eye on a patient barely awake, in one of the restored rooms. These health professionals are among the elite of doctors and are taking the path of Europe and the Gulf countries because they offer attractive prospects ".

Doctor Naji Abi Rached, medical director of the hospital and head of the cardiac resuscitation service, in front of the emergency entrance.

© Marc Daou, France 24

The blow is severe for the Lebanese medical sector, whereas the country was qualified as "hospital of the Arab world" for the reputed quality of its medical services, but also the fame of its doctors.

The latter are trained locally at the American University of Beirut and the Faculty of Medicine of the University of Saint Joseph, before leaving to specialize abroad, particularly in France and the United States.

"Despite the economic crisis, political instability and the lack of future prospects, there are still doctors who must stay, because we cannot all abandon the boat, continues Dr. Naji Abi Rached, who did his specialization in France. I myself chose to stay because I have responsibilities and because I still hope to find a better Lebanon ".

A future in which no longer seems to believe, at the age of 29, Doctor Patrice Nasas, a third-year resident in internal medicine, came to inquire about a patient in the cardiac care unit. "I had a lot of hopes for Lebanon, but in the current context, I am thinking of going to the United States, while I do not like the idea of ​​leaving my country, he confesses. I know personally many people in the sector who have taken the plunge and have already left, whether they are medical students, established doctors, or nurses ".

With the currency crisis, the salary in Lebanese pounds of Patrice Nasas is equivalent to just 65 dollars per month, according to the black market rates (1 dollar for 18,000 pounds in recent days, against 1 dollar for 1,500, according to the official rate), whereas before the crisis it fluctuated between 800 and 900 dollars.

Doctor Patrice Nasas, third year resident in internal medicine at the Lebanese Geitaoui Hospital.

© Marc Daou, France 24

"To get by, he adds, some caregivers try to combine two jobs, taking guards in a hospital and accepting other unofficial guards in another establishment, others ask for helps their parents, themselves financially weakened since the situation is becoming difficult for everyone ".

"Sometimes I really don't know what to say to patients"

Zélia Francis, doctor and head of the hospital's endocrinology department, who lived and followed part of her studies in Paris in the 2000s, is also thinking of leaving the country.

"I really want to stay in my country which is going through a difficult period, which I hope is transitory, and I am still here just to ensure continuity for my patients, but honestly, if things do not change and if the 'we do not see a ray of hope, it is true that it is very tempting to leave ".

She says she sometimes feels helpless and helpless in front of her patients as the situation worsens.

"While many drugs are no longer available in the country, a few days ago we received an alert on the insulin stocks which are dwindling, she confides, shaking her mobile phone in her hand. For my part, I receive hundreds of calls every day from patients asking me to prescribe them substitution treatments, even though I know that these have not been available for a few weeks and that no one reacts ".

And sigh: "It's a very complicated situation to deal with psychologically, even if we tried to find temporary solutions, but the crisis is becoming more and more acute to the point that I really don't know what to say to the patients. ". 

Doctors Zélia Francis, head of the hospital's endocrinology department, and Naji Abi Rached, hospital medical director, in deep discussion.

© Marc Daou, France 24

The shortages of drugs and materials are likely to multiply in the coming weeks, due to a lack of foreign currency, precisely US dollars needed for imports.

"An orthopedist told me recently that he was going to have to operate on young patients, although he does not have a hip prosthesis for the size of this age group, confided earlier Professor Pierre Yared. impossible to plan the purchase of equipment due to soaring prices, shortages and lack of transparency in the management of the crisis by the Banque du Liban, the Ministry of Health and the suppliers of materials and drugs ".

During the month of June, the union of private hospital owners warned that hospitals could be unable to administer certain treatments, including hemodialysis.

For its part, the Lebanese Geitaoui Hospital has found a temporary solution.

“A donor responded to a call that we had made and his generosity will allow us to provide our patients with dialysis for the next three months,” certifies the co-director of the establishment, Sister Hadia Abi Chebli. do not know what will happen after this date because it is a crisis that we manage, day by day and case by case ".

In response to the worsening economic crisis and shortages, the hospital recently inaugurated a dispensary to provide primary health care to the poorest for a nominal price, with the help of several NGOs, the Ministry of Health and the World Health Organization.

"We thought about the installation of this center after the explosion at the port of Beirut, the deterioration of the socio-economic situation of the country and the impoverishment of the population, specifies the doctor Naji Abi Rached, who came to discuss with the team. of the dispensary, located in a building a few steps from the hospital. We receive more and more people there and we expect an explosion in demand given the current situation and shortages. "

And according to him, all scenarios must now be considered.

Not only because of the shortages which cause problems and departures abroad, but also for simple logistics issues, when the electricity supplied by the State is rationed and it is difficult to refuel with fuel to run the generators in the hospital.

"In this case of logistical problems, the reception capacity will no longer be the same in the face of a possible new wave of Covid-19, and the situation may still worsen if there is no solution proposed by the 'State, he concludes. Yet we see that the leaders do not have many reactions vis-à-vis this crisis and that is why we expect the worst: that is to say total collapse of the health sector in Lebanon, which would lead to a disaster scenario and a humanitarian crisis ". 

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