Concern as mental health patients in Lebanon struggle to obtain medications

Residents pass by a shuttered pharmacy in Beirut during a nationwide strike on July 9, 2021. (AFP file photo)
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Updated 14 January 2022
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Concern as mental health patients in Lebanon struggle to obtain medications

  • Since the end of 2019, following the escalating economic and social collapse, the levels of mental disorders rose dramatically
  • Some estimates suggest one in five people suffers from anxiety, sadness or depression as a result of the crises affecting the country

BEIRUT: As the people of Lebanon continue to struggle with the effects of the financial crisis in the country, the political turmoil and the aftermath of the devastating explosion at Beirut’s port, concern is growing about the toll these crises are taking on mental health.

While no accurate statistics are available for the number of people who take sedatives, psychiatrists report that the number of patients visiting their clinics in the past year exceeded 12 a day.

Meanwhile, pharmacists estimate that people wishing to buy psychotropics — drugs that affect a person’s mental state, including antidepressants, anti-anxiety medication and mood stabilizers — constitute 30 to 35 percent of their customers.

According to some medical estimates, one in five people in Lebanon feels anxiety, sadness or depression as a result of the economic and social conditions in the country but medicine and healthcare are not readily available to many.

The Lebanese pound has plummeted in value against the dollar and soaring prices are exhausting incomes and salaries. The Beirut explosion on Aug. 4, 2020, and the armed clashes in the city’s Tayouneh neighborhood last October further fueled the sense hopelessness among many people.

“Since the end of 2019, following the escalating economic and social collapse, the levels of mental disorders rose dramatically,” said Hiba Dandachli, communications director of Embrace, an organization that provides mental health services.




Hiba Dandachli, communications director of Embrace, presenting the case of Lebanon's mental health patients during a TV talk show. (Twitter photo)

In 2021, she said, 20,000 people called the Embrace Lifeline, more than in any previous year. She said that a high proportion of the callers, mostly young people and teenagers, were suffering from conditions such as anxiety, depression and insomnia as result of the effects of the declining economic and social conditions and unemployment.

“The Lebanese took to the streets in 2019 to express their anger,” Dandachli said. “However, they feel despair due to the escalating crises.

“Without social justice and securing the fundamental right of stability, our services are limited to helping people, not providing solutions. We are sedatives.”

Joelle, 33, who works at an insurance company, said that she sought help from a psychiatrist because she was suffering from anxiety as a result the dire economic situation and the fear of being unable to provide for her the family.

“I started suffocating at night and experiencing panic attacks,” she said. The treatment that was prescribed requires medicine that is either unavailable in pharmacies or very expensive, she added.

A study published in December by the Lebanese American University indicated that “16.17 percent of young people, between 18 and 24 years old, suffer from severe depression since the Aug. 4 explosion, and 40.95 percent of women suffer post-traumatic stress disorder.”

“We mainly witness mood disorder cases at our clinic,” said Dr. Hanaa Azar, a psychiatrist who works with adults and children.

She believes that “between 70 and 80 percent of people in Lebanon take sedatives as a result of sleep disorders, stomach spasm, tachycardia, eczema, phobias, body pains and other physical symptoms that are symptoms of mental disorders.”

She added: “All generations suffer in one way or another from these disorders as a result of insecurity, especially children. As everyone returned to school and work, behavioral and academic disorders have emerged and obsessive-compulsive disorder cases have increased among adults.”

Doctors and psychiatrists are particularly worried about the shortage of medicines, especially since most are no longer subsidized by the state and the rest are only partly subsidized. Only cancer medications are still fully subsidized. Subsidies on drugs for neurological conditions depend on the price of the particular medicine.




Embrace volunteer health workers providing a lifeline service to residents of Lebanon who are psychologically affected by the worsening economic crisis. (Twitter photo)

“A very large number of Lebanese take a sedative drug, the price of which has risen from 25,000 Lebanese pounds to 420,000 within just two months.” The official exchange rate remains 1,500 pounds to the dollar, but this is unavailable and the currency currently trades on the informal black market at more than 30,000 pounds to the dollar.

Pharmacist Samer Soubra said he cannot understand why there are still medicine shortages even though prices have been increased to take account of the soaring exchange rate.

“Medicine distributors were reluctant to distribute to pharmacies in light of the high exchange rate,” he said. “Today, subsidies have been lifted on many medicines and they are now priced according to the exchange rate on the black market, yet some are still missing, including infant formula.”

Thousands of people in Lebanon resort to obtaining the medicines they need, especially psychotropics, from relatives in other countries or people who bring them from Turkey, Cyprus, Greece and Jordan, or from donations made by Lebanese expatriates in France.

Still, many are going without. “Some people have stopped taking their medication and have experienced health setbacks,” said Azar.

Psychiatrist Dr. Yara Chamoun said that many Lebanese who previously showed no signs of mental disorders have begun to suffer from them amid the economic crisis, especially young people.

“In addition to cases of depression and anxiety, we find cases of alcohol and drug abuse,” she said. “Patients say that they became addicted to them because they help them sleep or forget about the harsh reality.”

Psychiatrists find themselves at an impasse in efforts to treat patients when the required medication is not readily available, Chamoun said.

“Some alternative psychotropics might not work well enough on the patient, while others may be too expensive for them to afford,” she explained.

Amal Moukarzel, a Lebanese expatriate in France, founded Les Amis du Liban de Colombes (Friends of Lebanon in Colombes) with her husband and friends to collect donations of medicines and send them to Lebanon.

“We now send around 120kg of medicines from time to time, obtained from hospitals and sent in cooperation with Middle East Airlines to local associations in Lebanon to be distributed to needy patients,” she said.

Despite the logistical issues she faces, Moukarzel said she insists on sending “more of these much-needed medicines, most of which are for diabetes and blood pressure, as well as psychotropics.”


UAE braced for severe weather, task force on high alert

Updated 7 sec ago
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UAE braced for severe weather, task force on high alert

  • UAE’s disaster management authority warns residents to expect rain, storms over next two days
  • All private schools in UAE to switch to remote learning as precaution on Thursday and Friday 

DUBAI: Challenging weather is again expected in the UAE, with parts of the country’s east coast set to experience strong winds. 

The National Emergency Crisis and Disaster Management Authority said gusts of up to 40 kph were likely to impact the area on Thursday.

While the NCM forecasts less severe conditions than those in April, it has warned residents to expect rain and storms over the next two days. There is a possibility of hail in the eastern regions, possibly extending to some internal and western areas.

Clouds are expected to decrease on Friday and Saturday, with possible light to medium rain which may be heavier in some southern and eastern regions.

Government agencies are coordinating with the Joint Weather and Tropical Assessment Team to monitor developments, said a statement from the NCM.

The teams will assess the potential impact of weather conditions and implement proactive measures where necessary.

Dubai’s government announced all private schools in the UAE would switch to remote learning on Thursday and Friday as a precaution. 

Authorities have urged the public to exercise caution, adhere to safety standards and guidelines, refrain from circulating rumors, and rely on official sources for information.

The UAE is still recovering from last month’s storms which caused widespread flooding, submerging streets and disrupting flights at Dubai International Airport.


Hamas official insists Gaza ceasefire must be permanent

Updated 18 min 47 sec ago
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Hamas official insists Gaza ceasefire must be permanent

  • Suhail Al-Hindi, a senior Hamas official said the group would “deliver its response clearly within a very short period“
  • He stressed the aim was “to reach an end to this war“

GAZA, Palestinian Territories: Hamas will respond to an Israeli truce proposal for Gaza “within a very short period,” an official with the Palestinian militant group said Wednesday, stressing though that any ceasefire needs to be permanent.
Hamas is considering a plan for a 40-day ceasefire and the exchange of scores of hostages for larger numbers of Palestinian prisoners.
Suhail Al-Hindi, a senior Hamas official, told AFP the group would “deliver its response clearly within a very short period,” although he would not say precisely when that was expected to happen.
Speaking to AFP by phone from an undisclosed location, he said it was premature to say whether the Hamas envoys, who have returned from talks in Cairo to their base in Qatar, felt any progress was made.
He stressed the aim was “to reach an end to this war.”
But that would seem to be at odds with Israel’s determination to push ahead with its vast ground offensive in southern Gaza.
A source with knowledge of the negotiations said Qatari mediators expected a response from Hamas in one or two days.
The source said Israel’s proposal contained “real concessions” including a period of “sustainable calm” following an initial pause in fighting and the exchange of hostages of and prisoners.
The source said Israel’s withdrawal from the Gaza Strip remained a likely point of contention.
An Israeli official told AFP the government “will wait for answers until Wednesday night,” and then “make a decision” whether to send envoys to Cairo to nail down a deal.


Jordan says Israeli settlers attacked Jordanian aid convoys on way to Gaza - state news agency

Updated 33 min 45 sec ago
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Jordan says Israeli settlers attacked Jordanian aid convoys on way to Gaza - state news agency

DUBAI: Jordan said some Israeli settlers attacked on Wednesday two of its aid convoys that were on the way to Gaza, the Petra state news agency reported.

“Jordan strongly condemns extremist Israeli settlers’ attack on two Jordanian aid convoys”, it said.


US surgeon in Gaza: nothing prepared me for scale of injuries

Updated 01 May 2024
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US surgeon in Gaza: nothing prepared me for scale of injuries

  • Around 70 percent of the surgeries he performed were on injuries caused by shrapnel
  • Team would deal with 40-60 patients a day

CAIRO: A US vascular surgeon who left Gaza after a stint as a volunteer said on Wednesday nothing had prepared him for the scale of injuries he had faced there.
Dozens of patients a day. Most of them young. Most facing complicated injuries caused by shrapnel. Most ending up with amputations.
“Vascular surgery is really a disease for older patients and I would say I had never operated on anybody less than 16, and that was the majority of patients that we did this time around,” Shariq Sayeed, from Atlanta, Georgia, told Reuters in Cairo.
“Most were patients 13, 14, 15, 16 and 17 years of age. Mostly shrapnel wounds, and that was something I have never dealt with, that was something new.”
In his stint at the European Hospital in Gaza, Sayeed said his team would deal with 40-60 patients a day. The vast majority were amputation cases.
“And unfortunately there is a very high incidence of infection as well so once you have an amputation that doesn’t heal, you end of getting a higher amputation,” he said.
Around 70 percent of the surgeries he performed were on injuries caused by shrapnel, the rest mostly from blast injuries and collapsing buildings.
Ismail Mehr, an anaesthesiologist from New York State, who led the Gaza mission, said the volunteer medics were “speechless at what we saw” when they arrived this month in southern Gaza.
Mehr is chairman of IMANA Medical Relief, a program that focuses on disaster medical relief and health care support and has provided treatment to over 2.5 million patients in 34 countries and counting.
He has been to Gaza several times in the past, but could not imagine what he saw this time: “Truly everywhere I saw was destruction in Khan Younis, not a single building standing.”
Out of 36 hospitals that used to serve more than 2 million residents, just 10 were somewhat functional by early April, according to the World Health Organization.
Health facilities lacked medical supplies, equipment, staff, and power supplies, Mehr said. His biggest fear now is an expected Israeli assault into the southern city of Rafah, where half of Gaza’s 2.3 million people have sought shelter.
“I hope and I pray that Rafah is not attacked,” he said. “The health system will not be able to take care of that. It will be a complete catastrophe.”


UAE braced for severe weather, task force on high alert  

Updated 01 May 2024
Follow

UAE braced for severe weather, task force on high alert  

DUBAI: Challenging weather is again expected in the UAE, with parts of the country’s east coast set to experience strong winds. 

The National Emergency Crisis and Disaster Management Authority said gusts of up to 40 kph were likely to impact the area on Thursday.

While the NCM forecasts less severe conditions than those in April, it has warned residents to expect rain and storms over the next two days. There is a possibility of hail in the eastern regions, possibly extending to some internal and western areas.

Clouds are expected to decrease on Friday and Saturday, with possible light to medium rain which may be heavier in some southern and eastern regions.

Government agencies are coordinating with the Joint Weather and Tropical Assessment Team to monitor developments, said a statement from the NCM.

The teams will assess the potential impact of weather conditions and implement proactive measures where necessary.

Dubai’s government announced all private schools in the UAE would switch to remote learning on Thursday and Friday as a precaution. 

Authorities have urged the public to exercise caution, adhere to safety standards and guidelines, refrain from circulating rumors, and rely on official sources for information.

The UAE is still recovering from last month’s storms which caused widespread flooding, submerging streets and disrupting flights at Dubai International Airport.