A Lebanese neurosurgeon recalls the fight against COVID-19, amid an economic crisis and the race to save lives after the explosion that shook Beirut on August 4, 2020.
2020 was supposed to be just like any year.
Thriving throughout the decades, Lebanon’s health care system was one of the best in the Middle East. Medical and paramedical faculties graduated a legion of doctors and nurses who were praised wherever they went – capable, agreeable, and trained to withstand a mountain of pressure.
But nobody expected such a deluge.
It started with the economic crisis and the anti-austerity protests that erupted on October 17, 2019.
As early as November 2019 a feud sparked between hospitals and medical suppliers: suppliers wanted payments in fresh US dollars, while private hospitals threatened to stop admitting patients.
Limping into 2020, Lebanon was focused on the Carlos Ghosn corruption affair and the uprising in the streets. Doctors and nurses treated scores of injured protesters suffering from tear gas and pellet wounds.
Meanwhile, somewhere in China, a mysterious virus began ravaging the lungs of patients in the city of Wuhan, killing an alarming number of them within a few days. It was soon identified as belonging to the coronaviruses’ family, and was labeled COVID-19 in reference to the first cases which arose in late 2019.
The breakout
Along with the rest of the world, Lebanon, watched the news bewildered, unaware that the illness, which we were starting to learn more about, had made its way to Beirut on February 21, onboard an Iranian plane which carried 150 passengers – among them a 45-year-old woman who tested positive.
Lebanon had been welcoming hordes of tourists in an attempt to revive its economy, increasing the risk of importing the highly-contagious virus. As the Lebanese lira continued to devalue, the open-door policy allowed for a steadily increasing number of cases, putting people’s lives at risk.
COVID-19 became the new priority on the public agenda. All eyes were on the airport arrivals, government decisions, and the daily count of cases.
The Rafik Hariri Hospital quickly turned into a hub, receiving patients, quarantining them and proceeding with the testing.
Meanwhile, private hospitals were still desperately trying to sort out their dollar problems with the medical suppliers, the insurance companies and the Ministry of Health. Essential equipment – anesthesia drugs, medical gloves and dialysis instruments, to name a few – were becoming scarce.
As Rafik Hariri Hospital ran out of places for COVID-19 patients, most hospitals in the country were soon in a race against time to structurally and financially prepare for the biggest wave to come clamoring at their doors.
A shock came on March 10: the first Coronavirus death. While the country held its breath amidst the political and economic turmoil, the doctors and nurses worked non-stop, urging the population, many of whom still believed COVID-19 was a hoax, to abide by social distancing measures to reduce the spread of the virus.
But their voices weren’t heard, and their motivation started to wear down, as cases, which hit the 3-digit mark, erupted within their headquarters, putting their lives, their families’ and the patients’ they were in contact with in danger.
A state of medical emergency was declared on March 15; the airport was closed a few days later and the country witnessed its first COVID-19-related curfew on March 26.
The applause
As reported cases reached 438 including 10 deaths, the health workers received a boost of support from the Lebanese people on March 29, applauding our efforts from their balconies and showing us that they acknowledged our work.
Doctors and nurses smiled at the applause. But it was a bitter smile, as we watched other countries such as the Netherlands, Canada and France value their medical staff with salary bonuses. In Lebanon, we worked around the clock and saw our salaries plummeting progressively throughout the months.
We were overwhelmed, shattered, but we continued to fight with all our forces.
Due to the lack of human and financial resources to fight the growing pandemic, many hospitals were soon forced to reschedule or cancel admissions unrelated to COVID-19 and transform some of their wards to host cases. The dire situation of the medical sector, coupled with the political dallying, brought about a sense of impending doom amongst healthcare workers. As summer came and the virus began to spiral out of control, with no unified decision made regarding the strategy to contain the viral spread, disputes broke out between the members of Lebanon’s parliamentary COVID-19 health committee.
The economically-drained Lebanese, who no longer trusted any public institution, were torn between accepting the ever-changing governmental rules and revolting against further restrictions.
The deaths
July 20 was another turning point. Loay Ismail, a 32-year-old emergency doctor who contracted the virus at the Lebanese-Italian Hospital in Tyre was the first medic to die of COVID-19 in Lebanon.
On August 3, 47-year-old Zeinab Haidar, died at Beirut’s Zahraa Hospital after a losing battle with the virus, making her the second medical worker and the first nurse to fall victim to the virus.
Then, on August 4, Lebanon was shaken to its core, plunging the country into darkness. The Beirut port explosion left its mark in blood, broken glass and broken hearts.
Four nurses on duty at the Saint George Hospital University Medical Center died under the rubble: Jessy Kahwaji Daoud, Jessica Bezdjian, Mireille Germanos and Lina Abou Hamdan. Another nurse, Jacqueline Gebrin, died in Wardiyeh Hospital. The explosion ravaged the body of firefighter and paramedic nurse Sahar Fares, who was among the first responders at the site of the explosion.
Four hospitals were heavily damaged, including the Rizk and the Geitawi hospitals in Beirut’s Ashrafieh region. The Hotel Dieu de France was the only one in the area that was in working condition, despite suffering quite a bit of damage. The facility became a hub for the August 4 explosion at the Beirut port. The number of patients we received within the first few hours was colossal. Surgeries continued non-stop for three days.
Beirut buried 204 souls in the following days and weeks.
Two images struck us all.
The first was the iconic photo of a nurse at the Saint Georges Hospital University Medical Center, Pamela Zeinoun, cradling three newborns.
The second was the photo of the dog Flash in the Chilean rescue team on September 4, when Lebanon held its breath for 72 hours in hope that there might be someone left alive under the Mar Mikhael rubble. Hope was annihilated.
The emergency efforts and the subsequent massive task of rebuilding caused the grieving population to neglect all sorts of social distancing measures. It was not about COVID-19 anymore, Beirut had been destroyed.
But while Beirut treated its scars, and people salvaged what’s left of their houses and their belongings, a new COVID-19 wave was around the corner. It was only a matter of time before Lebanon witnessed a new spike in the number of cases.
The exodus
Over the next few months, Lebanon witnessed no less than 400 medical personnel take the airport road in search of a safer home. I was sadly among them. After we had given the country absolutely everything, the country could no longer provide us with our basic needs.
We were there at all times, in all circumstances. We never stopped working. While people were safe at home during the lockdowns, we exposed ourselves, exposed our families and friends, and held our hearts between our hands every time we had a scare at work.
The pressure was humongous, and the guilt even heavier. We kept asking ourselves as we contemplated with sorrow the social media feeds of people out and about, partying and living their lives without taking precautions: is it really worth it? Our salaries dwindled as our working hours increased. It just wasn’t livable anymore.
So, I took the plane to France, unaware of what the future may hold for me. I knew only one thing: I gave it my all. So did Loay, Zeinab, Jessy, Jessica, Mireille, Lina, Jacqueline, Sahar, Pamela, the Chilean rescue team, and every health worker who left the country in the past months.
The disappointment as I write this in my European apartment could not be bigger. Yes, this may have been a selfish decision. But the government was also selfish in its decisions regarding COVID-19, putting us under huge pressure and pushing us beyond our limits with no support or even signs of gratitude whatsoever.
“Beirut, it is you who should apologize to us”
At first, I said “Beirut, forgive us”.
But watching as 2020 ended with no restrictions and all hell breaking loose, to a government that still works hazardously and puts political, religious and personal interests first, instead of thinking of the whole community, I say: “Beirut, it is you who should apologize to us.”
For killing Loay and Zeinab. For murdering Jessy, Jessica, Mireille, Lina, Jacqueline and Sahar. For making Pamela famous in circumstances she wishes she would never remember. For taking the lives of many more under the radar. For killing our spirits and pushing us away.
I wake up each day thinking if there was, after all, a way I could have stayed in my country, work for my people, earn a decent salary, and live the life I always wanted to live among my beloved ones.
But starting a career in Lebanon right now, especially in the medical sector is suicide. People are surviving by the skin of their teeth, and I don’t know how much longer they will be able to hold on.
Surgeries are down in numbers in favor of COVID-19 beds. Cancer and dialysis patients are barely able to book their places to receive the treatments their lives depend on. Many cardiac operations are on hold, and elective or semi-urgent surgeries as well.
Until when, though? How much gas do hospitals still have in their tanks? How much of the diminishing aid materials received from the international community are left?
More and more nurses, doctors and medical students are dying and suffering: from COVID-19, from burnout, and from insufficient funds to sustain a living.
But they are still pushing to save lives.
For those heroes, I take my hat off in admiration.
For the souls we lost, I bow my head in desperation.
I’m sorry we deceived you. I’m sorry all we could give you was a telethon with Marcel Ghanem on August 15 and a day of applause on March 29.
You deserve more than this. Your names deserve to be remembered, and your photos to be spread across all media channels.
Over and over again.
To remind those who killed you and those who are killing your colleagues that you are heroes in a country that has failed to give you the least you could ask for: justice.
Fred Bteich is a Lebanese neurosurgeon and blogger based in Paris. He tweets @fredbteich.
The opinions expressed in the opinion sections are those of the authors and do not necessarily reflect the views of NOW.
