Yara Asmar, a researcher on Middle Eastern politics with a focus on Iran and Hezbollah, says she was driving on the highway that leads to Beirut’s airport and noticed the posters promoting the armed Shiite party electoral program.
The highway crossing Beirut’s southern suburbs, controlled by Iran-backed Hezbollah, is often lined up with the group’s propaganda. But, with elections just days away, there was a heavier emphasis on what the party provides for the people, and the loyalty it expects in return.
One poster caught Asmar’s eye.
“The resources are our responsibility,” it read.
What about public resources, she wondered. What about taxpayer money? Where’s the responsibility in this?
“They keep on bragging that they have nothing to do with corruption in the country,” Asmar told NOW. “But they’re abusing the resources of the Lebanese government to hide their weaknesses from the people, especially with the economic pressure exercised on Iran.”
Practically, since Hezbollah first announced its formation in the 1980s, the group has operated as a state within a state in the areas under its influence, and established a welfare state to pay for social programs, such as a healthcare system that provides subsidized services, making them a cheaper option for Hezbollah’s constituents than the majority of the other private hospitals that are spread throughout the country.
For the most part, this funding had been sufficient at maintaining the hospitals and health centers in South Lebanon, Bekaa, and Beirut’s southern suburbs.
That changed in 2018, when then-President Donald Trump pulled the United States out of the Joint Comprehensive Plan of Action (JCPOA), more commonly known as the Iran nuclear deal, and began implementing harsh sanctions on Iran, drastically limiting the amount of money that the Party of God received from its main financial and military backer.
This forced Hezbollah to find an alternative method of funding its healthcare operation.
Evolution based on needs
Hezbollah has never really been concerned about being involved in Lebanon’s political theater.
While members were elected to Parliament in 1992, politics was barely on the party’s radar, instead, they focused primarily on Israel’s continued occupation of south Lebanon until its eventual withdrawal in May 2000.
Even after Israel pulled out of Lebanon, Hezbollah was content with its minor role in Parliament, showing little interest in holding any positions in the government.
However, after the assassination of former Prime Minister Rafik Hariri in 2005, Hezbollah, for the first time, took two ministries in Fouad Siniora’s first government.
“Hezbollah before 2005, they weren’t interested in becoming part of the Lebanese government. They were an entity by themselves,” Asmar explained. “After 2005, they felt the need of being part of the government, especially with the Special Tribunal for Lebanon.”
While the armed Shiite group failed at preventing the STL from investigating Hariri’s assassination, they quickly expanded their role in the government, becoming a staple of Lebanese political life, ensuring that members of the party or people affiliated with it were holding multiple ministries.
It was not until 2018 that Hezbollah was forced to adapt once more.
In 2015, under the Obama administration, the US ushered in the Iran nuclear deal which saw many sanctions on Iran lifted, allowing the country to once again begin exporting oil without the fear of repercussion, and its economy to start recovering after decades of US sanctions.
They divert government resources to help their party. This happens both locally and nationally. Mostly for constituents but Lebanese parties have expenses and they are large bureaucratic animals. Lots of money is siphoned through them in different ways. But Hezbollah is a newbie and more reliant on Iran.
Trump, who was a vocal critic of the deal, pulled the US out in his second year in office and began slapping some of the harshest sanctions that the Western superpower has ever put on Iran. These moves were all part of a “maximum pressure” campaign aimed at decimating Iran’s economy and forcing them to return to the negotiating table in order to get a “better deal.”
In addition to crushing Iran’s economy, Trump’s sanctions made it harder for the country to continue funding its regional militia network as it used to.
As the sanctions set in, Hezbollah began to feel their effects, being forced to take austerity measures so that it could continue funding its fighters, families of its fallen soldiers, healthcare system, and other institutions since its costs were usually offset by the estimated $700m it would receive annually from Iran.
When Saad Hariri was forming his government following the 2018 elections, Hezbollah saw an opportunity to support its healthcare programs.
“They became picky about their choices of ministries. The key ministry that they wanted to take over was the Ministry of Health,” Asmar said. “From the general budget, still this ministry gets a lot of money. Like in 2018, they got $480 million.”
For the last decade, the health ministry was primarily run by a member of Parliamentary Speaker Nabih Berri’s Amal Movement, another Shiite party and close ally of Hezbollah, and, on two occasions, Druze leader and Hezbollah opponent Walid Joumblatt’s Progressive Socialist Party. But Hezbollah was determined to have this portfolio, and successfully placed Jamil Jabak, who is rumored to be Hezbollah Secretary-General Hassan Nasrallah’s personal physician, in the role.
Nasrallah was all too aware that with Hezbollah holding such an important ministry, there were suspicions that they would use the position to benefit themselves, something common in Lebanese politics.
“They divert government resources to help their party,” Mohanad Hage Ali, a fellow at the Carnegie Middle East Center in Beirut, told NOW. “This happens both locally and nationally. Mostly for constituents but Lebanese parties have expenses and they are large bureaucratic animals. Lots of money is siphoned through them in different ways. But Hezbollah is a newbie and more reliant on Iran.”
In an attempt to reassure the public that Hezbollah was not like the other parties, a narrative that he often pushes in his speeches, the Shiite leader said that the party would not use its newfound power to help itself.
“Of course, [Jabak] is a brother and friend. He is close and trusted… This is a ministry for all the Lebanese people,” Nasrallah stated.
This was reaffirmed in 2022 by Hezbollah’s deputy secretary-general, Naim Qassem, who also insisted that the group does not misuse state funds, arguing that any serious criticism of the party was all part of a Western-backed smear campaign to destroy them.
Then, after Hariri resigned during the October 17 popular uprising in 2019, Hassan Diab was tapped to form a government.
Once again, Hezbollah pursued the health ministry, with party member Hamad Hassan, who had served in Baalbek’s Municipality since 2010, being named minister.
Hassan remained in his position until Diab dissolved the government in the wake of the August 4 Beirut Port explosion in 2020. But, before he left the ministry, he ensured that Hezbollah’s hospitals were some of the best-funded in Lebanon.
Keeping the money flowing
When it comes to providing a service for its community, Hezbollah does not skimp and makes sure that all the necessities are accounted for.
According to Kassem Kassir, a Lebanese analyst close to Hezbollah, the group’s medical facilities are licensed by the Islamic Health Authority, which is associated with Hezbollah, and include all types of medical services ranging from basic care to looking after soldiers injured in combat.
While Kassir says that these medical centers are available to everyone, they primarily care for members of the Shiite community, and more so those who are supporters of Hezbollah.
In order to make the centers more desirable, services are subsidized, making them cheaper than other private hospitals which can cost thousands of dollars just for basic treatments.
“There is a special pricing system to facilitate the provision of services,” Kassir told NOW. “Hospitals are linked to social security and the Ministry of Health. In addition, it receives support from the party [Hezbollah] and from Iran.”
One of the most famous of Hezbollah’s hospitals is the al-Rasool al-Azam Hospital located in Bourj al-Brajneh, in Beirut’s southern suburbs.
Like the other health facilities, al-Rasool al-Azam is a modern hospital that provides the same medical care seen at most other hospitals.
While it was previously only moderately funded by the health ministry, it has since become arguably the highest funded hospital in Lebanon.
Previously, Ghassan Hasbani, who served as health minister from 2016 until 2019, created a system for deciding how much extra funding a hospital receives from the government based on the number of beds in the hospital and its significance to Lebanon’s medical sector.
In 2016, prior to Hezbollah taking over the ministry, the government gave al-Rasool al-Azem 9,250,000,000 Lebanese Lira annually (around $6.2 million at the official exchange rate).
Then, in the days following the port explosion and just before Diab’s government resigned, the funding for al-Rasool al-Azam increased to 14,750,000,000 lira annually (around $9.7 million at the official exchange rate), an increase of 5,500,000,000 lira ($3.6 million) despite the hospital not being damaged in the explosion.
It’s the business model of Hezbollah towards the Shia community. Providing an alternative to the Lebanese government. Showing the weaknesses of the Lebanese government and providing an alternative. Just like the concept of having Qard al-Hassan, their own alternative banking system to the Lebanese banking system. It’s really important for them to keep on providing these services, showing alternatives, keep on controlling the community through these services.
Beirut’s three most prominent hospitals, al-Roum, Hotel Dieu, and the American University of Beirut Medical Center, which were damaged in the explosion, did not see their funding increase. Even when the annual budgets for all three of these hospitals are combined, they barely surpass that of al-Rasool al-Azam alone.
The Health Ministry under Hassan also added 15 new medical centers to the list of institutions to be funded by the government, all of which were sponsored by Hezbollah.
In total, the funding for Hezbollah-run hospitals nearly doubled from around 16 billion lira ($10.7 million) to 30 billion lira ($20 million).
“Hezbollah acts as a regular sectarian party,” Hage Ali explained. “Just trying to divert state resources to health institutions in its areas, basically improving services for constituents.”
It was not just state funding that was allegedly diverted to the Hezbollah-run medical centers. Foreign aid that was sent to Lebanon to help combat the Covid-19 pandemic reportedly never arrived to some of the hospitals on the frontline fighting the global pandemic, such as the Rafik Hariri University Hospital.
“A lot of hospitals were complaining that the international money was not getting to them,” Asmar said. “And not only this. They were talking about a number of trainings and centers that we didn’t see.”
Instead, Hezbollah announced its own initiative to combat the pandemic that would see 25,000 people deployed and over 30 medical centers opened up, including four disused hospitals.
Even as money and supplies were being donated to Lebanon, the US refused to send any financial aid to the health ministry since it was being run by Hezbollah.
Hezbollah did not only use the ministry to gain extra funding for its hospitals, though, allegedly using its influence to get Iranian-made drugs approved by the health committee.
“Hezbollah used the Ministry to push for Iranian medication under the pretext that these medications did not exist or they were really expensive, there’s always an alternative and so on,” Asmar stated.
In some cases, the medicine approved by the committee for distribution in Lebanon had not undergone the necessary tests to prove its efficacy or to address any potential side effects, particularly with cancer patients.
Approval of Iranian drugs to be sold in the Lebanese market allowed for pharmacists in Hezbollah-controlled areas to sell the cheaper medications as people struggled to find medicine amid a medicine shortage and hoarding when the economic crisis began to worsen.
Providing these services and ensuring that residents in Hezbollah strongholds are able to find medicine in their pharmacies allows the party to maintain the Shiite community’s dependency, all the while making them look like heroes as the government fails.
This strategy was also utilized during the 2021 fuel crisis, which saw cars lined up outside of gas stations for well over a kilometer throughout all hours of the day. Hezbollah used its relationship with Iran to secure a small amount of fuel as the caretaker government scrambled for a solution.
“It’s the business model of Hezbollah towards the Shiite community,” Asmar said.
“Providing an alternative to the Lebanese government. Showing the weaknesses of the Lebanese government and providing an alternative. Just like the concept of having Qard al-Hassan, their own alternative banking system to the Lebanese banking system. It’s really important for them to keep on providing these services, showing alternatives, and keep on controlling the community through these services.”