Lebanese Emergency Services Are Overwhelmed and Need Better Gear to Save Lives in Wartime

Search and rescue team members try to find victims following an overnight raid by the Israel army on the Palestinian camp of Ain el-Hilweh, in Sidon, Lebanon, 01 October 2024. (EPA)
Search and rescue team members try to find victims following an overnight raid by the Israel army on the Palestinian camp of Ain el-Hilweh, in Sidon, Lebanon, 01 October 2024. (EPA)
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Lebanese Emergency Services Are Overwhelmed and Need Better Gear to Save Lives in Wartime

Search and rescue team members try to find victims following an overnight raid by the Israel army on the Palestinian camp of Ain el-Hilweh, in Sidon, Lebanon, 01 October 2024. (EPA)
Search and rescue team members try to find victims following an overnight raid by the Israel army on the Palestinian camp of Ain el-Hilweh, in Sidon, Lebanon, 01 October 2024. (EPA)

When Israel bombed buildings outside the southern Lebanese city of Sidon, Mohamed Arkadan and his team rushed to an emergency unlike anything they had ever seen.

About a dozen apartments had collapsed onto the hillside they once overlooked, burying more than 100 people. Even after 17 years with the civil defense forces of one of the world's most war-torn nations, Arkadan was shocked at the destruction. By Monday afternoon — about 24 hours after the bombing — his team had pulled more than 40 bodies — including children's — from the rubble, along with 60 survivors.

The children's bodies broke his heart, said Arkadan, 38, but his team of over 30 first responders' inability to help further pained him more. Firetrucks and ambulances haven’t been replaced in years. Rescue tools and equipment are in short supply. His team has to buy their uniforms out of pocket.

An economic crisis that began in 2019 and a massive 2020 port explosion have left Lebanon struggling to provide basic services such as electricity and medical care. Political divisions have left the country of 6 million without a president or functioning government for more than two years, deepening a national sense of abandonment reaching down to the men whom the people depend on in emergencies.

“We have zero capabilities, zero logistics,” Arkadan said. “We have no gloves, no personal protection gear.”

War has upended Lebanon again Israel’s intensified air campaign against Hezbollah has upended the country. Over 1,000 people have been killed in Israeli strikes since Sept. 17, nearly a quarter of them women and children, according to the Health Ministry. Hundreds of thousands of people have fled their homes, sleeping on beaches and streets.

The World Health Organization said over 30 primary health care centers around Lebanon’s affected areas have been closed.

On Tuesday, Israel said it began a limited ground operation against Hezbollah and warned people to evacuate several southern communities, promising further escalation.

Lebanon is “grappling with multiple crises, which have overwhelmed the country’s capacity to cope,” said Imran Riza, the UN's humanitarian coordinator for Lebanon, who said the UN had allocated $24 million in emergency funding for people affected by the fighting.

Exhausted medical staff are struggling to cope with the daily influx of new patients. Under government emergency plans, hospitals and medical workers have halted non-urgent operations.

Government shelters are full

In the southern province of Tyre, many doctors have fled along with residents. In Nabatiyeh, the largest province in southern Lebanon, first responders say they have been working around the clock since last week to reach hundreds of people wounded in bombings that hit dozens of villages and towns, often many on the same day.

After the bombing in Sidon nearly 250 first responders joined Arkadan's team, including a specialized search-and-rescue unit from Beirut, some 45 kilometers (28 miles) to the north. His team didn't have the modern equipment needed to pull people from a disaster.

“We used traditional tools, like scissors, cables, shovels,” Arkadan said.

“Anyone here?” rescuers shouted through the gaps in mounds of rubble, searching for survivors buried deeper underground. One excavator removed the debris slowly, to avoid shaking the heaps of bricks and mangled steel.

Many sought refuge in the ancient city of Tyre, 20 kilometers (12 miles) north of the border with Israel, thinking it was likely to be spared bombardment. More than 8,000 people arrived, said Hassan Dbouk, the head of its disaster management unit.

He said that there were no pre-positioned supplies, such as food parcels, hygiene kits and mattresses, and moving trucks now is fraught with danger. Farmers have been denied access to their land because of the bombings and the municipality is struggling to pay salaries.

Meanwhile, garbage is piling up on the streets. The number of municipal workers has shrunk from 160 to 10.

“The humanitarian situation is catastrophic,” Dbouk said.

Wissam Ghazal, the health ministry official in Tyre, said in one hospital, only five of 35 doctors have remained. In Tyre province, eight medics, including three with a medical organization affiliated with Hezbollah, were killed over two days, he said.

Over the weekend, the city itself became a focus of attacks.

Israeli warplanes struck near the port city’s famed ruins, along its beaches and in residential and commercial areas, forcing thousands of residents to flee. At least 15 civilians were killed Saturday and Sunday, including two municipal workers, a soldier and several children, all but one from two families.

It took rescuers two days to comb through the rubble of a home in the Kharab neighborhood in the city’s center, where a bomb had killed nine members of the al-Samra family.

Six premature babies in incubators around the city were moved to Beirut. The city’s only doctor, who looked after them, couldn’t move between hospitals under fire, Ghazal said.

One of the district’s four hospitals shut after sustaining damage from a strike that affected its electricity supply and damaged the operations room. In two other hospitals, glass windows were broken. For now, the city’s hospitals are receiving more killed than wounded.

“But you don’t know what will happen when the intensity of attacks increases. We will definitely need more.”

Making do with what they have

Hussein Faqih, head of civil defense in the Nabatiyeh province, said that “we are working in very difficult and critical circumstances because the strikes are random. We have no protection. We have no shields, no helmets, no extra hoses. The newest vehicle is 25 years old. We are still working despite all that.”

At least three of his firefighters’ team were killed in early September. Ten have been injured since then. Of 45 vehicles, six were hit and are now out of service.

Faqih said he is limiting his team’s search-and-rescue missions to residential areas, keeping them away from forests or open areas where they used to put out fires.

“These days, there is something difficult every day. Body parts are everywhere, children, civilians and bodies under rubble,” Faqih said. Still, he said, he considers his job to be the safety net for the people.

“We serve the people, and we will work with what we have.”



What Do ‘Expert Level’ Talks Signal for the Progress of the Iran-US Nuclear Negotiations? 

US Secretary of Energy Ernest Moniz and Head of the Iranian Atomic Energy Organization Ali Akbar Salehi, left, meet at a hotel in Vienna, July 9, 2015. (Carlos Barria/Pool Photo via AP, File)
US Secretary of Energy Ernest Moniz and Head of the Iranian Atomic Energy Organization Ali Akbar Salehi, left, meet at a hotel in Vienna, July 9, 2015. (Carlos Barria/Pool Photo via AP, File)
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What Do ‘Expert Level’ Talks Signal for the Progress of the Iran-US Nuclear Negotiations? 

US Secretary of Energy Ernest Moniz and Head of the Iranian Atomic Energy Organization Ali Akbar Salehi, left, meet at a hotel in Vienna, July 9, 2015. (Carlos Barria/Pool Photo via AP, File)
US Secretary of Energy Ernest Moniz and Head of the Iranian Atomic Energy Organization Ali Akbar Salehi, left, meet at a hotel in Vienna, July 9, 2015. (Carlos Barria/Pool Photo via AP, File)

Negotiations between Iran and the United States over Tehran's rapidly advancing nuclear program will move Wednesday to what's known as the “expert level” — a sign analysts say shows that the talks are moving forward rapidly.

However, experts not involved in the talks who spoke with The Associated Press warn that this doesn't necessarily signal a deal is imminent. Instead, it means that the talks between Iranian Foreign Minister Abbas Araghchi and US Mideast envoy Steve Witkoff haven't broken down at what likely is the top-level trade — Tehran limiting its atomic program in exchange for the lifting of economic sanctions.

“Agreeing to technical talks suggests both sides are expressing pragmatic, realistic objectives for the negotiations and want to explore the details,” said Kelsey Davenport, the director for nonproliferation policy at the Arms Control Association who long has studied Iran's nuclear program.

“If Witkoff was making maximalist demands during his talks with Araghchi, such as dismantlement of the enrichment program, Iran would have no incentive to meet at the technical level.”

That technical level, however, remains filled with possible landmines. Just how much enrichment by Iran would be comfortable for the United States? What about Tehran's ballistic missile program, which US President Donald Trump first cited in pulling America unilaterally out of the accord in 2018? Which sanctions could be lifted and which would be remain in place on Tehran?

“The most important determinant of expert talks’ value lies in whether there is a political commitment to do something and experts just need to figure out what,” said Richard Nephew, an adjunct fellow at the Washington Institute for Near East Policy who worked on Iran sanctions while at the US State Department during negotiations over what became the 2015 nuclear deal.

“If the experts also have to discuss big concepts, without political agreement, it can just result in spun wheels.”

Experts and the 2015 nuclear deal

The 2015 nuclear deal saw senior experts involved in both sides of the deal. For the US under President Barack Obama, Energy Secretary Ernest Moniz reached an understanding working with Ali Akbar Salehi, then the leader of the Atomic Energy Organization of Iran. Both men's technical background proved key to nailing down the specifics of the deal.

Under the 2015 agreement, Iran agreed to enrich uranium only to 3.67% purity and keep a stockpile of only 300 kilograms (661 pounds). Today, Iran enriches some uranium up to 60% purity — a short, technical step away from weapons-grade levels of 90%. The last report by the International Atomic Energy Agency put Iran's overall uranium stockpile in February at 8,294.4 kilograms (18,286 pounds).

The deal also limited the types of centrifuges Iran could spin, further slowing Tehran's ability to rush for a bomb, if it chose to do so. It also set out the provisions of how and when sanctions would be lifted, as well as time limits for the accord itself.

Reaching limits, relief and timelines require the knowledge of experts, analysts say.

“A nonproliferation agreement is meaningless if it cannot be effectively implemented and verified,” Davenport said. “The United States needs a strong technical team to negotiate the detailed restrictions and intrusive monitoring that will be necessary to ensure any move by Iran toward nuclear weapons is quickly detected and there is sufficient time to respond.”

It remains unclear who the two sides will be sending for those negotiations.

Hiccups already heard in these negotiations

Both the Americans and the Iranians have been tightlipped over exactly what's been discussed so far, though both sides have expressed optimism about the pace. However, there has been one noticeable dispute stemming from comments Witkoff made in a television interview, suggesting Tehran could be able to enrich up to 3.67% purity. However, analysts noted that was the level set by the 2015 deal under Obama.

Witkoff hours later issued a statement suggesting that comparison struck a nerve: “A deal with Iran will only be completed if it is a Trump deal.”

“Iran must stop and eliminate its nuclear enrichment and weaponization program,” Witkoff added.

Araghchi responded by warning that Iran must be able to enrich.

"The core issue of enrichment itself is not negotiable,” he said.

Despite that, experts who spoke to the AP said they remained positive about the talks' trajectory so far.

“Although still early stages, I’m encouraged so far,” said Alan Eyre, a former US diplomat once involved in past nuclear negotiations with Tehran. “The pace of negotiations — to include starting expert level meetings this Wednesday — is good.”

He added that so far, there didn't appear to be any “mutually exclusive red lines” for the talks as well — signaling there likely wasn't immediately any roadblocks to reaching a deal.

Nephew similarly described reaching the expert level as a “positive sign.” However, he cautioned that the hard work potentially was just beginning for the negotiations.

“They imply the need to get into real details, to discuss concepts that senior (officials) might not understand and to answer questions. I also think too much can be read into them starting,” Nephew said. “Expert talks can sometimes be a fudge for seniors to avoid working on tough issues — ‘let’s have experts discuss it while we move on to other things’ — or to sidestep big political decisions."

Corey Hinderstein, the vice president for studies at the Carnegie Endowment for International Peace and a former US government nuclear expert, described herself as feeling “cautious optimism” over the expert talks beginning.

“Heads of delegation are responsible for setting strategic goals and defining success,” she said. “But if there is a deal to be made, the technical experts are the ones who will get it done.”