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’s Happening in Forgotten Gaza?

Fighters from Hamas' Al-Qassam Brigades in the Gaza Strip. (Reuters file)
Fighters from Hamas' Al-Qassam Brigades in the Gaza Strip. (Reuters file)
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What’s Happening in Forgotten Gaza?

Fighters from Hamas' Al-Qassam Brigades in the Gaza Strip. (Reuters file)
Fighters from Hamas' Al-Qassam Brigades in the Gaza Strip. (Reuters file)

While the world is focused on the war in Lebanon and its dangers, the situation in Gaza has been largely overlooked.

Despite ongoing suffering, it has received little attention, especially with winter rains approaching, which are adding to the hardships faced by its residents.

Israeli forces are continuing their military operations in Gaza, although they have eased somewhat.

On Tuesday, the Palestinian Ministry of Health reported that Israeli airstrikes led to four massacres in the last 24 hours, killing 23 people and injuring 101.

The latest attack targeted displaced people in the al-Fattah neighborhood, resulting in numerous casualties.

As the conflict enters its 361st day, the toll in Gaza has reached 41,638 dead and 96,460 injured since October 7, worsening the humanitarian crisis.

The Israeli army claims to have destroyed 90% of Hamas’s military capabilities, including half of its tunnels and assassinating several of its leaders.

However, it admitted that Hamas has regained control and is suppressing dissent violently.

Israeli officials allege that Hamas has been monopolizing humanitarian aid entering Gaza, taking a portion for its leaders and selling the rest at high prices.

As a result, the cost of a single cigarette has soared to 20 shekels (about $6), and Hamas still controls smuggling operations for goods through its members in the West Bank.

Goods entering Gaza through private wholesalers face heavy taxes from Hamas. The Israeli army claims that Hamas has set up a trade system with the West Bank and Türkiye, allowing it to pay salaries to its members.

This system enables traders in Gaza to buy goods from the West Bank, with payments processed through Hamas. Money sent from Türkiye is used to pay wholesalers in Hebron or Nablus.

Hamas also posts on Telegram, inviting healthcare workers to Nasser Hospital in Khan Younis to collect their salaries, as well as teachers to specific schools for payment.

Hamas leaders maintain command centers in various neighborhoods, which are known to the public.

Those who go to these centers seeking help may face serious consequences, including detention for questioning, punishment, or even death for minor offenses like theft.

Israeli generals say the failure to recruit local leaders for Gaza is largely due to fear of Hamas’s violent crackdown.

With the Palestinian Authority refusing to take on any responsibilities in the enclave, Hamas remains the only group managing affairs.

In response, Hamas is working to reopen markets, shops, and restaurants selling traditional sweets like knafeh and baklava across Gaza. They are also cleaning streets, removing debris, and improving drainage systems.

In light of the situation, the Israeli army is preparing to appoint a “temporary military governor” to oversee Gaza.

It recognizes that military rule will involve daily interactions with the local population and Hamas operatives, leading to a prolonged occupation and resistance.