Blast and Financial Crisis Weigh Heavily on Mental Health of Lebanese

Noelle Jouane, a mental health program manager at the Bekaa unit of Medecins du Monde, which provides medical care, attends an interview with Reuters in Beirut, Lebanon July 23, 2021. (Reuters)
Noelle Jouane, a mental health program manager at the Bekaa unit of Medecins du Monde, which provides medical care, attends an interview with Reuters in Beirut, Lebanon July 23, 2021. (Reuters)
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Blast and Financial Crisis Weigh Heavily on Mental Health of Lebanese

Noelle Jouane, a mental health program manager at the Bekaa unit of Medecins du Monde, which provides medical care, attends an interview with Reuters in Beirut, Lebanon July 23, 2021. (Reuters)
Noelle Jouane, a mental health program manager at the Bekaa unit of Medecins du Monde, which provides medical care, attends an interview with Reuters in Beirut, Lebanon July 23, 2021. (Reuters)

Tatiana Hasrouty had always felt safe in her home, a few kilometers away from Beirut port where her father had worked for decades at the facility’s grain silo. But on Aug. 4, the huge chemical explosion that destroyed the structure killed her father and tore her life apart.

Ghassan Hasrouty was in the operations room monitoring the unloading of a grain shipment when the ammonium nitrate that had been stored unsafely for years at the port exploded killing him and over 200 people and destroying large parts of the capital.

“I was sleeping when the blast happened so it was as if my place of safety and rest was no longer there and my father who was my soul... he also was no longer there,” 20-year-old Tatiana said.

Though physically unharmed by the blast that wreaked havoc in her house, she immediately felt a psychological scar and reached out for mental health support.

Psychiatrists, therapists and NGO workers cite a surge in Lebanese seeking psychological care over the past year as the country’s deepening financial crisis combined with the explosion and a global pandemic weigh heavily on the population.

Dr. Georges Karam, head of public relations at the Institute for Development, Research, Advocacy and Applied Care (IDRAAC) says the center, which provides free mental health care, had seen a fourfold increase in patients since the financial crisis erupted in Oct. 2019.

Even more sought help in the weeks following the blast, when around 20 patients a day approached IDRAAC’s walk-in clinic.

Dr. Karam says he still sees at least three patients a week with mental trauma directly related to the blast.

Around 90% of patients who experience such trauma get better in a few months, but for 10% the effects linger for years and funding for free treatment is running scarce, he said.

“The problem going forward is what to do now as we know a lot of people still need help,” he said.

Noelle Jouane, a mental health program manager at the Bekaa unit of Medecins du Monde, which provides medical care, also noted the surge.

Prior to the financial crisis and the blast 80% of their patients were refugees or foreigners, but now most are Lebanese.

“When someone receives a hit, first you don’t really feel the pain but after a few days it starts to hurt,” Jouane said.

For those who can’t access free mental health services, paid treatment is often out of reach as few insurers reimburse it.

Terrible situation
Lebanon’s economic meltdown has seen its currency lose over 90% of its value in less than two years plunging more than half of the population into poverty.

Worsening shortages of basic goods including fuel and medicine have made daily life a struggle for many with parts of Beirut still looking like a bomb site.

“People are in shock, they don’t know where to go and what to do … the fear of not finding resources… it’s like someone is suffering and can’t see the light at the end of the tunnel,” Jouane said.

Shortages of medicines have affected psychiatric patients who could relapse and need hospitalization, experts warn.

“I saw 17 or 18 patients one day and all had the problem, they couldn’t find their medication and more than half have been taking half the dosage to ration what is remaining,” Dr. Karam said.

“It is a terrible situation.”

Joumana Ammar, a child and adolescent psychotherapist at the American University of Beirut Medical Center said she has treated many children over the past year experiencing symptoms such as separation anxiety and bed-wetting as a result of the blast.

A teenage patient saw their health condition worsen when they couldn’t find their prescription medicine in pharmacies, Ammar said.



India and Pakistan Don’t Fight Wars Like Other Countries. Here’s Why 

This photograph taken on May 9, 2025 shows the Neelum River flowing through Muzaffarabad, the capital of Pakistan-administered Kashmir. (AFP)
This photograph taken on May 9, 2025 shows the Neelum River flowing through Muzaffarabad, the capital of Pakistan-administered Kashmir. (AFP)
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India and Pakistan Don’t Fight Wars Like Other Countries. Here’s Why 

This photograph taken on May 9, 2025 shows the Neelum River flowing through Muzaffarabad, the capital of Pakistan-administered Kashmir. (AFP)
This photograph taken on May 9, 2025 shows the Neelum River flowing through Muzaffarabad, the capital of Pakistan-administered Kashmir. (AFP)

India and Pakistan have fought three full-scale wars since they gained independence from Britain in 1947. They’ve also had dozens of skirmishes and conflicts, including one atop a glacier dubbed the coldest and highest-altitude battlefield in the world.

The latest escalation follows a deadly gun attack on tourists that India blames Pakistan for — Islamabad denies any connection. But they don’t fight wars like other countries.

The dominant factor is their nuclear weapons arsenal, a distinct way of deterring major attacks and a guarantee that fighting doesn’t get out of hand, even when the situation is spiraling.

Here’s how — and why — India and Pakistan fight the way they do:

Their nuclear arsenals can destroy each other “Pakistan and India have enough nuclear weapons to wipe the other side out several times over,” says security analyst Syed Mohammed Ali, who is based in Islamabad, the Pakistani capital. “Their nuclear weapons create a scenario for mutually assured destruction.”

Both countries have “deliberately developed” the size and range of their stockpile to remind the other about the guarantee of mutually assured destruction, he adds.

Neither country discloses their nuclear capabilities but each is thought to have between 170 and 180 warheads that are short-, long- and medium-range. Both countries have different delivery systems — ways of launching and propelling these weapons to their targets.

The arsenals are a defensive move to prevent and deter further fighting, because “neither side can afford to initiate such a war or hope to achieve anything from it,” Ali says.

It might not look this way to the outsider, but nuclear weapons are a reminder to the other side that they can't take things too far.

But the secrecy around their arsenals means that it's unclear if Pakistan or India can survive a first nuclear strike and retaliate, something called “second-strike capability.”

This capacity stops an opponent from attempting to win a nuclear war through a first strike by preventing aggression that could lead to nuclear escalation.

Without this capability, there is, in theory, nothing to stop one side from launching a warhead at the other.

Kashmir at the crux of the dispute India and Pakistan have each laid claim to Kashmir since 1947, when both gained independence, and border skirmishes have created instability in the region for decades. Each country controls a part of Kashmir, which is divided by a heavily militarized border.

The two archrivals have also fought two of their three wars over Kashmir — a disputed Himalayan region divided between the them where armed insurgents resist Indian rule. Many Muslim Kashmiris support the rebels’ goal of uniting the territory, either under Pakistani rule or as an independent country.

Border flare-ups and militant attacks in India-controlled Kashmir have prompted New Delhi to take an increasingly tough position on Islamabad, accusing it of “terrorism.”

In the latest conflict, India punished Pakistan by hitting what it said were sites used by Pakistan-backed militants linked to a gun massacre last month.

A conventional military imbalance India is one of the biggest defense spenders in the world, with $74.4 billion in 2025, according to the Military Balance report from the International Institute for Strategic Studies. It’s also one of the world’s largest arms importers.

Pakistan is no slouch, spending $10 billion last year, but it can never match India’s deep pockets. India also has more than double the number of active armed forces personnel than Pakistan does.

While India’s armed forces are traditionally focused on Pakistan, it has another nuclear neighbor to contend with, China, and it is increasingly concerned with maritime security in the Indian Ocean. Those are two factors that Pakistan doesn’t have to consider in its security paradigm.

Pakistan's long and narrow shape, together with the outsized role of the military in foreign policy, makes it easier to move the armed forces around and prioritize defense.

A pattern of escalation and defusing Neither Pakistan or India are in a hurry to announce their military moves against the other and, as seen in the current flare-up of hostilities, it can take a while for confirmation of strikes and retaliation to surface.

But both launch operations into territories and airspace controlled by the other. Sometimes these are intended to damage checkpoints, installations, or sites allegedly used by militants.

They are also aimed at embarrassing or provoking — forcing leaders to bow to public pressure and respond, with the potential for miscalculation.

Many of these activities originate along the Line of Control, which divides Kashmir between India and Pakistan. It's largely inaccessible to the media and public, making it hard to independently verify claims of an attack or retaliation.

Such incidents raise international alarm, because both countries have nuclear capabilities, forcing attention back to India and Pakistan and, eventually, their competing claims over Kashmir.

The fear of nuclear war has put the two countries at the top of the agenda, competing with the papal conclave, US President Donald Trump’s policies, and the Sean “Diddy” Combs trial in the news cycle.

No desire for conquest, influence or resources Pakistan and India’s battles and skirmishes are away from the public eye.

Strikes and retaliation are late at night or early in the morning and, with the exception of the drone attacks on Thursday, they mostly take place away from densely populated urban centers. It shows that neither country has the desire to significantly harm the other’s population. Attacks are either described as surgical or limited.

Neither country is motivated by competition for resources. Pakistan has huge mineral wealth, but India isn't interested in these and, while there are stark ideological differences between Hindu-majority India and Muslim-majority Pakistan, they don’t seek control or influence over the other.

Other than Kashmir, they have no interest in claiming the other’s territory or exercising dominance.