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.



Syria's Military Hospital Where Detainees Were Tortured, Not Treated

Torture survivor Mohammed Najib dreaded being taken by his jailers to a military hospital where he was beaten - AFP
Torture survivor Mohammed Najib dreaded being taken by his jailers to a military hospital where he was beaten - AFP
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Syria's Military Hospital Where Detainees Were Tortured, Not Treated

Torture survivor Mohammed Najib dreaded being taken by his jailers to a military hospital where he was beaten - AFP
Torture survivor Mohammed Najib dreaded being taken by his jailers to a military hospital where he was beaten - AFP

Former Syrian detainee Mohammed Najib has suffered for years from torture-induced back pain. Yet he dreaded being taken by his jailers to a military hospital, where he received beatings instead of treatment.

The prison guards forbade him from revealing his condition, only sending him to hospital for his likely tuberculosis symptoms -- widespread in the notorious Saydnaya prison where he was detained.

Doctors at Tishreen Hospital, the largest military health facility in Damascus, never inquired about the hunch on his back -- the result of sustained abuse.
Freed just hours after the fall of Bashar al-Assad, Najib has a tennis ball-sized bulge on his lower back.
The 31-year-old can barely walk, and the pain is unbearable.

But he insisted on showing AFP around a jail in the military hospital compound.

"I hated being brought here," Najib said as he returned with two friends who had shared the same cell with him after they were accused of ties to the armed rebellion that sought Assad's overthrow.

"They hit us all the time, and because I couldn't walk easily, they hit me" even more, he said, referring the guards.

Because he was never allowed to say he had anything more than the tuberculosis symptoms of "diarrhoea and fever", he never received proper treatment.

"I went back and forth for nothing," he said.

Assad fled Syria last month after opposition factions wrested city after city from his control until Damascus fell, ending his family's five-decade rule.

The Assads left behind a harrowing legacy of abuse at detention facilities that were sites of extrajudicial executions, torture and forced disappearances.

Hours after Assad fled, Syrian opposition broke into the notorious Saydnaya prison, freeing thousands, some there since the 1980s.

Since then, Tishreen Hospital has been out of service pending an investigation.

- 'Assisting torture' -

Human rights advocates say Syria's military hospitals, most notably Tishreen, have a record of neglect and ill-treatment.

"Some medical practitioners that were in some of these military hospitals (were) assisting... interrogations and torture, and maybe even withholding treatments to detainees," Hanny Megally of the UN Commission of Inquiry on Syria told AFP.

Former Saydnaya detainees told AFP about the ordeals they went through after they got sick.

It would begin with a routine examination by two of the jail's military doctors.

One of them used to beat prisoners, sometimes to death, four ex-detainees said.

Guards relentlessly beat them from the moment they were pulled from their cells to the hospital jail, then to its main building to meet the doctors, and finally escorted back to prison.

At the hospital's jail, those who were too ill were left to die or even killed, several former detainees said.

Three years ago, Najib and other inmates were tortured using the "tyre" method inside Saydnaya for merely talking to each other.

They were forced into vehicle tyres and beaten with their foreheads against their knees or ankles.

After a first check-up by a military doctor at Saydnaya, Najib was prescribed painkillers for his back pain.

The doctor eventually accepted to transfer him to Tishreen Hospital for tuberculosis symptoms.

Former prisoners said guards looking to minimize their workload would order them to say they suffered from "diarrhoea and fever" so they could transfer everyone to the same department.

- 'Clean him' -

When Omar al-Masri, 39, was taken to the hospital with a torture-induced leg injury, he too told a doctor he had an upset stomach and a fever.

While he was awaiting treatment, a guard ordered him to "clean" a very sick inmate.

Masri wiped the prisoner's face and body, yet when the guard returned, he angrily repeated the same order: "Clean him".

As Masri repeated the task, the sick prisoner soon took his last breath. An agitated Masri called out to the guard who gave him a chilling response: "Well done."

"That is when I learnt that by 'clean him', he meant 'kill him'," he said.

According to a 2023 report by the Association of Detainees and the Missing in Sednaya Prison, security forces at the hospital jail and even medical and administrative staff inflicted physical and psychological violence on detainees.

A civilian doctor told AFP she and other medical staff at Tishreen were under strict orders to keep conversations with prisoners to a minimum.

"We weren't allowed to ask what the prisoner's name was or learn anything about them," she said, requesting anonymity for fear of reprisals.

She said that despite reports about ill treatment at the hospital, she had not witnessed it herself.

But even if a doctor was courageous enough to ask about a prisoner's name, the scared detainee would only give the number assigned to him by the guards.

"They weren't allowed to speak," she said.

After a beating in his Saydnaya cell, Osama Abdul Latif's ribs were broken, but the prison doctors only transferred him to the hospital four months later with a large protrusion on his side.

Abdul Latif and other detainees had to stack the bodies of three fellow inmates into the transfer vehicle and unloaded them at Tishreen hospital.

"I was jailed for five years," Abdul Latif said.

But "250 years wouldn't be enough to talk about all the suffering" he endured.