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.



How Hamas Recruited, Trained New Fighters During the War

Military training manuals titled “Anti-Armor Weapons – Northern Brigade” and dated 2023 provide insight into Hamas’ methods for preparing recruits to target Israeli forces (Asharq Al-Awsat)
Military training manuals titled “Anti-Armor Weapons – Northern Brigade” and dated 2023 provide insight into Hamas’ methods for preparing recruits to target Israeli forces (Asharq Al-Awsat)
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How Hamas Recruited, Trained New Fighters During the War

Military training manuals titled “Anti-Armor Weapons – Northern Brigade” and dated 2023 provide insight into Hamas’ methods for preparing recruits to target Israeli forces (Asharq Al-Awsat)
Military training manuals titled “Anti-Armor Weapons – Northern Brigade” and dated 2023 provide insight into Hamas’ methods for preparing recruits to target Israeli forces (Asharq Al-Awsat)

Hamas said it recruited and trained thousands of fighters during the 15-month Gaza war, a claim supported by former US Secretary of State Antony Blinken.

Abu Obaida, spokesman for Hamas’ military wing, the Al-Qassam Brigades, said in July: “We recruited thousands of new fighters, strengthened key capabilities, set up ambushes, and made explosives and rockets.”

The announcement highlights Hamas’ efforts to expand its military strength during the conflict.

In his final address as US Secretary of State on January 14, Blinken confirmed Hamas recruited new fighters during the war.

“Indeed, we assess that Hamas has recruited almost as many new militants as it has lost,” Blinken revealed. “That is a recipe for an enduring insurgency and perpetual war,” he explained.

The statements from US officials and Hamas have raised questions about how the group managed to recruit and train fighters amid the war.

However, military training manuals belonging to Hamas, discovered by an Asharq Al-Awsat correspondent in the rubble of Jabalia camp in northern Gaza, provided partial insight into the group’s methods for preparing its fighters.

The Jabalia refugee camp was the site of a highly intense Israeli military operation that lasted around 100 days. According to Israeli army statements, the operation resulted in the deaths of dozens of Israeli officers and soldiers.

Hamas, however, has remained silent about its own losses during the battles, leaving questions about the full scale of casualties in the prolonged fighting.

Military training manuals titled “Anti-Armor Weapons – Northern Brigade” and dated 2023 provide insight into Hamas’ methods for preparing recruits to target Israeli forces.

The documents include instructions on using light weapons, guided rockets, and other munitions, aiming to train new fighters for operations against Israeli troops.

The manuals detail shooting techniques, effective firing ranges, and guidelines for targeting Israeli armored vehicles, particularly weaknesses in Merkava tanks to maximize damage and ensure destruction.

They also explain the use of various projectiles, including RBG rockets, PG-7V, F-7, BG-7M, Yassin rockets, tandem warheads, and both Chinese and Russian munitions, as well as the TBG rocket system.

According to Hamas sources speaking to Asharq Al-Awsat, such manuals have long been part of Al-Qassam Brigades’ military training.

Recruits have been trained practically at military sites using these guides. The sources added that the manuals found in Jabalia, where clashes took place, were intended to help fighters, particularly new recruits, deal with the Israeli assault.

Hamas sources said the training manuals significantly aided fighters in battles across Gaza, particularly in the north, which faced the heaviest and most extensive Israeli assaults.

“The military capabilities were being eroded,” the sources said.

“However, field commanders quickly addressed this by recruiting new fighters and finding alternatives to manage the battle effectively,” they added.

The sources noted that many fighters recruited during the Gaza war had undergone only basic, fast-track training before being sent to the battlefield. After losing many experienced fighters, the group relied on trainees and loyalists with minimal preparation.

“These new recruits fought alongside seasoned fighters,” the sources said. “They received basic instructions and were taught to use advanced weapons like guided rockets but were mostly skilled with light arms like Kalashnikov rifles.”

Despite limited training, the recruits played a vital role in the conflict.

Sources acknowledged that new recruits had limited field experience and faced challenges but found urban and guerrilla warfare easier. Most of these fighters were involved in battles in northern Gaza, especially in Jabalia and Beit Lahia, while a smaller group fought in Beit Hanoun and took part in operations that killed Israeli soldiers.

Hamas emphasized its recruitment abilities during the first hostage exchange after last Sunday’s ceasefire. Al-Qassam Brigades members made a public appearance in Gaza City, which is in northern Gaza.

Hamas reportedly used a “deception” tactic, sending out vehicles resembling those used to transport hostages while also deploying decoy vehicles from different areas.

They also instructed their members to gather in Saraya Square to distract from the vehicle carrying female prisoners.

The exact number of new recruits remains unclear, though they have been called “2024 recruits” after a statement by Abu Obaida. Israeli media estimates the number at around 4,000 fighters, with some accusing Mohammad Sinwar, brother of the late Yahya Sinwar, of leading the recruitment.

Blinken criticized Israel’s approach in Gaza, saying Hamas can’t be defeated by military means alone. He stressed the need for a political solution to prevent the group’s return.

The Wall Street Journal reported that Mohammad Sinwar is focused on rebuilding the group's military strength.

Hamas’ recruitment during the war and its continued resistance have made it a tough challenge for Israel, which has had to return to areas it thought were cleared of militants, only to face renewed fighting.

Before the war, Hamas’ Al-Qassam Brigades had about 30,000 fighters in 24 battalions.

Blinken noted that Hamas had replaced the fighters it lost during the conflict and that militants in northern Gaza continue to regroup after Israeli military operations, showing the ongoing challenge for Israel without a political solution.