Lebanon's Only Suicide Hotline Inundated

Mia Atoui, cofounder and vice president of Embrace, an NGO which runs a suicide-prevention hotline in Lebanon, says a lot of people have lost hope (AFP/ANWAR AMRO)
Mia Atoui, cofounder and vice president of Embrace, an NGO which runs a suicide-prevention hotline in Lebanon, says a lot of people have lost hope (AFP/ANWAR AMRO)
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Lebanon's Only Suicide Hotline Inundated

Mia Atoui, cofounder and vice president of Embrace, an NGO which runs a suicide-prevention hotline in Lebanon, says a lot of people have lost hope (AFP/ANWAR AMRO)
Mia Atoui, cofounder and vice president of Embrace, an NGO which runs a suicide-prevention hotline in Lebanon, says a lot of people have lost hope (AFP/ANWAR AMRO)

The phones at Lebanon's only suicide hotline hardly ever stop ringing as people grow more and more desperate in the face of a financial downturn that has spurred a mental health crisis.

In one call, a father says he is thinking of taking his own life because he is unable to feed his children, and in another, a man recently made homeless says he has lost all hope.

There are dozens of such calls every day, and around 1,100 a month, in a nation that has seen an exodus of healthcare specialists and shortages of drugs to treat anxiety, depression and psychosis.

The number of people phoning in has more than doubled since last year, and is expected to continue to grow in the coming months as hopes dim for a battered population pushed to the brink by a seemingly endless succession of woes.

One morning this month, "we woke up at 5:30 am to a call from a 31-year-old who is homeless" and feeling suicidal on Beirut's east-west flyover, said Mia Atoui, the co-founder and vice president of Embrace, the NGO that runs the hotline.

Before that, the organization got a call from a dad living in Lebanon's Bekaa Valley who was feeling suicidal because he had four kids he could no longer afford to feed, she added.

"We are receiving similar calls every day... the crisis has worsened enormously."

Atoui said higher demand had prompted the organization to extend hotline operations to 21 hours a day, up from 17, with the aim of reaching 24 hours in the coming months.

A free therapy clinic run by the organization is fully booked until October, with more than 100 people on the waiting list, AFP reported.

The number of children phoning in has also risen, with people under the age of 18 accounting for 15 percent of callers in July, up from less than 10 percent in previous months.

"A lot of people have lost hope," Atoui said.

Since the start of the country's financial crisis in 2019, the triggers for emotional distress have kept piling up, with the coronavirus pandemic and a monster blast at the Beirut port last year stretching a nation's psyche to its limit.

The past four months have seen Lebanon land on even tougher times, with dwindling foreign currency reserves sparking shortages of key imports including fuel, medicine and bread amid around-the-clock power cuts.

With hospitals going out of service and schools at risk of closing down, Lebanese have fled the country en masse, leading to an epidemic of loneliness on top of the misery that now plagues daily life.

Fadi Maalouf, the head of the psychiatry department at the prestigious American University of Beirut Medical Center, said he has seen an upsurge in the load of patients coming in for treatment.

"We are definitely seeing more anxiety and depression, but also more advanced conditions," he said.

The situation, Maalouf said, had been worsened by a dual dilemma.

The bulk of mental health specialists have left, leaving patients struggling to find expert help, while shortages of antidepressants, mood stabilizers, and anti-anxiety medication have interrupted treatment for many.

"We saw patients who cut down on their treatment so that the supply they have would last longer, and they came to us in our outpatient clinic with a worsening of their condition," Maalouf said.

"We even saw patients who decided to stop their treatment and they become more severely depressed, even suicidal, and they ended up in our emergency room," he added.

"These are all patients who were previously stable."

With demand on the rise, clinical psychologist Nanar Iknadiossian is struggling to keep up.

The 29-year-old works for 13 hours a day in back-to-back sessions and still receives new referrals she is unable to take on.

The pace at which the crisis is worsening requires "very quick solution-focused approaches" to therapy, she told AFP.

"It's like psychological first aid... we are just doing damage control."

But with Lebanon's economic crisis causing poverty rates to climb to cover nearly 80 percent of the population, many cannot afford food, let alone expert help.

"Last month, we received a call from a widowed mother who has three kids she can't afford to feed," said Magalie Eid, a 23-year-old volunteer operator at Embrace.

"She was lost."

Boushra, a 26-year-old volunteer operator who asked to be identified by only her first name over privacy concerns, said her job now feels like "mission impossible".

"We are supposed to give hope in a country where hope does not exist."



'We Will Die from Hunger': Gazans Decry Israel's UNRWA Ban

 Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
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'We Will Die from Hunger': Gazans Decry Israel's UNRWA Ban

 Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed
Itimad Al-Qanou, a displaced Palestinian mother from Jabalia, eats with her children inside a tent, amid Israel-Gaza conflict, in Deir Al-Balah, central Gaza Strip, November 9, 2024. REUTERS/Ramadan Abed

After surviving more than a year of war in Gaza, Aisha Khaled is now afraid of dying of hunger if vital aid is cut off next year by a new Israeli law banning the UN Palestinian relief agency from operating in its territory.

The law, which has been widely criticised internationally, is due to come into effect in late January and could deny Khaled and thousands of others their main source of aid at a time when everything around them is being destroyed.

"For me and for a million refugees, if the aid stops, we will end. We will die from hunger not from war," the 31-year-old volunteer teacher told the Thomson Reuters Foundation by phone.

"If the school closes, where do we go? All the aspects of our lives are dependent on the agency: flour, food, water ...(medical) treatment, hospitals," Khaled said from an UNRWA school in Nuseirat in central Gaza.

"We depend on them after God," she said.

UNRWA employs 13,000 people in Gaza, running the enclave's schools, healthcare clinics and other social services, as well as distributing aid.

Now, UNRWA-run buildings, including schools, are home to thousands forced to flee their homes after Israeli airstrikes reduced towns across the strip to wastelands of rubble.

UNRWA shelters have been frequently bombed during the year-long war, and at least 220 UNRWA staff have been killed, Reuters reported.

If the Israeli law as passed last month does come into effect, the consequences would be "catastrophic," said Inas Hamdan, UNRWA's Gaza communications officer.

"There are two million people in Gaza who rely on UNRWA for survival, including food assistance and primary healthcare," she said.

The law banning UNRWA applies to the Israeli-occupied West Bank, Gaza and Arab East Jerusalem, areas Israel captured in 1967 during the Six-Day War.

Israeli lawmakers who drafted the ban cited what they described as the involvement of a handful of UNRWA's thousands of staffers in the attack on southern Israel last year that triggered the war and said some staff were members of Hamas and other armed groups.

FRAGILE LIFELINE

The war in Gaza erupted on Oct. 7, 2023, after Hamas attack. Israel's military campaign has levelled much of Gaza and killed around 43,500 Palestinians, Gaza health officials say. Up to 10,000 people are believed to be dead and uncounted under the rubble, according to Gaza's Civil Emergency Service.

Most of the strip's 2.3 million people have been forced to leave their homes because of the fighting and destruction.

The ban ends Israel's decades-long agreement with UNRWA that covered the protection, movement and diplomatic immunity of the agency in Israel, the West Bank and the Gaza Strip.

For many Palestinians, UNRWA aid is their only lifeline, and it is a fragile one.

Last week, a committee of global food security experts warned there was a strong likelihood of imminent famine in northern Gaza, where Israel renewed an offensive last month.

Israel rejected the famine warning, saying it was based on "partial, biased data".

COGAT, the Israeli military agency that deals with Palestinian civilian affairs, said last week that it was continuing to "facilitate the implementation of humanitarian efforts" in Gaza.

But UN data shows the amount of aid entering Gaza has plummeted to its lowest level in a year and the United Nations has accused Israel of hindering and blocking attempts to deliver aid, particularly to the north.

"The daily average of humanitarian trucks the Israeli authorities allowed into Gaza last month is 30 trucks a day," Hamdan said, adding that the figure represents 6% of the supplies that were allowed into Gaza before this war began.

"More aid must be sent to Gaza, and UNRWA work should be facilitated to manage this aid entering Gaza," she said.

'BACKBONE' OF AID SYSTEM

Many other aid organizations rely on UNRWA to help them deliver aid and UN officials say the agency is the backbone of the humanitarian response in Gaza.

"From our perspective, and I am sure from many of the other humanitarian actors, it's an impossible task (to replace UNRWA)," said Oxfam GB's humanitarian lead Magnus Corfixen in a phone interview with the Thomson Reuters Foundation.

"The priority is to ensure that they will remain ... because they are essential for us," he said.

UNRWA supports other agencies with logistics, helping them source the fuel they need to move staff and power desalination plants, he said.

"Without them, we will struggle with access to warehouses, having access to fuel, having access to trucks, being able to move around, being able to coordinate," Corfixen said, describing UNRWA as "essential".

UNRWA schools also offer rare respite for traumatised children who have lost everything.

Twelve-year-old Lamar Younis Abu Zraid fled her home in Maghazi in central Gaza at the beginning of the war last year.

The UNRWA school she used to attend as a student has become a shelter, and she herself has been living in another school-turned-shelter in Nuseirat for a year.

Despite the upheaval, in the UNRWA shelter she can enjoy some of the things she liked doing before war broke out.

She can see friends, attend classes, do arts and crafts and join singing sessions. Other activities are painfully new but necessary, like mental health support sessions to cope with what is happening.

She too is aware of the fragility of the lifeline she has been given. Now she has to share one copybook with a friend because supplies have run out.

"Before they used to give us books and pens, now they are not available," she said.