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.”



Fear Stalks Tehran as Israel Bombards, Shelters Fill Up and Communicating Grows Harder

Shops remain shuttered Tehran's historic Grand Bazaar, Monday, June 16, 2025. (AP)
Shops remain shuttered Tehran's historic Grand Bazaar, Monday, June 16, 2025. (AP)
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Fear Stalks Tehran as Israel Bombards, Shelters Fill Up and Communicating Grows Harder

Shops remain shuttered Tehran's historic Grand Bazaar, Monday, June 16, 2025. (AP)
Shops remain shuttered Tehran's historic Grand Bazaar, Monday, June 16, 2025. (AP)

The streets of Tehran are empty, businesses closed, communications patchy at best. With no bona fide bomb shelters open to the public, panicked masses spend restless nights on the floors of metro stations as strikes boom overhead.

This is Iran’s capital city, just under a week into a fierce Israeli blitz to destroy the country's nuclear program and its military capabilities. After knocking out much of Iran's air defense system, Israel says its warplanes have free rein over the city's skies. US President Donald Trump on Monday told Tehran's roughly 10 million residents to evacuate “immediately.”

Thousands have fled, spending hours in gridlock as they head toward the suburbs, the Caspian Sea, or even Armenia or Türkiye. But others — those elderly and infirm — are stuck in high-rise apartment buildings. Their relatives fret: what to do?

Israeli strikes on Iran have killed at least 585 people and wounded over 1,300, a human rights group says. State media, also a target of bombardment, have stopped reporting on the attacks, leaving Iranians in the dark. There are few visible signs of state authority: Police appear largely undercover, air raid sirens are unreliable, and there’s scant information on what to do in case of attack.

Shirin, 49, who lives in the southern part of Tehran, said every call or text to friends and family in recent days has felt like it could be the last.

“We don’t know if tomorrow we will be alive,” she said.

Many Iranians feel conflicted. Some support Israel's targeting of Iranian political and military officials they see as repressive. Others staunchly defend the country and retaliatory strikes on Israel. Then, there are those who oppose Iran’s rulers, but still don't want to see their country bombed.

To stay, or to go? The Associated Press interviewed five people in Iran and one Iranian American in the US over the phone. All spoke either on the condition of anonymity or only allowed their first names to be used, for fear of retribution from the state against them or their families.

Most of the calls ended abruptly and within minutes, cutting off conversations as people grew nervous or because the connection dropped. Iran’s government has acknowledged disrupting internet access. It says it's to protect the country, though that has blocked average Iranians from getting information from the outside world.

Iranians in the diaspora wait anxiously for news from relatives. One, an Iranian American human rights researcher in the US, said he last heard from relatives when some were trying to flee Tehran earlier in the week. He believes that lack of gas and traffic prevented them from leaving.

The most heartbreaking interaction, he said, was when his older cousins with whom he grew up in Iran told him “We don’t know where to go. If we die, we die.”

“Their sense was just despair,” he said.

Some families have made the decision to split up.

A 23-year-old Afghan refugee who has lived in Iran for four years said he stayed behind in Tehran but sent his wife and newborn son out of the city after a strike Monday hit a nearby pharmacy.

“It was a very bad shock for them,” he said.

Some, like Shirin, said fleeing was not an option. The apartment buildings in Tehran are towering and dense. Her father has Alzheimer’s and needs an ambulance to move. Her mother's severe arthritis would make even a short trip extremely painful.

Still, hoping escape might be possible, she spent the last several days trying to gather their medications. Her brother waited at a gas station until 3 a.m., only to be turned away when the fuel ran out. As of Monday, gas was being rationed to under 20 liters (5 gallons) per driver at stations across Iran after an Israeli strike set fire to the world's largest gas field.

Some people, like Arshia, said they are just tired.

“I don’t want to go in traffic for 40 hours, 30 hours, 20 hours, just to get to somewhere that might get bombed eventually,” he said.

The 22-year-old has been staying in the house with his parents since the initial Israeli strike. He said his once-lively neighborhood of Saadat Abad in northwestern Tehran is now a ghost town. Schools are closed. Very few people even step outside to walk their dogs. Most local stores have run out of drinking water and cooking oil. Others closed.

Still, Arshia said the prospect of finding a new place is too daunting.

“We don’t have the resources to leave at the moment,” he said.

Residents are on their own

No air raid sirens went off as Israeli strikes began pounding Tehran before dawn Friday. For many, it was an early sign civilians would have to go it alone.

During the Iran-Iraq war in the 1980s, Tehran was a low-slung city, many homes had basements to shelter in, and there were air raid drills and sirens. Now the capital is packed with close-built high-rise apartments without shelters.

“It's a kind of failing of the past that they didn’t build shelters,” said a 29-year-old Tehran resident who left the city Monday. “Even though we’ve been under the shadow of a war, as long as I can remember.”

Her friend's boyfriend was killed while going to the store.

“You don’t really expect your boyfriend or your anyone, really to leave the house and never return when they just went out for a routine normal shopping trip,” she said.

Those who choose to relocate do so without help from the government. The state has said it is opening mosques, schools and metro stations for use as shelters. Some are closed, others overcrowded.

Hundreds crammed into one Tehran metro station Friday night. Small family groups lay on the floor. One student, a refugee from another country, said she spent 12 hours in the station with her relatives.

“Everyone there was panicking because of the situation,” she said. “Everyone doesn’t know what will happen next, if there is war in the future and what they should do. People think nowhere is safe for them.”

Soon after leaving the station, she saw that Israel had warned a swath of Tehran to evacuate.

“For immigrant communities, this is so hard to live in this kind of situation,” she said, explaining she feels like she has nowhere to escape to, especially not her home country, which she asked not be identified.

Fear of Iran mingles with fear of Israel

For Shirin, the hostilities are bittersweet. Despite being against the theocracy and its treatment of women, the idea that Israel may determine the future does not sit well with her.

“As much as we want the end of this regime, we didn’t want it to come at the hands of a foreign government,” she said. “We would have preferred that if there were to be a change, it would be the result of a people’s movement in Iran.”

Meanwhile, the 29-year-old who left Tehran had an even more basic message for those outside Iran:

“I just want people to remember that whatever is happening here, it’s not routine business for us. People’s lives here — people’s livelihoods — feel as important to them as they feel to anyone in any other place. How would you feel if your city or your country was under bombardment by another country, and people were dying left and right?”

“We are kind of like, this can’t be happening. This can’t be my life.”