Lebanon_health_crisis
6 min read
07 November, 2024

"Baba, it’s a sonic boom," Hassan's* three-year-old fearfully tells him. Like any parent, Hassan had tried his best to shield his child from the horrors of war. When their town of Saida, south of Beirut, was bombed, he told his son it was “happy shooting,” like wedding celebratory gunfire or fireworks.

But one day, as the terrifying noise struck again, his wife asked if it was an airstrike or a sonic boom — caused by Israeli jets breaking the sound barrier. “I told her it was a sonic boom, and my son overheard,” Hassan revealed. 

“Now, whenever it happens, he just stops speaking. He runs to me and says nothing. I can only see in his eyes that he’s scared. It was never a case before,” the worried father tells The New Arab.

At other times, it’s the opposite, Hassan continues, saying his toddler will become agitated or “scream a lot" at his parents. “I think if we stay alive, the trauma will hit him later. When he’s bigger, he will remember everything.”

As Israel’s war expands into Lebanon, the mental health of its population is spiralling, not sparing even the youngest ones. Exposed to the daily trauma of intense bombing, many children have begun developing behaviours that deeply worry their parents.

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“Some children are not communicating, engaging, or playing anymore. It might be a syndrome of PTSD,” explains Abeer Jammoul, a clinical psychologist at Embrace, an organisation providing mental health assistance in Lebanon.

“Many have had to leave behind joyful childhood moments. Our goal is to help them find ways to cope and bring as much of their faces amidst all these challenges,” Abeer adds. 

Israel's war adds to an already heavy burden on Lebanon's residents, who have faced multi-layered crises since 2019. Since then, the country has endured one of the most severe financial crises in modern history, the COVID-19 pandemic, the Beirut port explosion, and political deadlock, leading to institutional failure and leaving most citizens to cope on their own. 

'We see depression as a major problem' 

These struggles have resulted in an epidemic of psychological conditions. A recent study published by IDRAAC, another NGO focusing on mental health, has found that two-thirds of Lebanese exhibit at least one mental health disorder.

Dr Elie Karam, the founder of IDRAAC, described the results as a “disaster”. Notably, this research was conducted before the current war, suggesting the actual scope of the problem may be even greater.

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Abeer Jammoul describes a constant state of trauma, where people are unable to heal or even process one event before another traumatic incident occurs. “It’s even tougher every time. People have suffered to the extent that their survival mode can be easily accessed, but they are not functioning well.”

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On 1 November, organisation World Vision warned that more than 88,400 children are at risk of experiencing mental health issues as conflict spreads across Lebanon [Getty]

For Hassan, the ongoing aggression's devastating psychological impact is affecting his entire family. Both Hassan and his wife are experiencing anxiety, sleep troubles, and anger issues.

“When I’m driving and someone hits me by mistake, I’ll get angry very easily, which was not the case before. My wife also has this problem and she was never like that,” Hassan says. 

Dr Rami Bou Khalil, the head of psychiatry at the Hotel-Dieu de France Hospital in Beirut, says the current situation is the worst he has ever seen, with potentially catastrophic long-term consequences.

“I have always been optimistic because we are known to be resilient. As a country, we have experienced many issues in the past, but we adapt very easily. However, amid one crisis after another, people are now exhausted, the system is dysfunctional, and I think this will become worse in a few months,” he warns.

Most of Dr Rami's recent patients share similar symptoms — insomnia, heart palpitations, appetite changes, abdominal pain, headaches, and fatigue — physical signs of the deepening despair creeping into their lives.

“We see depression as a major problem,” says Dr Rami.

Mental health professionals talk about a sharp rise in demand for support. Abeer Jammoul, who supervises the Embrace-run National Lifeline for suicide prevention and emotional support, notes that since the pager attack on 17 September, the hotline receives no fewer than 35–40 calls daily.

Abeer finds this surge especially concerning as the “nature of the calls has shifted”, with many now related to war and displacement. “It speaks to the profound psychological impact these events have on our communities,” she believes.

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'Life is still worth living' 

In response to the demand, various organisations have begun establishing mental health assistance facilities. MSF is providing psychological first aid to the displaced population in different areas of the country.

Many are reliving the violence that forced them from their homes, experiencing recurring flashbacks and nightmares; some resort to self-harm as a coping mechanism.

“We’re trying to give them a sense of hope that life is still worth living,” says George Abu Khalil, a psychologist working with MSF.

Hassan’s wife began seeing a therapist who travels from Beirut once a week. Each visit costs $50, which their household of two working professionals can currently afford. However, he admits that over the long term, it will become a burden on their household expenses.

Most of the population doesn’t have access to such resources. According to the World Bank figures, almost 80% of the society lives in multidimensional poverty, which effectively means millions of people cannot afford to go to the doctor.

“Psychotherapy is effective for the most wealthy, who will be able to finish their treatment. It's becoming something really exclusive," Dr Rami comments.

The war has even further limited access to public mental health services. The psychiatric ward at the Rafik Hariri University Hospital, one of the biggest public hospitals in the country, was closed to treat bombing victims. Bed availability in other public psychiatric wards is extremely limited, and costs at private institutions, such as Hotel Dieu, have risen to $600–$700 per night, a price beyond most people’s reach.

Another alarming trend is the rise in suicidal tendencies, especially among adolescents. “This isn’t something we can handle easily,” Dr Rami says. “In this situation, suicide attempts may recur. If parents manage to hospitalise their child once, they may not be able to do so again in three months or two years. It’s like a one-shot opportunity to treat the patient.”

The current crisis is also likely to worsen the conditions of patients already dealing with chronic mental health issues, such as schizophrenia or bipolar disorder.

With over 1.5 million people facing displacement, many struggle to access their therapy or medications.

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Psychiatric drugs, like lithium — a basic mood stabiliser — are also in short supply due to disrupted supply chains.

On the other hand, counterfeit medications from Iran and Syria, including antidepressants and antipsychotics, can be easily purchased without a prescription.

“If someone wants to advise their neighbour to take Zoloft, all they have to do is buy it and gift it to them,” Dr Rami remarks sarcastically.

The psychiatrist worries this may lead people to unhealthy coping mechanisms. “People will resort to substance abuse, with alcohol or cannabis easily accessible for them. We’re going to have a bigger problem when the crisis ends.”

Addressing the current crisis feels like battling on many fronts. “We work without the right tools. Psychotherapy isn’t readily available, hospitalisations are difficult, and medications are starting to run short,” he continues.

“Over time we will truly see the repercussions of all this.”

*Name changed upon request 

Jagoda Grondecka is an award-winning independent journalist focusing on Afghanistan and the Middle East. She is currently reporting from Lebanon 

Follow her on X: @jagodagrondecka and Instagram: @grondecka