{"id":184763,"date":"2021-10-21T17:06:40","date_gmt":"2021-10-21T15:06:40","guid":{"rendered":"https:\/\/www.arabtelegraph.com\/?p=184763"},"modified":"2021-10-21T17:06:44","modified_gmt":"2021-10-21T15:06:44","slug":"how-greed-fueled-lebanons-deadly-milk-and-medicine-shortage","status":"publish","type":"post","link":"https:\/\/www.arabtelegraph.com\/?p=184763","title":{"rendered":"How greed fueled Lebanon\u2019s deadly milk and medicine shortage"},"content":{"rendered":"\n

Ammouneh Haydar sits on a plastic chair in the sparsely furnished apartment she hasn\u2019t left for a month. As the sun sets, a single fluorescent lamp casts its weak glow across the room. Within minutes, a power outage lasting 22 hours will reduce the place to darkness.<\/strong><\/p>\n\n\n\n

Haydar, 32, will confine herself to her tiny home in the village of Tleil near the Syrian border for another ten days. Her husband, Ibrahim Urfali, was killed in a fuel tank explosion in mid-August, and she is adhering to a mourning tradition common for grieving widows in some conservative Muslim communities in Lebanon, refraining from contact with men for 40 days.<\/p>\n\n\n\n

Tears stream down her cheeks during a moment of quiet reflection. Her six-year-old, the couple\u2019s second-born, pulls Haydar\u2019s face to his and showers it with kisses, seemingly desperate to ease his mother\u2019s agony.<\/p>\n\n\n\n

She forces a small smile.<\/p>\n\n\n\n

Haydar\u2019s tragedy is emblematic of her country\u2019s crisis.<\/p>\n\n\n\n

Like the vast majority of Lebanon\u2019s population, her material losses have multiplied at breakneck speed since the country\u2019s financial disaster began two years ago. The family\u2019s already modest earnings have been whittled down to almost nothing. Rampant shortages have deprived her of the ability to adequately feed her four children.<\/p>\n\n\n\n

\"\/\"\/
Ammouneh Haydar shows a nearly empty container of infant formula. In the midst of Lebanon\u2019s economic crisis, she has struggled to adequately feed her four children since<\/em><\/strong> her husband died in a fuel tank explosion<\/strong><\/em>.<\/figcaption><\/figure><\/div>\n\n\n\n

Even as local television stations screened images of large amounts of stockpiled infant formula at the end of August, Haydar says she couldn\u2019t find any to buy for her seven-month-old son. She says she resorted to feeding him hot water mixed with sugar.<\/p>\n\n\n\n

Lebanon\u2019s financial crash was fueled by the greed of a commercial elite, and it is ordinary people like Haydar who are paying a high price \u2014 in her husband\u2019s case, the ultimate price \u2014 for it.<\/p>\n\n\n\n

Deadly side-effects of hoarding<\/h3>\n\n\n\n

The country\u2019s economic depression has been driven by a rapid depletion of public finances, exacerbated by what the World Bank says was \u201cdeliberate\u201d mismanagement of the crisis on the part of the ruling elite. But the hoarding of essential goods has also dealt the economy a devastating blow.<\/p>\n\n\n\n

Lebanon\u2019s Prime Minister Najib Mikati said last month that traders and \u201ccorrupted people\u201d have withheld 74% of the country\u2019s subsidized goods \u2014 fuel, medicine, food and baby formula \u2014 from the public over the past year. This accounts for around $7.4 billion of the $10 billion Mikati says the state spent on subsidies in a year.<\/p>\n\n\n\n

\"\/\"\/
Nurses talk in the darkened hallway of the Al Hamshari Hospital during a power outage<\/em><\/strong><\/figcaption><\/figure>\n\n\n\n

Import data, statements from the Central Bank and dozens of interviews with pharmacists, doctors, patients and aid workers conducted by CNN point to an increase in some subsidized goods coming into Lebanon in the first half of 2021 when many parents were struggling to feed their babies, cancer patients didn\u2019t have life-saving drugs and diesel exhaustion caused hundreds of businesses to temporarily shutter.<\/p>\n\n\n\n

The fuel tank explosion which cost Haydar\u2019s husband his life highlights the potentially devastating impact of hoarding.<\/p>\n\n\n\n

On August 14, Lebanon\u2019s military seized a tanker-load of fuel from a smuggler in Tleil, 110km from Beirut.<\/p>\n\n\n\n

In the early hours of the following day, troops tried to distribute the diesel to scores of local men desperate to fuel the generators that power their families\u2019 homes. Ibrahim Urfali was scrambling for a share when the tank exploded, killing at least 31 people, and leaving more than 79 injured.<\/p>\n\n\n\n

His wife said Urfali suffered burns to more than 95% of his body.<\/p>\n\n\n\n

He and the others gravely wounded in the blast were taken to nearby hospitals for treatment. Some of the medication they needed was missing, and its absence was chalked up to Lebanon\u2019s financial tailspin.<\/p>\n\n\n\n

Several of the wounded were flown overseas for treatment, another sign of how far the fortunes of Lebanon \u2014 for decades the medical capital of the Middle East \u2014 have fallen.<\/p>\n\n\n\n

\"\/\"\/
Mohamad Hawik, 15, lies in a bed at the Al Salam Hospital in Tripoli in September. He was wounded in the fuel tank explosion and lost three of his brothers.<\/em><\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

After unsuccessful efforts to fly him abroad, Urfali died.<\/p>\n\n\n\n

Days after he succumbed to his burns, Lebanon\u2019s health ministry revealed that more than 6,800 ampules of one of the missing medicines \u2014 albumin \u2014 had been found in a Beirut warehouse piled high with hoarded medication.<\/p>\n\n\n\n

Albumin is a drug typically used to treat severe burns and resuscitate lost fluids, which doctors CNN spoke to said is essential to lowering morbidity rates.<\/p>\n\n\n\n

The discovery of the Albumin stockpile, in an affluent Beirut neighbourhood, came during health ministry raids on more than 10 storage units \u2014 which the ministry said mostly belonged to importers and pharmacists \u2014 in which huge amounts of hoarded medications and baby formula had been stashed away.<\/p>\n\n\n\n

\u201cWe found all the kinds of medicine and baby formula we had been looking for,\u201d one health ministry official who participated in the raids on warehouses, and who asked not to be named, told CNN.<\/p>\n\n\n\n

The medication and formula seized in the raids has since been distributed to hospitals and others in need, the health ministry said.<\/p>\n\n\n\n

The Health Ministry says several of the warehouse owners who hoarded medications have been arrested and that evidence gathered in the raids has been forwarded to Lebanon\u2019s judiciary.<\/p>\n\n\n\n

The raids appear to have stopped since a new government was formed in early September. The country\u2019s new health minister, Firass Abiad, did not respond to CNN\u2019s repeated requests for comment on why this was the case.<\/p>\n\n\n\n

Subsidies and smuggling<\/h3>\n\n\n\n

In 2020, in the midst of a deepening financial crisis, the Lebanese government started to subsidize essential goods in response to hyperinflation and rising unemployment. With a majority of goods imported the move was seen as a lifeboat, but the plan \u2014 seen by experts as unsustainable \u2014 soon backfired.<\/p>\n\n\n\n

\"\/\"\/
Rabih Haydar, Ibrahim Urfali\u2019s brother-in-law, walks through the woods surrounding his house.<\/em><\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

Local media reports highlighted the illegal smuggling of fuel to Syria. After traders bought fuel in Lebanon at subsidized prices, they reportedly took it across the border to sell at global market rates, leading to significant profits. As the local currency plummeted, profit margins grew. The lira has lost over 90% of its value in two years, whereas global markets have been largely unchanged.<\/p>\n\n\n\n

\u201cThe [Central] Bank essentially financed the profits of traders,\u201d Zouhair Berro, head of the Consumers Protection Association, a Lebanese watchdog group, told CNN. \u201cThrough stockpiling, traders would wait for the price to rise and then sell it at a high price. In this way, very little reached the people.\u201d<\/p>\n\n\n\n

The Central Bank claims it warned the Lebanese government about the abuse of subsidies since last June, but their claims have been met with widespread skepticism. The bank has been repeatedly accused of of aiding capital flight from Lebanon and helping the commercial elite shore up profits in the face of the country\u2019s financial freefall \u2014 accusations bank officials reject.<\/p>\n\n\n\n

At the height of Lebanon\u2019s fuel crisis in July \u2014 when queues at petrol pumps extended for miles and power outages spiked dramatically \u2014 the country\u2019s Central Bank spent around $800 million on fuel imports, Central Bank Governor Riad Salameh told local media in August. That money would typically sustain Lebanon for three months, he said.<\/p>\n\n\n\n

Army raids on petrol pumps in August uncovered tens of millions of litres of hoarded petrol, according to state media and multiple videos showing fuel stockpiles.<\/p>\n\n\n\n

\"\/\"\/
A street vendor sells black-market fuel on the side of the main road that connects Tripoli to Akkar in September<\/em><\/strong><\/figcaption><\/figure>\n\n\n\n

In June, Lebanon\u2019s Central Bank largely stopped supplying dollars to banks to extend lines of credit \u2014 an essential part of the subsidy mechanism \u2014 to importers of infant baby formula and medicine, saying it could no longer afford the drain on its reserves, and citing a significant discrepancy between its bloated import bill and shortages in the market.<\/p>\n\n\n\n

\u201cThe bill for medicine and healthcare supplies in the first half of 2021 exceeds the entire bill of 2020,\u201d the bank said in a statement in July.<\/p>\n\n\n\n

The bank said it had been billed around $1.5 billion on medicines and infant formula in the first six months of 2021 alone, compared to $1.173 billion it had paid in the whole of 2020.<\/p>\n\n\n\n

\u201cThe numbers just don\u2019t add up,\u201d said another high-ranking Central Bank official. \u201cWe discovered these big figures \u2026 we went out of our minds.\u201d<\/p>\n\n\n\n

Data from Euromonitor International, a strategic market research group, also showed a boost in baby formula imports in the first half of 2021. Lebanon\u2019s pharmaceuticals importers syndicate chief Karim Gebara also acknowledged a growth in medicine imports, though he accused the central bank of attempting to exaggerate import growth in the medicine sector.<\/p>\n\n\n\n

\u201cWe believe that [the Central Bank\u2019s] analysis is not correct \u2026 the data of the order of pharmacists says no, there is a growth of around 10% between this year and last year,\u201d he says. \u201cWe also took data of an international company that do analysis of markets. They say the market grew by 10%.\u201d<\/p>\n\n\n\n

\"\/\"\/
The Ibad Al Rahman Association in Beirut provides various social services and aims to help people who are struggling to access medication.<\/strong><\/em><\/figcaption><\/figure><\/div>\n\n\n\n

Gebara says medication imports stopped in May when a pre-approval process for medicine importers was halted by the Central Bank. In August, the Bank said it resumed pre-approvals for subsidized medicines. However, when CNN interviewed doctors at four major hospitals a month later, they said the medicine crisis had not been alleviated by the change.<\/p>\n\n\n\n

CNN interviews with aid workers, pharmacists and new mothers also found that while shortages of baby formula and other essential supplies intensified this summer, they began several months before the Central Bank effectively paused the subsidy program.<\/p>\n\n\n\n

Asked why the Central Bank paused supplying dollars for subsidies, a high level bank official, who asked to remain anonymous, told CNN it was \u201cbecause we can\u2019t continue \u2026 We don\u2019t have money anymore. It\u2019s done.\u201d<\/p>\n\n\n\n

Inside Lebanon\u2019s public hospitals<\/h3>\n\n\n\n

At Lebanon\u2019s biggest public hospital, the Rafik Hariri University Hospital, the mood is sombre.<\/p>\n\n\n\n

Dejected looking patients and their loved ones sit on the ground outside the main entrance. There is no toilet paper in any of the bathrooms \u2014 one nurse helpfully offers someone a medical mask instead.<\/p>\n\n\n\n

Medical staff and patients alike, it seems, are battling not just shortages of medicine and essential supplies, but a sense of impending doom.<\/p>\n\n\n\n

\"\/\"\/
Tharwat sits inside the oncology ward at the Rafik Hariri University Hospital in Beirut<\/em><\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

Tharwat crouches by a windowsill in the oncology ward, staring into the distance. The 50-year-old has just been diagnosed with Amyloidosis, a heart condition which requires treatment with a chemotherapy medication that neither she nor her doctors can find.<\/p>\n\n\n\n

\u201cI don\u2019t understand it,\u201d Tharwat, who asked not to be fully identified, says. \u201cI don\u2019t understand how I can\u2019t find medication.\u201d As she says this, her sister breaks down in tears and scurries out of the room.<\/p>\n\n\n\n

\u201cI\u2019m someone who loves life,\u201d Tharwat, wide-eyed and emaciated, explains. \u201cI had a beauty shop. I had customers who I loved. Why is this happening to me.\u201d<\/p>\n\n\n\n

\u201cThe absolute worst part of my job is when I have patients with curable cancers, but who I cannot treat,\u201d RHUH\u2019s Head of Oncology, Dr. Issam Shehadeh, tells CNN, adding that the majority of cancer patients in Lebanon now cannot receive treatment.<\/p>\n\n\n\n

In the hospital\u2019s basement, the mood in the pharmacy is akin to that in a morgue.<\/p>\n\n\n\n

The department\u2019s head Raida Bitar opens cabinet after cabinet, refrigerator after refrigerator. Each is empty, or mostly empty: Chemotherapy drugs, medications to raise blood pressure, medicines to treat pregnant women \u2014 all missing.<\/p>\n\n\n\n

\"\/\"\/
Head pharmacist Raida Bitar shows empty cabinets at the Rafik Hariri University Hospital.<\/em><\/strong><\/figcaption><\/figure>\n\n\n\n

Bitar says some patients have died because the hospital ran out of one cheap and usually widely-available drug, Noradrenaline. \u201cThey died because we couldn\u2019t raise their blood pressure.\u201d<\/p>\n\n\n\n

An international aid organization recently donated supplies of Noradrenaline to the hospital, so the pharmacy now has a small amount in stock.<\/p>\n\n\n\n

Bitar says newborn babies have died because of a lack of Magnesium Sulfate \u2014 also recently donated \u2014 which is given to mothers who suffer from hypertension.<\/p>\n\n\n\n

\u201cThese are all very cheap medications,\u201d she says. \u201cMagnesium Sulfate costs 10 cents per ampule.\u201d<\/p>\n\n\n\n

\u201cThis isn\u2019t only a financial problem,” she adds. “This is a problem of shortages. Suppliers are greedy, the Central Bank isn\u2019t managing the crisis well, the previous government didn\u2019t manage the crisis well. And patients are paying the price.\u201d<\/p>\n\n\n\n

Even upper middle-class patients are not immune from the effects of the crisis.<\/p>\n\n\n\n

Carine Abou Saab, who is battling Hodgkin’s Lymphoma, underwent an incomplete course of treatment because of the lack of immunotherapy drugs.<\/p>\n\n\n\n

\"\/\"\/
Carine Abou Saab sits iniside her sister’s house in Jounieh, outside Beirut. She is battling Hodgkin\u2019s Lymphoma.<\/em><\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

When she tried to get hold of the missing medication herself, the serial number on the drug she secured was wrong \u2014 suggesting either that it was counterfeit, or that it had been exported from Lebanon to Syria only to be reimported and sold on the Lebanese black market at a higher price.<\/p>\n\n\n\n

While Abou Saab was being treated, her three-year-old daughter Maria was diagnosed with leukemia. Abou Saab managed to get hold of the medication Maria needed, but says that given the ongoing crisis in Lebanon, she would prefer her to be treated in Portugal, where Maria is a citizen.<\/p>\n\n\n\n

\u201cWe feel trapped here. As soon as Maria\u2019s immunity improves, I\u2019m going to take her out,\u201d says Abou Saab.<\/p>\n\n\n\n

To alleviate the shortages, non-profit organizations and community groups have stepped in. One of these, the Barbara Nassar Association for Cancer Patient Support, is helping cancer patients secure medication through its international networks.<\/p>\n\n\n\n

Hani Nassar, who co-founded the organization with his wife, Barbara, days before she died of cancer, says it’s impossible to keep up with the growing demand.<\/p>\n\n\n\n

“If the relatives of patients only knew what was happening in cancer wards, they would commit a massacre,\u201d he says. \u201cDoctors and nurses are having to choose between who gets treatment and who doesn’t \u2014 basically who gets to live.”<\/p>\n","protected":false},"excerpt":{"rendered":"

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