Concern as mental health patients in Lebanon struggle to obtain medications

Residents pass by a shuttered pharmacy in Beirut during a nationwide strike on July 9, 2021. (AFP file photo)
Residents pass by a shuttered pharmacy in Beirut during a nationwide strike on July 9, 2021. (AFP file photo)
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Updated 14 January 2022

Concern as mental health patients in Lebanon struggle to obtain medications

Concern as mental health patients in Lebanon struggle to obtain medications
  • Since the end of 2019, following the escalating economic and social collapse, the levels of mental disorders rose dramatically
  • Some estimates suggest one in five people suffers from anxiety, sadness or depression as a result of the crises affecting the country

BEIRUT: As the people of Lebanon continue to struggle with the effects of the financial crisis in the country, the political turmoil and the aftermath of the devastating explosion at Beirut’s port, concern is growing about the toll these crises are taking on mental health.

While no accurate statistics are available for the number of people who take sedatives, psychiatrists report that the number of patients visiting their clinics in the past year exceeded 12 a day.

Meanwhile, pharmacists estimate that people wishing to buy psychotropics — drugs that affect a person’s mental state, including antidepressants, anti-anxiety medication and mood stabilizers — constitute 30 to 35 percent of their customers.

According to some medical estimates, one in five people in Lebanon feels anxiety, sadness or depression as a result of the economic and social conditions in the country but medicine and healthcare are not readily available to many.

The Lebanese pound has plummeted in value against the dollar and soaring prices are exhausting incomes and salaries. The Beirut explosion on Aug. 4, 2020, and the armed clashes in the city’s Tayouneh neighborhood last October further fueled the sense hopelessness among many people.

“Since the end of 2019, following the escalating economic and social collapse, the levels of mental disorders rose dramatically,” said Hiba Dandachli, communications director of Embrace, an organization that provides mental health services.




Hiba Dandachli, communications director of Embrace, presenting the case of Lebanon's mental health patients during a TV talk show. (Twitter photo)

In 2021, she said, 20,000 people called the Embrace Lifeline, more than in any previous year. She said that a high proportion of the callers, mostly young people and teenagers, were suffering from conditions such as anxiety, depression and insomnia as result of the effects of the declining economic and social conditions and unemployment.

“The Lebanese took to the streets in 2019 to express their anger,” Dandachli said. “However, they feel despair due to the escalating crises.

“Without social justice and securing the fundamental right of stability, our services are limited to helping people, not providing solutions. We are sedatives.”

Joelle, 33, who works at an insurance company, said that she sought help from a psychiatrist because she was suffering from anxiety as a result the dire economic situation and the fear of being unable to provide for her the family.

“I started suffocating at night and experiencing panic attacks,” she said. The treatment that was prescribed requires medicine that is either unavailable in pharmacies or very expensive, she added.

A study published in December by the Lebanese American University indicated that “16.17 percent of young people, between 18 and 24 years old, suffer from severe depression since the Aug. 4 explosion, and 40.95 percent of women suffer post-traumatic stress disorder.”

“We mainly witness mood disorder cases at our clinic,” said Dr. Hanaa Azar, a psychiatrist who works with adults and children.

She believes that “between 70 and 80 percent of people in Lebanon take sedatives as a result of sleep disorders, stomach spasm, tachycardia, eczema, phobias, body pains and other physical symptoms that are symptoms of mental disorders.”

She added: “All generations suffer in one way or another from these disorders as a result of insecurity, especially children. As everyone returned to school and work, behavioral and academic disorders have emerged and obsessive-compulsive disorder cases have increased among adults.”

Doctors and psychiatrists are particularly worried about the shortage of medicines, especially since most are no longer subsidized by the state and the rest are only partly subsidized. Only cancer medications are still fully subsidized. Subsidies on drugs for neurological conditions depend on the price of the particular medicine.




Embrace volunteer health workers providing a lifeline service to residents of Lebanon who are psychologically affected by the worsening economic crisis. (Twitter photo)

“A very large number of Lebanese take a sedative drug, the price of which has risen from 25,000 Lebanese pounds to 420,000 within just two months.” The official exchange rate remains 1,500 pounds to the dollar, but this is unavailable and the currency currently trades on the informal black market at more than 30,000 pounds to the dollar.

Pharmacist Samer Soubra said he cannot understand why there are still medicine shortages even though prices have been increased to take account of the soaring exchange rate.

“Medicine distributors were reluctant to distribute to pharmacies in light of the high exchange rate,” he said. “Today, subsidies have been lifted on many medicines and they are now priced according to the exchange rate on the black market, yet some are still missing, including infant formula.”

Thousands of people in Lebanon resort to obtaining the medicines they need, especially psychotropics, from relatives in other countries or people who bring them from Turkey, Cyprus, Greece and Jordan, or from donations made by Lebanese expatriates in France.

Still, many are going without. “Some people have stopped taking their medication and have experienced health setbacks,” said Azar.

Psychiatrist Dr. Yara Chamoun said that many Lebanese who previously showed no signs of mental disorders have begun to suffer from them amid the economic crisis, especially young people.

“In addition to cases of depression and anxiety, we find cases of alcohol and drug abuse,” she said. “Patients say that they became addicted to them because they help them sleep or forget about the harsh reality.”

Psychiatrists find themselves at an impasse in efforts to treat patients when the required medication is not readily available, Chamoun said.

“Some alternative psychotropics might not work well enough on the patient, while others may be too expensive for them to afford,” she explained.

Amal Moukarzel, a Lebanese expatriate in France, founded Les Amis du Liban de Colombes (Friends of Lebanon in Colombes) with her husband and friends to collect donations of medicines and send them to Lebanon.

“We now send around 120kg of medicines from time to time, obtained from hospitals and sent in cooperation with Middle East Airlines to local associations in Lebanon to be distributed to needy patients,” she said.

Despite the logistical issues she faces, Moukarzel said she insists on sending “more of these much-needed medicines, most of which are for diabetes and blood pressure, as well as psychotropics.”


Houthi terror chief among 20 killed as coalition strikes back

Houthi terror chief among 20 killed as coalition strikes back
Updated 19 January 2022

Houthi terror chief among 20 killed as coalition strikes back

Houthi terror chief among 20 killed as coalition strikes back
  • Coalition air strikes hit militia targets in Yemen's capital following Houthi drone attack in Abu Dhabi
  • Abdullah Qassim Al-Junaid, the dead Houthi leader, was head of the Iran-backed militia’s aviation academy

JEDDAH: A Houthi terrorist chief was one of about 20 people killed on Tuesday when airstrikes by the Coalition to Restore Legitimacy in Yemen struck militia targets in Sanaa.

Abdullah Qassim Al-Junaid, the head of the Iran-backed militia’s aviation academy, had been sentenced to death in his absence by a court in Marib last year on charges of staging a military coup and committing war crimes.

Tuesday’s airstrikes targeting Houthi camps and strongholds in the Yemeni capital were the heaviest in nearly three years. They followed a Houthi drone attack on Monday on an oil storage depot on the outskirts of UAE capital Abu Dhabi, in which three people died, and the launch of eight armed drones from Yemen to Saudi Arabia, which the Kingdom’s air defenses intercepted and destroyed.

After Monday’s drone strike the UAE said it reserved the right to respond to “terrorist attacks and criminal escalation,” and Saudi Crown Prince Mohammed bin Salman and Abu Dhabi Crown Prince Sheikh Mohammed bin Zayed Al-Nahyan agreed in a phone call to “jointly stand up to these acts of aggression.”

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The US vowed to hold the Houthis accountable for the attack, which was also condemned by the UN, the EU, Britain andFrance, and throughout the Gulf and the wider Middle East, including Israel.
Israeli Prime Minister Naftali Bennett sent a letter of condolence to Abu Dhabi’s crown prince, offering “security and intelligence support in order to help you protect your citizens from similar attacks.”

Bennett said: “I have ordered the Israeli security establishment to provide their counterparts in the UAE with any assistance, should you be interested. Israel is committed to working closely with you in the ongoing battle against extremist forces in the region, and we will continue to partner with you to defeat our common enemies.” 

The attack on Abu Dhabi came as the Houthis suffered a series of military defeats in the Yemen war, including a lengthy battle in which they were driven out of Shabwa province by the UAE-trained Giants Brigades. That defeat dealt a blow to the Houthis’ campaign to capture the battleground province of Marib, the government’s last stronghold in the north.

“There is no end in sight for the Yemen war,” said Elisabeth Kendall, a researcher at the University of Oxford’s Pembroke College. “Rather, the conflict is escalating.”

However, she added: “The UAE will not rush to a knee-jerk reaction. It has invested heavily in Yemen, particularly in new political and military infrastructure in the south. It is unlikely to veer from its long-term strategy… on the basis of a provocation.”


Sudanese barricade streets, staging rallies in protest against coup

Sudanese barricade streets, staging rallies in protest against coup
Updated 19 January 2022

Sudanese barricade streets, staging rallies in protest against coup

Sudanese barricade streets, staging rallies in protest against coup
  • EU foreign affairs chief says repeated calls for authorities to refrain from violence against protesters ‘have fallen on deaf ears’

KHARTOUM: Sudanese shuttered shops and barricaded streets with burning tires and rocks on Tuesday, staging angry rallies to protest against one of the bloodiest days since a coup derailed the country’s democratic transition.

Security forces on Monday opened fire killing at least seven people as thousands marched against the army’s Oct. 25 takeover, taking the total number killed in a crackdown since the coup to 71, according to medics.

“No, no to military rule,” protesters chanted in southern Blue Nile state, where some carried banners daubed with the slogan “No to killing peaceful protesters,” said witness Omar Eissa.

The protests come as Washington ramps up pressure in a bid to broker an end to the months-long crisis in the northeast African nation, with top US diplomats expected to arrive in the capital Khartoum for talks.

Sudan’s main civilian bloc, the Forces for Freedom and Change, called for two days of civil disobedience to begin on Tuesday.

“Shop closed for mourning,” said a series of small signs posted on the closed outlets at the sprawling Sajane construction supplies market in Khartoum. One of the merchants, Othman El-Sherif, was among those shot dead on Monday.

Protesters — sometimes numbering in the tens of thousands — have regularly taken to the streets since the coup led by Gen. Abdel Fattah Al-Burhan nearly three months ago.

The military power grab derailed a fragile transition to civilian rule following the April 2019 ouster of autocrat Omar Bashir, with Prime Minister Abdalla Hamdok resigning earlier this month warning Sudan was at a “dangerous crossroads threatening its very survival.”

After Monday’s deaths, the UN special representative Volker Perthes condemned the use of live ammunition, while the US Embassy criticized “violent tactics of Sudanese security forces,” the latest such appeals by world powers, which have not curbed a rising death toll. On Tuesday, police fired tear gas at dozens of protesters setting up roadblocks in east Khartoum.

In several other parts of Khartoum, many pharmacies and other shops were shuttered.

Sudan’s University for Science and Technology suspended all activities as part of civil disobedience, according to an official statement.

Outside the capital, hundreds of protesters also staged demonstrations in other cities, witnesses said.

“We took to the streets to protest the massacre that the security forces committed in Khartoum yesterday,” said protester Hassan Idris, in the eastern state of Kassala.

Al-Burhan on Tuesday formed a fact-finding committee to probe Monday’s violence, with its findings to be submitted within 72 hours, Sudan’s ruling Sovereign Council said in a statement.

It comes as US Assistant Secretary of State Molly Phee and special envoy for the Horn of Africa, David Satterfield, were expected in Khartoum, where they would “reiterate our call for security forces to end violence and respect freedom of expression and peaceful assembly,” spokesman Ned Price said.

On Monday, Sudan’s police said they used “the least force” to counter the protests, in which about 50 police personnel were also wounded.

Sudan’s authorities have repeatedly denied using live ammunition against demonstrators, and insist scores of security personnel have been wounded during protests. A police general was stabbed to death last week.

On Tuesday the “Friends of Sudan” — a group of Western and Arab nations calling for the restoration of the country’s transitional government, and which includes the US, EU, Saudi Arabia, the UAE and the UN — held talks in Saudi Arabia.

“Deep concern about yesterday’s violence,” the UN envoy Perthes said on Twitter, after attending the meeting via video link.

“International support and leverage is needed. Support for political process needs to go along with active support to stop violence.”

The EU foreign policy chief said Sudan’s military rulers have shown an unwillingness to negotiate a peaceful settlement to the country’s ongoing crisis.

EU foreign affairs chief Josep Borrell said that repeated calls for Sudanese authorities to refrain from violence against protesters “have fallen on deaf ears.”

Borrell said the ongoing crackdown, including violence against civilians and the detention of activists and journalists, has put Sudan on “a dangerous path away from peace and stability.” He urged the military authorities to de-escalate tensions, saying: “avoiding further loss of life is of the essence.”

The crackdown, Borrell said, also risks derailing UN efforts to find a peaceful solution to the crisis.

The protest groups, which have continued to mobilize protesters against the coup, have rejected negotiations with the generals. They insist on handing over power to a fully civilian government to lead the transition.


As Shiite rivals jostle in Iraq, Sunni, Kurdish parties targeted

 As Shiite rivals jostle in Iraq, Sunni, Kurdish parties targeted
Updated 18 January 2022

As Shiite rivals jostle in Iraq, Sunni, Kurdish parties targeted

 As Shiite rivals jostle in Iraq, Sunni, Kurdish parties targeted
  • In recent days, unknown attackers have hurled grenades at Kurdish and Sunni targets including political party offices and a lawmaker’s home

BAGHDAD: As Iraq’s Shiite leaders jostle to secure a majority in the newly elected parliament, Sunni and Kurdish minorities have been caught up in a spate of warning grenade attacks, analysts say.

In recent days, unknown attackers have hurled grenades at Kurdish and Sunni targets including political party offices and a lawmaker’s home — groups that could help Shiite cleric Moqtada Sadr win the critical parliamentary majority needed to make his choice of prime minister.

“It is a way of punishing the forces that have allied with Moqtada Sadr to form a parliamentary majority,” said political scientist Ihsan Al-Shammari.

“Their message is political,” he added, calling the attacks “part of the mode of political pressure” adopted by some groups.

In multi-confessional and multi-ethnic Iraq, the formation of governments has involved complex negotiations since the 2003 US-led invasion toppled dictator Saddam Hussein.

No single party holds an outright majority, so the next leader will be voted in by whichever coalition can negotiate allies to become the biggest bloc — which then elects Iraq’s president, who then appoints a prime minister.

HIGHLIGHTS

•Grenades have been lobbed at the home of a Taqadum lawmaker, as well as at the party offices of Azm, Taqadum and the KDP in Baghdad.

•On Sunday, flashbang stun grenades were hurled into the branches of two Kurdish banks in Baghdad — wounding two people.

In previous parliaments, parties from Iraq’s Shiite majority have struck compromise deals to work together and form a government, with an unofficial system whereby the prime minister is Shiite, the president is a Kurd and the speaker of parliament is Sunni.

But Sadr, who once led an anti-US militia and who opposes all foreign interference, has repeatedly said the next prime minister will be chosen by his movement.

So rather than strike an alliance with the powerful Shiite Coordination Framework — which includes the pro-Iran Fatah alliance, the political arm of the former paramilitary Hashd Al-Shaabi — Sadr has forged a new coalition.

That includes two Sunni parties, Taqadum and Azm, as well as the Kurdistan Democratic Party.

It has infuriated the Coordination Framework — who insist their grouping is bigger.

In recent days, grenades have been lobbed at the home of a Taqadum lawmaker, as well as at the party offices of Azm, Taqadum and the KDP in Baghdad.

On Sunday, flashbang stun grenades were hurled into the branches of two Kurdish banks in the capital Baghdad — wounding two people.

The heads of both banks are said to be close to political leaders in Iraq’s autonomous northern Kurdistan region.

There has already been unrest following the election, with Prime Minister Mustafa Al-Kadhimi escaping unhurt when an explosive-packed drone hit his residence in November during what his office called an “assassination attempt.”

No group has claimed the attack.

While the culprits of the recent grenade blasts have also not been identified, a security source charged that the attacks “convey the messages of the parties that lost in the elections.”

The purpose, the security source claimed, is to “disrupt the formation of the government” — implicitly pointing to the Coordination Framework, and in particular the Fatah alliance.

Fatah lost much of its political capital in the Oct. 10 polls, having secured only 17 seats, compared to the 48 it had before.

It alleged the vote was rigged, but Iraq’s top court rejected a complaint of electoral irregularities filed by Hashd.

Hashd, which maintains an arsenal of weapons, fighters and supporters, has sought a variety of ways to make itself heard outside parliament, including demonstrations and sit-ins.

“Rather than accepting defeat at the polls, they threaten violence,” said Lahib Higel, of the International Crisis Group.

Sadr has considered striking deals with certain members of the Coordination Framework, such as Fatah chief Hadi Al-Ameri, at the expense of other figures in the bloc, such as former Prime Minister Nuri Al-Maliki, Higel said.

But such an arrangement “is not Iran’s preference” Higel argued, adding that Tehran “would rather see a consensus that includes all Shiite parties.”

However, she said Iran could settle for a deal where Shiite parties held sway. “It is possible that they (Iran) would accept a scenario where not everyone is represented in the next government, as long as there is a sufficient amount of Shiite parties, including some Hashd factions,” she said.


Giants Brigades discover cache of mines, explosive devices smuggled by Houthis under guise of UN aid

Giants Brigades discover cache of mines, explosive devices smuggled by Houthis under guise of UN aid
Updated 18 January 2022

Giants Brigades discover cache of mines, explosive devices smuggled by Houthis under guise of UN aid

Giants Brigades discover cache of mines, explosive devices smuggled by Houthis under guise of UN aid
  • The minister said the boxes had UN logos on them and called on the UN and relief organizations to investigate
  • He urged the international community to designate the militia as a terrorist organization

RIYADH: The Giant Brigades fighting the Houthis in Yemen have discovered a large quantity of mines and explosive devices hidden by the militia in aid boxes in Harib, Saudi Press Agency reported on Tuesday.

The Houthi militia left the boxes, used to smuggle weapons, behind after fleeing the district in Marib province, Yemen’s information minister Moammar Al-Eryani said.

The minister said the boxes had UN logos on them and condemned the Houthi actions as “a heinous crime that reveals the ugly face of the criminal militia.”

He said the crime reveals tricks used by the militia to transport weapons and ammunition and exploit humanitarian work as a cover to continue killing Yemenis and carry out criminal activities. 

It also shows how the militia employs airports and ports to smuggle ballistic missiles and Iranian-made drones, he said. 

“We call on the UN and international relief organizations to investigate the incident and denounce the crime of using their logos as cover to transport and store mines and explosive devices used by the Houthi militia in homes, schools, mosques, markets, roads, (targeting) innocent civilians, including women, children, and the elderly,” Al-Eryani said.

He also called on the international community, and UN and US envoys for Yemen to condemn these practices and put pressure on the Houthi militia to stop its crimes against civilians.

He urged the international community to designate it as a terrorist organization and prosecute its leaders in the International Criminal Court as “war criminals.”

The discovery comes a day after the Houthis carried out a drone and missile attack on the UAE that killed three people.

The attack was condemned by the UN and the international community.


UAE calls for UN Security Council session over Houthi attack on Abu Dhabi

Lana Nusseibeh, the UAE's ambassador to the UN, urged the Security Council to convene in response to the deadly terrorist attack on Abu Dhabi on Monday. (UN)
Lana Nusseibeh, the UAE's ambassador to the UN, urged the Security Council to convene in response to the deadly terrorist attack on Abu Dhabi on Monday. (UN)
Updated 18 January 2022

UAE calls for UN Security Council session over Houthi attack on Abu Dhabi

Lana Nusseibeh, the UAE's ambassador to the UN, urged the Security Council to convene in response to the deadly terrorist attack on Abu Dhabi on Monday. (UN)
  • Emirati envoy Lana Nusseibeh urged the council to speak with one voice and ‘unequivocally’ condemn the outrage
  • Three people were killed and six injured in drone strike on oil facility, and a fire was sparked at Abu Dhabi’s international airport

NEW YORK: The UAE mission at the UN in New York on Tuesday called on the Security Council to convene in response to the deadly terrorist attack on Abu Dhabi a day earlier.

In a letter addressed to the Norwegian delegation, which holds the presidency of the council this month, the UAE’s permanent representative to the UN denounced the Houthi militia in Yemen for targeting civilians “in flagrant violation of international law” and called on the council to “unequivocally” condemn the attacks “with one voice.”

“The UAE expresses its condolences to the families of the deceased and wishes those injured a speedy recovery,” Lana Nusseibeh said in the letter.

“This illegal and alarming escalation is a further step in the Houthis’ efforts to spread terrorism and chaos in our region.

“It is another attempt by the Houthis, using the capabilities they have unlawfully acquired in defiance of UN sanctions, to threaten peace and security.”

Three people were killed and six injured in a drone assault on a key oil facility in the Emirati capital, and a separate fire was sparked at Abu Dhabi’s international airport, police said. The Houthis claimed responsibility for the attack, which immediately drew condemnation worldwide.

On Friday the Security Council unanimously condemned another hostile Houthi act, the seizure on Jan. 3 of the UAE-flagged ship Rwabee in the Red Sea off the coast of Yemen and the detention of its crew.

In a statement drafted by the UK, council members demanded the immediate release of the vessel and those on board, and urged the Houthis to guarantee the safety and well-being of the crew.

They also called on all sides to resolve the issue quickly and highlighted the importance of preserving freedom of navigation in the Gulf of Aden and Red Sea, in accordance with international law.

The hijacking of the Rwabee marked the latest Houthi assault in the Red Sea, a crucial route for international trade and energy shipments.