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.”


Syrian fighters search for Daesh sleeper cells near prison

Syrian fighters search for Daesh sleeper cells near prison
Updated 58 min 12 sec ago

Syrian fighters search for Daesh sleeper cells near prison

Syrian fighters search for Daesh sleeper cells near prison
  • About a half-dozen Daesh fighters surrendered Friday morning, among scores of militants hiding in a basement in the northern section of the prison
  • Daesh group's Jan. 20 attack on the prison was the biggest military operation by the extremist group since the fall of their self-declared caliphate in 2019

BEIRUT: US-backed Kurdish-led fighters searched Friday near a Syrian prison for Daesh group militants as dozens of armed extremists holed up in a small part of the jail, a Kurdish official said.
About a half-dozen Daesh fighters surrendered Friday morning, among scores of militants hiding in a basement in the northern section of the prison, according to Siamand Ali, a spokesman for the US-backed Syrian Democratic Forces.
He would not confirm or deny a report by the Britain-based Syrian Observatory for Human Rights, an opposition war monitor, that SDF fighters discovered the bodies of 18 of their comrades inside Gweiran prison, also known as Al-Sinaa prison, in northeast Syria on Friday.
Daesh group’s Jan. 20 attack on the prison was the biggest military operation by the extremist group since the fall of their self-declared caliphate in 2019. It came as the militants staged deadly attacks in both Syria and Iraq that stoked fears that Daesh may be staging a comeback.
The weeklong assault on one of the largest detention facilities in Syria has turned the city of Hassakeh into a conflict zone. The Kurdish-led administration declared a curfew and sealed off the city, barring movement in and out.
Thousands of people in Hassakeh were displaced in recent days because of the fighting.
The SDF claimed Wednesday it had regained full control of the prison — a week after scores of militants overran the facility. The attackers allowed some to escape but also took hostages, including child detainees, and clashed with SDF fighters in violence that killed dozens.
The SDF had said that between 60 and 90 militants were hiding out in the northern section of the prison.
Ali said the militants are in the basement of a two-story building and that those who remain inside are refusing to surrender. “Our units are surrounding the building and are trying to convince them to surrender,” he said.
The Observatory said SDF fighters are betting that more time will force Daesh militants to surrender as their food dwindles.
The Hawar News Agency, ANHA, an online Kurdish news service, reported that several automatic rifles, a rocket-propelled grenade and hand grenades were confiscated from the Daesh gunmen who surrendered Friday. It added that SDF fighters are conducting search operations in the prison as well as several Hassakeh neighborhoods in search for Daesh sleeper cells.
The SDF said about 3,000 inmates have surrendered since its operation to retake the prison’s northern wing began three days ago.
At least 300 foreign child detainees are believed to be held in the Gweiran facility. Thousands more, mostly under the age of 12, are held with their mothers in locked camps in other parts of northeastern Syria on suspicion of being families of Daesh members. Most countries have refused to repatriate them, with only 25 out of 60 countries taking back their children, some without their mothers.
The Britain-based Observatory put the death toll from the struggle at over 260, including over 180 militants and more than 73 fighters from the Kurdish-led force. At least seven civilians were killed in the fighting, the Observatory said.
The SDF said preliminary information put the force’s death toll at 35.


HRW: New sentence for rights campaigner spotlights Tehran’s assault on civil society

HRW: New sentence for rights campaigner spotlights Tehran’s assault on civil society
Updated 28 January 2022

HRW: New sentence for rights campaigner spotlights Tehran’s assault on civil society

HRW: New sentence for rights campaigner spotlights Tehran’s assault on civil society
  • Narges Mohammadi was sentenced to 6 years behind bars and 74 lashes after a 5-minute court hearing
  • Rights organization says ‘unaccountable and deeply repressive state’ responsible for struggles of Iranian residents

LONDON: Human Rights Watch has slammed Tehran for leveling a new charge against a human rights defender just a year after she was released from jail, arguing that it “demonstrates Iranian authorities’ commitment to crush any grassroots human rights efforts.”

Narges Mohammadi, a rights defender, was sentenced to six years behind bars earlier this month for “assembly and collusion to act against national security,” and to two years in prison and 74 lashes for “acting against national security and disrupting public order,” her husband told HRW.

The trial, he said, was held behind closed doors — and lasted no more than five minutes.

Tara Sepehri Far, senior Iran researcher at Human Rights Watch, said: “Iranian authorities’ cruel detention and prosecution of Narges Mohammadi only one year after she was released from an earlier prison term and then piling on more unfair prison sentences are clearly intended to crush her into silence at all costs.”

She continued: “People like Narges Mohammadi are the ones who work to bring Iranian civil society together. Governments that are engaging diplomatically with Iran should make sure to press the government to stop its relentless crackdown against human rights defenders.”

Iran has long been criticized for its treatment of Iranians who are perceived to have voiced discontent with the regime or who advocate for any change, big or small.

In early January, Iranian poet and filmmaker Baktash Abdin died of coronavirus disease (COVID-19) while serving a six-year sentence in Iran’s notorious Evin prison.

At the time, Paris-based media rights group Reporters Without Borders placed the blame for his death squarely at the feet of the Iranian government.

He “had been unjustly sentenced to six years in prison and was in detention in hospital, ill with COVID-19 and deprived of the necessary care,” said the group, adding: “RSF blames the regime’s authorities for his death.” 

HRW said sentences for people like Mohammadi and the death of those like Abdin are part of a pattern of repression that penetrates to the core of the Iranian model of governance.

The group said: “At the center of Iranian residents’ struggles is an unaccountable and deeply repressive state. Iranian authorities ignore or punish peaceful dissent and have launched a sustained crackdown on civil society, from labor activists, lawyers and human rights defenders to journalists and even former senior political leaders.”


6 dead, 30 missing after migrant boat sinks off Tunisia

6 dead, 30 missing after migrant boat sinks off Tunisia
Updated 28 January 2022

6 dead, 30 missing after migrant boat sinks off Tunisia

6 dead, 30 missing after migrant boat sinks off Tunisia
TUNIS: At least six Africans trying to migrate to Europe died and an estimated 30 were missing in the Mediterranean Sea after their boat sank off the coast of Tunisia on Thursday, according to Tunisia’s Defense Ministry.
Tunisian naval and coast guard forces retrieved the bodies, rescued 34 survivors and are searching for the people listed as missing, the ministry said in a statement. The survivors told rescuers that the boat had 70 people on it and they were headed for Italy, the ministry said.
The boat had left from neighboring Libya and sank about 40 kilometers (24 miles) off the Tunisian town of Zarzis, near the Libyan border, it said.
The survivors included people from Egypt, Sudan and Ivory Coast, according to Mongi Slim, head of the Tunisian Red Crescent.
It’s the latest of several migrant boat sinkings in the region. The central Mediterranean route, which runs from North Africa to southern Italy, is the busiest and deadliest migration route to Europe. People travel from Libya and Tunisia in crowded boats and at the mercy of the smugglers they pay to get them across the sea.
About 60,000 people arrived in Italy by sea last year, and some 1,200 died or disappeared on the journey, according to the United Nations refugee agency.
The Tunisian Defense Ministry said authorities thwarted eight boat migration trips in the last 48 hours off the coast of the city of Sfax, and 130 people from Tunisia and sub-Saharan Africa were detained.

Rockets hit Baghdad airport compound

Rockets hit Baghdad airport compound
Updated 28 January 2022

Rockets hit Baghdad airport compound

Rockets hit Baghdad airport compound
  • US air base, known as Camp Victory, is located around the perimeter of Baghdad’s civilian airport

BAGHDAD: At least three rockets landed in the Baghdad International Airport compound and near an adjacent US air base, damaging one disused civilian aeroplane, Iraqi police sources said.
The police sources did not report any other damage or any injuries. The damaged aircraft was an out of use Iraqi Airways plane, they said.
The US air base, known as Camp Victory, is located around the perimeter of Baghdad’s civilian airport.
Rocket attacks which US and some Iraqi officials blame on Iran-aligned Shiite militia groups who oppose the US military presence in the region have regularly hit the complex in recent years.


Coalition says target in Saada airstrike was a Houthi special security camp

Coalition says target in Saada airstrike was a Houthi special security camp
Updated 28 January 2022

Coalition says target in Saada airstrike was a Houthi special security camp

Coalition says target in Saada airstrike was a Houthi special security camp
  • Coalition spokesman slams Houthis for peddling misleading information
  • Joint Forces Command ready to present facts to UN Humanitarian and Red Cross teams

RIYADH: The Coalition to Restore Legitimacy in Yemen on Friday denied targeting a prison in Saada and accused the Houthi militia of trying to mislead the public.

Houthi officials on Thursday claimed that coalition air strikes last week killed around 90 people and wounded more than 200 at Saada prison.

In a statement carried by the Saudi Press Agency, Coalition spokesman Brig. Gen. Turki Al-Malki said the targeted location was a Houthi special security camp, which is a "legitimate military target". 

Al-Maliki cited a report of the Joint Incidents Assessment Team (JIAT) dated January 27, 2022, after investigating the Houthis' claim.

The statement said there are four locations identified as prisons in the Joint Forces Command’s No Strike List (NSL) in Saada, all of which are being used by the "terrorist Houthi militia" in launching "cross-border attacks to target civilians and civilian objects."

The closest prison is located 1.8 kilometers away from the site targeted in a coalition air strike.

"What was announced and disseminated by the terrorist Houthi militia in its media outlets is a blatant attempt to mislead the public opinion regarding the true nature of the location in an attempt to garner sympathy from UN organizations and INGOs," Al-Maliki said in the statement.

He assured that the Joint Forces Command "applies the highest targeting standards."

The Coalition said it is prepared to shed light on the issue with representatives of the UN Office for the Coordination of Humanitarian Affairs (OCHA) and Red Cross.

"The terrorist Houthi militia bears the full responsibility in case it uses civilians as human shields in its military locations," Al-Maliki said.

Fighting has escalated in recent weeks, with more air strikes on what the coalition says are Houthi military targets.

The Iran-aligned Houthi movement has stepped up missile and drone attacks on the United Arab Emirates and cross-border launches on neighbouring Saudi Arabia.

The coalition had previously accused the Houthis of using civilian centers as a shield against legitimate strikes.