A Fragile Ceasefire: Lebanon’s Health System Struggles Amid Crisis and Recovery

“An already decimated health system remarkably withstood this latest storm, but it has been further weakened,” said WHO Representative to Lebanon Dr. Abdinasir Abubakar.

The ceasefire and cessation of hostilities that took effect on 27 November brought temporary relief for millions caught in Lebanon’s devastating conflict. However, the nation’s suffering persists, with an already fragile health system grappling with profound unmet needs. Bordering Syria and Israel, Lebanon faces the compounded challenges of an economic meltdown, political deadlock, a protracted refugee crisis, and now, the toll of war.

Lebanon hosts 1.5 million Syrian refugees, making it acutely vulnerable to regional crises. The cross-border dynamics with Syria further exacerbate the situation as Syrian nationals enter Lebanon while some refugees return to Syria. This constant flux strains Lebanon’s overburdened infrastructure and health services.

“An already decimated health system remarkably withstood this latest storm, but it has been further weakened,” said WHO Representative to Lebanon Dr. Abdinasir Abubakar. “The challenges are complex and call for specialized, sustained support.”

A Wounded Economy and Health System

Lebanon’s economy has been shrinking since 2019, with cumulative real GDP contracting by 38%, according to the World Bank. The war has dealt another devastating blow, pushing the limits of a health system already teetering on collapse.

More than 1 million displaced individuals have returned to southern Lebanon, where health facilities are overwhelmed, infrastructure is in ruins, and staff shortages persist. Many hospitals are operating below capacity due to financial restraints and an exodus of health workers. Over 530 health workers and patients have been killed or injured in attacks on health facilities, while thousands more have emigrated, leaving critical gaps in health care delivery.

The Growing Risk of Disease

The conflict has decimated water and sanitation systems, increasing the risk of disease outbreaks. Nearly 7% of buildings in southern Lebanon are in ruins, leaving thousands displaced and facing precarious living conditions. Those who have returned home must contend with explosive remnants of war and significant health risks.

Trauma Care: An Urgent Need

Since October 2023, over 4,000 people have died, and 17,000 have been injured in Lebanon. The physical destruction resembles that of a natural disaster, with thousands of buildings destroyed and an estimated 8 million tonnes of debris. Complex injuries, open wounds, and fractures are widespread.

“One in four people with life-changing injuries will need long-term rehabilitation,” said Dr. Ahmad Alchaikh Hassan, WHO Trauma Technical Officer. “Many require assistive technologies and prosthetics, which Lebanon’s health system cannot currently provide at scale.”

Specialized care, including reconstructive surgery, physiotherapy, and prosthetics, is critical. The need for ophthalmologists to address eye injuries and mental health services to support trauma survivors is equally urgent.

WHO’s Comprehensive Response

The World Health Organization (WHO) and Lebanon’s Ministry of Public Health are working tirelessly to address these challenges. Key efforts include:

• Scaling Up Trauma Care: Providing specialized training for surgeons and trauma care teams.
• Rehabilitation Support: Building capacity for post-conflict rehabilitation and equipping facilities with prosthetics and assistive devices.
• Mental Health Interventions: Offering training for health workers to address psychological trauma.
• Surveillance and Preparedness: Enhancing disease outbreak surveillance and preparing for potential future crises.
• Replenishing Supplies: Delivering medical supplies, blood bags, and reagents to ensure continuity of care.

"WHO and national health authorities have carried out mass casualty management trainings across Lebanon, strengthening responses and saving countless lives,” said Dr. Hassan.

WHO has also developed awareness materials on unexploded ordinances and health risks, aiding first responders and civilians in navigating post-conflict dangers.

The Road Ahead

The journey to recovery will be long and challenging. As Lebanon rebuilds, the health system requires sustained technical and financial support to achieve resilience.

“Our aim is to assist the health system to bounce back and be prepared for future challenges,” said Dr. Abubakar. “This is just the beginning, and the need for support has never been greater.”

The resilience of Lebanon’s people and health workers continues to inspire hope amid hardship. With coordinated efforts and international assistance, the nation can rebuild its health system and provide the care its citizens so desperately need.