Beirut (AP)-She is a nurse in Beirut Hospital, but Rita Harb still cannot find her grandfather’s heart medicine.
She had searched pharmacies up and down in Lebanon and was called a friend abroad. Even her relationship with the doctor cannot ensure the safety of the drug. Unlike many people during the Lebanese financial crisis, she can afford it-they just aren’t there.
In order to achieve this goal, her 85-year-old grandfather is replacing his medicine with more small doses to reach his dose. That might run out soon.
“But if he dies, he is dead.”
On the shelves around Lebanon, all medicines for diabetes, blood pressure, antidepressants and fever medicine for COVID-19 treatment have disappeared.
Officials and pharmacists said that this panic has exacerbated the shortage because the governor of the central bank stated that the government will not be able to maintain subsidies, including subsidies for medicines, due to weak foreign exchange reserves.
The announcement “caused a snowstorm and an earthquake,” said Ghassan al-Amin, the head of the pharmaceutical group.
Lebanese are now searching for important drugs across the country. The elderly asked about religious charities and aid groups. Family members begged on social media or traveled to neighboring Syria. Foreigners are donating money.
This is the latest stage in the economic collapse of this country with a population of 5 million, which was once a regional hub for banking, real estate and medical services.
More than half of the population fell into poverty, and people’s savings lost value. Public debt deteriorated severely, the local currency plummeted, and nearly 80% of its value was lost. Under the influence of economic pressure and the coronavirus pandemic, the health sector is succumbing.
The Lebanese have returned to the state of storing basic knowledge such as water and fuel, as they did during the 15-year civil war in the country. Trust in the country’s ruling class-which has been in power since the end of the war in 1990-is fading away as the country is struggling to deal with the financial collapse, the pandemic, and the aftermath of the fatal bombing of Beirut port on August 4, destroying facilities and cities.
Lebanon imports almost everything, including 85% of medicines.
For a debt-laden government, eliminating subsidies is an inevitable step. This is expected to cause prices and inflation to soar, and the Lebanese pound will fall further. It was fixed at US$1,500 to US$1 for decades, and is now hovering around US$7,000 to US$1 on the black market.
People are hoarding drugs, worrying that they will not be able to afford them. Suppliers are shelving medicines, worrying that they will not have enough money to buy more medicines, or hope to sell them at higher prices after subsidies are removed. The troubled pharmacy cannot be listed because the supplier now requires cash payment.
At the same time, the difference between the official and black-market dollar exchange rates has intensified smuggling, which now drives subsidized Lebanese drugs to neighboring countries.
Malak Khiami, a pharmacist at the Amel Association, a humanitarian organization that provides basic healthcare, said that in the chaos, 6 out of 10 brand-name drugs are unavailable.
Amin said that of the 3,400 union-organized pharmacies, nearly 300 have closed.
The problem became so serious that an angry buyer, an off-duty soldier, pulled out a gun and threatened to tell him that he did not have the basic painkiller Panadol pharmacist.
Ziad Jomaa said in a pharmacy in Bchamoune outside Beirut that he and the gun buyer were victims of a corrupt and failed political class.
The incident was captured by closed-circuit television footage, which aroused Qiao Ma’s sympathy, including the sympathy of the analgesic supplier, who immediately gave him 50 boxes.
But he had to adopt new security measures. He closed the door of the pharmacy at night, took orders through only one window, and hired a guard.
Qiao Ma said: “They made me confront the public.”
Civil society intervenes to fill the gap.
In one of the Amel centers in the Baajour district of Beirut, 800 people sought medicine or health services at a nominal cost in October, nearly twice the number in August. Since the war with Israel in 2006 destroyed most of Beirut and killed more than 1,000 people, Amer has maintained the longest emergency relief plan.
Board member Zeina Mohanna said: “People are going through a huge and difficult time.” They are “worried about survival.”
63-year-old Intissar Hatoum lined up in the pharmacy in the center. She grabbed a plastic bag with an empty pill box and tried her best: inhaler, high blood pressure and heart medicine, anticoagulant. Her unemployed husband suffers from kidney disease. Less urgent is her cholesterol medicine.
A housewife, Hatoum relies on her son, a taxi driver, to pay for medical expenses, often skipping hot meals to pay. He has asked southern Lebanon and all parts of Syria for their prescriptions.
She said: “He didn’t leave the place he hadn’t seen.”
Lebanese rely heavily on medicines. According to a study by BlomInvest Bank, nearly 44% of all health care expenditures are spent on drugs, while in Western countries, this proportion is about 17%.
For decades, the market has been controlled by about twenty importers. The law grants select importers exclusive rights in each sector, keeps competitors out, and gives them great power to resist reform.
Exclusive import rights are an important feature of Lebanon’s economic order. After the civil war, Lebanon’s economic order was controlled by militia leaders, wealthy businessmen and real estate owners. Focusing on services, it relies on imports and foreign labor.
Economic reporter Viviane Akiki said that with the collapse of this model, the market for foreign medicines will inevitably shrink. “The shortage of dollars will bring new solutions.”
But it is not clear whether Lebanon’s small-scale domestic drug production can make up for this shortfall.
Near Zoukaq al-Blat in Beirut, Mahmoud Mahmoud’s pharmacy is quiet. Some painkillers, supplements and shampoo bottles were scattered on the empty shelves.
Mahmoud believes that suppliers are curbing drugs waiting for price increases or smuggling. He said that a gout medicine was found in Iraq and sold for $7, which is more than five times the price in Lebanon.
“They are destroying this industry,” Mahmoud said. “As the country develops, this industry is collapsing.”