Human dignity is the same for all human beings: when I trample on the dignity of another, I am trampling on my own. – Pope Francis.
The sun was hitting hard, typical of Lebanon’s beautiful summers. However, this summer was different, and the heat seemed to press not only on the skin but even more on the soul. I parked my car a little farther away, choosing to walk partly for my health, partly to let the rhythm of my steps calm the anxiety inside me. While walking, I was repeating the breathing box – one of my favorite relaxing technique – (inspiration – pause – expiration – pause) -, at the rhythm of my steps, four seconds at a time.
The economic collapse in 2019, the Beirut Blast on August 4, 2020, the health emergency COVID pandemic, all have arrived like waves breaking over each other, washing away certainties one by one. I am a physician, yes, but I am first a human being with a heart and multitude of emotions. I am also a Lebanese citizen carrying my own share of exhaustion and loss. Still, as I approached the dispensary where I had been volunteering since the beginning of the crisis, I straightened my shoulders, took a deep breath, and stepped inside with a big smile on my face. My patients did not need another bearer of despair. They needed a healthcare professional with a positive mindset, able to spread hope, and to deliver compassionate care.
“Attention, representation, and affiliation are necessary to care.” – Rita Charon.
The waiting room was filled with faces I could have easily met in another places and circumstances. A chilling sensation suddenly freezes me as my eyes met those of a woman of my age. I knew that face. I grew up in this neighborhood, we met at the bakery, at the church, we played together at the public garden. Her clothes were modest but carefully chosen; her posture upright as if holding on to the last visible thread of dignity. I greeted her with a warm smile, but she looked away quickly, her gaze heavy with shame and pain for being here, waiting for free care in a country that had once promised her stability.
“The worst illness is not cholera or typhus, but the loss of dignity.” – Albert Camus, The Plague (La Peste).
That morning, I felt this multiple times, familiar faces avoiding mine. These people were not poor, but like me was once a part of Lebanon’s middle class. They were the ones who used to donate to dispensaries not to take from them. They were independent, providing the essential and non-essential needs for their families, and they are today standing in line for free consultations, free medications, craving for anything free… a warm smile, a warm word… and I was not different. “Thank you for staying and not leaving the country,” a woman whispered to me once. These were the warm words which filled me with joy that day.
For months, I heard people repeating to me “Doctor, I never thought I’d end up here…begging for help.” I heard also patients telling the same story: “ma fi” (there is none) after going from one dispensary to another just to collect the medications they needed for the week. Many patients stopped taking their essential medications, blood pressure pills, diabetes meds, psychotropic medications…I can remember this young girl who was previously admitted two or three times to the psychiatric ward because of non-adherence to her oral treatment, but who finally was stabilized after receiving the new expensive anti-psychotic injections. She looked at me crying, she had to stop them and was afraid, frightened by the idea of a relapse. “I don’t want to meet the devil again,” she shouted.
Since 2019, Lebanon’s economic collapse has devastated the healthcare system. The Lebanese pound lost over 90% of its value. Hospitals operated on electric generated and were also struggling to pay staff; many doctors and nurses emigrated, more than 40% of physicians and 30% of nurses left between 2019 and 2022, pharmacies closed or ran out of stock; over half of households could not access essential medications by 2021. Cancer treatments were interrupted, surgeries postponed. During this period, dispensaries themselves were a micro image of Lebanon’s healthcare collapse. They were operating under multiple constraints, with a shortage in Physicians and nurses and medicine arriving sporadically.
The shift was not merely economic; it was moral and existential. Under these circumstances, dignity became a daily challenge, with people navigating vulnerability and uncertainty, The healthcare staff had the moral responsibility not only to heal, but to affirm humanity.
“The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.” – Martin Luther King, Jr.
For months, I carried the weight of stories to which I could deeply relate. I felt every patient’s pain, every struggle as if they were my own. I, too, went from one pharmacy to another, unable to find essential medications for a loved one living with a chronic illness.
At the end of each day of this difficult period, before going to bed, I opened my notebook and started to write the invisible wounds of humiliation and loss of dignity. In those moments, I realized how deeply our healthcare crisis touches every one of us, no matter which side we were sitting.
But what could resilience look like now? Is it in seeing and recognizing each other through hope? “Resilience is forged through the fires of compassion.,” I read once. But when the entire system is broken, can compassion alone keep us standing strong, or will it consume what is left of us?
References:
- The fragile healthcare system in Lebanon: sounding the alarm about its possible collapse | Health Economics Review | Full Text
- WHO EMRO – Joint statement by Dr Tedros Adhanom Ghebreyesus, WHO Director General, and Dr Ahmed Al Mandhari, Regional Director for the Eastern Mediterranean, on Lebanon
- Lebanon: Almost three-quarters of the population living in poverty | UN News