No anesthesia, no oxygen: Lebanon hospitals flatline as cash crisis hits

Young women wearing protective masks walk outside Beirut’s Rafik Hariri University Hospital, where a woman is treated for coronavirus. (AFP file photo)

• Government has owed nearly $1.3 billion since 2011 to private hospitals

BEIRUT: A cash crisis has hit Lebanon’s hospitals amid the coronavirus pandemic and the country’s ongoing economic turmoil.
As of Monday, one of the two companies that provides oxygen gas to hospitals will only deliver them in return for cash payment in dollars, which are in scarce supply in the country. Another problem facing Lebanese hospitals is a shortage of nitrous oxide, which is used in the production of anesthetic gas.
Dr. Sleiman Haroun, president of the Syndicate of Hospitals in Lebanon, said it was impossible to do operations without this essential substance.
“There are 136 private hospitals in Lebanon and now they have stopped receiving new cases unless they are emergency cases subsidized by the Central Bank of Lebanon,” he told Arab News.
Importers of medical supplies face a problem as the Central Bank is delaying approvals of money transfers, hindering payments for the import of medical supplies.
“Government payments of dues to private hospitals are not done regularly, including dues in Lebanese pounds from the Ministry of Health, the National Social Security Fund and military health funds … Government payments are even less than what we must pay to importers of medical suppliers, and these payments are based on the official exchange rate of LBP1,507 for $1,” he said.
The government has owed nearly $1.3 billion since 2011 to private hospitals, while these facilities have owed medical supply providers $350 million over the past two years.
The inability to treat patients is incompatible with Lebanon’s commitments as a member country of the International Covenant on Economic, Social and Cultural Rights. 
According to Human Rights Watch this covenant says countries should guarantee the right of every individual to the best standards of physical and mental health. States should adopt measures necessary to the fulfillment of medical health, and prevent any “diminishing of the quality of health services” like people’s inability to obtain medicines which were previously available to them.
The Lebanese economy has always relied on a steady flow of dollars and the Central Bank has pegged the Lebanese pound to the US currency since 1997, according to a fixed exchange rate of LBP1,507.
However, in the past decade the amount of dollars in the Lebanese market has steadily declined due to a retreat in economic growth, a decrease in expatriates’ remittances, and the war in Syria.
In the second half of 2019, with a decline in confidence in the Lebanese economy, top depositors withdrew their money from banks, exacerbating the country’s financial crisis with a growing scarcity of dollars in the market.
The banking sector, in response to street protests last year, restricted money transfers abroad. It froze US deposits, heaping pressure on the Lebanese pound which sunk in valuation to LBP5,200 on the black market and to an official rate of LBP3,200 after the Central Bank started supplying the market with US dollars.
Lebanon imports all its medical supplies from abroad. Hospitals make their payments in Lebanese pounds, while importers pay in dollars according to the official fixed rate.
The Central Bank has decided to subsidize 85 percent of payments for medical equipment in dollars, while companies have to provide 15 percent from fresh dollars bought at the market exchange rate.
“The Central Bank decided to classify nitrous oxide as an industrial product not eligible for subsidy, whereas it is a medical product par excellence, and no surgery could be performed without this type of anaesthetic,” Haroun said. “Also, Lebanese factories that manufacture oxygen gas are also subsidized and need spare parts that should be imported from abroad via fresh money, which increases the pressure on hospitals. All hospitals took austerity measures by closing departments and dismissing employees and staff, and if the situation continues as we are, we are heading toward a medical disaster.”
He feared that there would be a medical brain drain from Lebanon if the hospital crisis continued.