Lebanon

Lebanon: Authorities violating right to health and endangering lives by failing to provide fuel to hospitals [EN/AR]

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The Lebanese authorities’ failure to resolve a catastrophic fuel crisis has crippled people’s daily lives and left hospitals hanging by a thread, said Amnesty International today. The organization is calling on the authorities to uphold economic and social rights in their response and prioritize the redistribution of fuel to hospitals and other healthcare facilities, which have been on the brink of collapse.

Hundreds of patients, including new-born babies on ventilators and other lifesaving medical devices risk dying if hospitals run out of fuel. With a thriving black market, smuggling and fuel-hoarding diverting supplies away from life-critical services, it is equally imperative for the authorities to take immediate steps to hold perpetrators to account.

“The Lebanese authorities cannot continue to stand by and watch people’s lives being devastated by the fuel crisis leaving it to private initiatives or NGOs to address crucial humanitarian needs. People’s health and lives have been put on the line as hospitals have drastically cut back operations,” said Heba Morayef, Regional Director for the Middle East and North Africa at Amnesty International.

“The authorities must urgently prioritize health facilities and other life-critical services by redistributing seized fuel stocks to them and implementing court orders ordering them to do so. They must also tackle the thriving black market by blocking smuggling channels, seizing illegal hoarded fuel and holding perpetrators to account.”

On 11 August, Lebanon’s Central Bank (BDL) announced it could not continue to subsidize fuel imports, causing gasoline and diesel prices to skyrocket and prompting immediate critical shortages of both on the market. On 22 August, the government announced a 66% increase in gasoline prices – a partial reduction of fuel subsidies – in an attempt to ease the crippling shortages that have brought the country to a standstill.

The shortage of fuel availability on the market has been exacerbated by smuggling of fuel across the border to Syria and hoarding to sell at black market rates. This was confirmed by a BDL communique on 14 August, which stated that BDL had spent more than $828 million on fuel imports in July- enough to cover Lebanon’s power supply for three months. $708 million was allocated for the import of gasoline and diesel and $120 million for the fuel consumption of the state-owned Electricité Du Liban (EDL). In the same statement, the bank acknowledged fuel had been hoarded and smuggled and was not reaching “households, hospitals and food industries”.

Hospitals grapple with fuel shortage

Throughout August, military and security forces announced they had confiscated millions of litres of gasoline and diesel that had been hoarded or stored in preparation for smuggling. Yet hospital directors at three of Lebanon’s largest hospitals confirmed to Amnesty International the health sector was surviving day to day – unable to secure enough fuel to sustain operations for even for one month.

In August, the American University of Beirut Medical Center (AUBMC), Rafic Hariri University Hospital (RHUH), and Al Makassed Hospital, issued public distress calls appealing to the government and international agencies for fuel. They said that the fuel crisis had severely damaged their operations and placed their patients’ lives at risk. Despite this, the authorities have failed to ensure they have access to sufficient supplies.

Dr Firas Abiad, the Director-General of RHUH, Lebanon’s largest public hospital, explained to Amnesty International that, the hospital used to receive 20 hours of power from the state per day and relied on seven generators during the remaining four hours. Over the past month this has dropped as low as just four hours per day – and at one stage stopped completely leaving the hospital continuously reliant on generators that are not designed to run non-stop. Although they have received some sporadic deliveries of fuel from the army it is not enough to sustain their operations leaving them reliant on donations from UN organizations.

Dr Joseph Otayek, the Director of AUBMC, told Amnesty International that although a judge had ordered 5,000 liters of confiscated fuel to be delivered to the hospital, they have not received any fuel supply from the army or Internal Security. He said the hospital requires 50,000 litres for its daily operations.

On 17 August, Judge Abir Safa had ordered Al Nahr Police Station to deliver 10 thousand liters of fuel confiscated by the authorities to RHUH and AUBMC, 5,000 liters each, at the subsidized price.

“The Lebanese authorities’ failure to comply with a court ruling ordering confiscated fuel to be delivered to all hospitals is shocking. The authorities must do everything within their power to ensure that supplies of fuel seized by security forces are distributed to ahospitals and other critical services to allow them to operate in a sustainable manner,” said Heba Morayef.

Two senior doctors at RHUH told Amnesty International on 23 August that 10 patients in the intensive care unit and at least 21 newborns living on ventilators and incubators were at risk of dying if hospital operations are interrupted due to fuel shortages.

Dr Firas Abiad said staff were “working in almost war conditions” and many were unable to make it to work due to the gas shortage. “Soon I’ll find myself facing a tough decision: should I close our emergency rooms?” he said.

AUBMC warned in statement on 14 August that in case of a forced shutdown caused by the fuel shortage 40 adult patients and 15 children living on respirators would die immediately, 180 requiring dialysis would die after a few days and hundreds of others in subsequent weeks. The hospital’s director said they “survive on the hope of receiving day-by-day supplies from private donors and companies”.

Dr Mohammed Badr, Director of al-Makassed Hospital in Beirut, told Amnesty International that the hospital had stopped elective surgery three months ago and has been forced to shut two out of three floors, including COVID-19 and paediatric care units and to end free treatment for poorer patients. He said a quarter of hospital staff have been unable to reach the hospital due to the petrol shortage. “We are hitting rock bottom and have been left alone to face this inhumane condition,” he said.

Tackling fuel smuggling and hoarding

The Lebanese authorities’ failure to hold anyone account for the smuggling and flourishing black-market trade which involves hoarding of large quantities of fuel in unsafe conditions has had tragic consequences.

To date, dozens people have been killed or injured due to explosions from dangerously stockpiled fuel in residential areas

On 15 August, a fuel tank explosion in Tleil village, in the northern district of Akkar, killed at least 31 people and injured dozens with the unofficial death toll still rising.

The explosion occurred after the Lebanese army had begun to distribute fuel they had seized to local residents. The army arrested the owners of the tank and the land and announced a military investigation. On 26 August, the military prosecutor charged three people for hoarding dangerous material and endangering lives.

Amnesty International is calling on the Lebanese authorities to refer the investigation to the civil judicial system to ensure an independent and impartial investigation into the incident. “It should not take a deadly tragedy like the Akkar explosion for the Lebanese authorities to take action on fuel hoarding. The authorities must investigate the full market chain and hold accountable all those involved in smuggling or hoarding, regardless of rank or status to send a clear message that fuel hoarding will not be tolerated,” said Heba Morayef.