A ticking clock, screeching car tyre, ambulance siren: for people impacted by the Beirut blast one year ago, such noises still trigger panic and anxiety.
“I jump when the door slams,” says Hiba Dandachli, communications director for Lifeline, the Lebanese suicide prevention helpline. “I didn’t used to do that.”
On August 4 2020, an explosion ripped through the city so powerful that it registered as a 3.5 magnitude earthquake. It was one of the largest non-nuclear explosions ever recorded, leaving more than 220 dead, 6,500 injured, and 300,000 displaced. It damaged buildings up to 20km away and 36 per cent of health facilities in the city.
“The first feeling was confusion. Nobody knew what had happened. Some people thought it was an assassination. I saw the smoke. Then came panic – people started realising how vast the explosion was, understanding that whole neighbourhoods were wiped out,” says Fadi Daccache, deputy mental health coordinator at the International Medical Corps (IMC).
Twelve months on and the emergency situation – compounded with the country’s crippling socio-economic crisis and Covid – is digging its claws deeper into the Lebanese capital.
Since autumn 2019, the Lebanese currency has lost more than 90 per cent of its value. Now, 55 per cent of people live below the poverty line, fuel and staple foods are in short supply, hospital shelves lay bare of medications, and doctors are fleeing for a better life.
This week came reports that women can no longer afford sanitary towels, which have been priced up to the equivalent of £17. The Guardian reported that a four-year-old girl died last Friday from a scorpion sting because anti-venom was out of stock.
In the wake of the blast, the number of people seeking mental health support surged. But, restricted government funding, coupled with an already low general health budget, means victims struggle to access it. The average private therapy session now costs 600,000 Lebanese pounds (£285).
NGOs and international aid have been forced to pick up the baton. “Most people who used private clinics before can no longer afford it. Some people are not able to even cover their transportation fees to get to our [free] therapy or get medication,” Mr Daccache says.
The IMC sent psychological first aiders alongside mobile medical units in the months after the blast – bi-weekly sessions soon doubled, he adds.
The mental health need is becoming more desperate, Mr Daccache explains: “Symptoms only started to show three to six months after the blast: [there’s] an increase in people with depression, PTSD and anxiety.
“People refusing to go into their houses; many people experiencing somatic symptoms – stomach aches; people not able to sleep; people really alert and jumpy; children aged six, seven or older bed wetting.”
Ms Dandachli, of Lifeline, speaks of similar cases: “Many children are still suffering from fear and PTSD. Many are afraid of getting close to windows, they fear loud sounds. It’s harder to deal with – they don’t realise or understand.”
The helpline, Lifeline, has received more than 9,500 calls in 12 months – in the three years prior to the blast it answered 5,500. “Many [callers] were at imminent risk of losing their lives to suicide,” Ms Dandachli says. With growing demand, it now takes six weeks to receive a therapy appointment through the free service.
With city-wide power cuts the norm, the helpline itself struggles. “Instead of [running] 24 hours a day, we are down to half the number of hours,” Ms Dandachli says.
Funds, too, are drying up. Ms Dandachli says: “There was a surge in funds and donations post-blast, but, a year on – and with a completely deteriorated system – funds are diminishing. [Donors] focus on what they see in front of them.”
“NGOs have taken on the role of government. But we are not a replacement for the government, we are a support system. And we need [financial] support ourselves [to continue]. Our need is immense and increasing by the day,” she adds.
Mr Daccache wishes that people who have lost family or friends manage to find closure for their mental health.
But Beirut remains paralysed, the investigation into the blast wracking up dust. On Monday, Amnesty International issued a statement reading: “Lebanese authorities promised a swift investigation, instead they have brazenly blocked and stalled justice at every turn.”
Speaking of the crisis, Ms Dandachli adds: “It’s the hidden, unhealed wounds that remain inside of us... a few of us have addressed it; many haven’t. There has been no justice for the victims and the Lebanese.”
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