Lebanon: “Who could have imagined what the world had in store for us?”

Crossfire between Hezbollah and Israel first escalated on October 8, 2023, and Israeli airstrikes have intensified, spreading across Lebanon into densely populated areas. More than 3,500 people have been killed and 15,000 have been injured, mostly in recent weeks. 

The conflict has also displaced more than 896,000 people, mainly from southern Lebanon, southern Beirut, and Baalbek-Hermel governorate, according to the International Organization for Migration.  In response to the escalating crisis, 22 Doctors Without Borders/Médecins Sans Frontières (MSF) mobile medical teams are providing psychological first aid, general medical consultations, medication, and mental health support across the country.

MSF is also distributing essential items such as blankets, mattresses, and hygiene kits, and supplying water to schools and shelters where displaced people have gathered. Our teams offer hot meals and drinking water to hundreds of displaced families like Sekna’s, and we have donated fuel and trauma kits to several hospitals, pre-positioned more than two tons of medical supplies, and trained over 400 health care workers in trauma care and mass casualty management across the country. Beginning November 11, our medical teams are also providing direct hands-on support in the emergency room and an operating theater of Baabda hospital in Beirut governorate and in the operating theater, emergency room, and inpatient department of Turkish hospital in South governorate. 

Dire living conditions without water, heating, or sanitation

Most displaced people have moved to other governorates, with 66 percent seeking refuge in areas like Mount Lebanon, located in the central part of the country; Akkar in the north; and northern Beirut. 

Some people have been able to stay with friends or family, others have rented houses. But many are forced into overcrowded shelters that are already at capacity, and often lack basic services such as clean water, heating, and sanitation. 

“I am lucky to stay in a house, but many are in shelters, like my daughters and their families who are scattered across the country,” Sekna says. “It was only thanks to my brother-in-law’s son, who is helping us pay for this rented house, that we were able to find shelter.” She says he wanted to help his uncle knowing his medical condition would make it very difficult to stay in a shelter. 

Despite the roof over her head, Sekna struggles with the cold like so many others. “We can’t afford heating; we just pile on blankets.”

“Even if it was humble, with a few olive trees, it was my life and my memories,” Sekna says of the life she built with her husband, Abu Ali. “Oh, love of my life, who could have imagined what the world had in store for us?”

Overwhelming needs amid attacks on medical facilities

As winter approaches, people staying in overcrowded shelters are vulnerable to preventable diseases. The MSF medical mobile teams working across the country are already seeing cases of skin infections and respiratory illnesses, particularly among children and older adults.

“Without access to clean water, proper sanitation, and heating, people’s health is further threatened,” says Itta Helland-Hansen, MSF deputy emergency coordinator in Lebanon. “Lebanon’s health care system is already overstretched and this only adds pressure.”

Heavy Israeli airstrikes have also made it even harder for people to access medical care and impeded its delivery. Since mid-September 2024, the World Health Organization’s Surveillance System for Attacks on Health Care has documented 137 attacks on health care facilities, with 226 health workers killed and 199 injured while on duty since October 8, 2023.

Sekna is deeply worried about her son-in-law, who volunteers with the Lebanese Red Cross.

“May God protect him,” she says. “He refused to leave. He insisted on staying for his duty but I worry for him every day. Just a few weeks ago, a hospital near him in Tebnine, south of Lebanon, was hit. I can’t stop thinking about him.”

Due to the violence, road damage, and security risks, MSF is unable to reach people in some affected areas in Lebanon. MSF has been forced to close our clinic in the Burj el Barajneh Palestinian refugee camp in Beirut’s southern suburbs and temporary suspend activities in Baalbek-Hermel, relocating medical supplies from the northeast. Vulnerable people in these areas, particularly those who used to get treatment at our clinic, now find it more challenging to reach essential care.

Economic collapse, health care strain, and war

The toll of the ongoing conflict is compounded by years of hardship. Lebanon has endured one of the worst economic crises in the world that left more than 80 percent of people living in poverty. The country’s financial collapse has wiped out savings and caused widespread unemployment, and the cost of living has skyrocketed.

People in Lebanon have been pushed to their limits. For many people who receive some help from relatives or their community or can rely on their savings, this support is not sustainable and will eventually be depleted. Others, particularly Palestinian and Syrian refugees, migrant workers, and those displaced outside of the established shelters without basic services or support, are in even worse situations, as their already vulnerable conditions are exacerbated by constant fear for their lives.

“International actors need to step up their efforts to stop the violence and prevent further suffering and loss of life in the region,” says Itta. “The humanitarian situation in Lebanon is already dire and expected to be prolonged. It could worsen if urgent action is not taken. People who are holding on will reach their breaking point—things are not sustainable, and the humanitarian situation will get worse. For those who are already vulnerable, we will only see more threats to their health and more lives lost.”