Hospitals facing up to their worst fear

As war affects power supply, they might have to reject patients

BY MOHAMAD BAZZI | Newsday Middle East Correspondent

August 9, 2006

BEIRUT, Lebanon - A dozen infants lie in incubators, with humming machines and gentle violet lights overhead. In some rooms, a nurse sits next to each premature baby, meticulously recording vital signs.

The nurses at the American University of Beirut Medical Center have shut off the air conditioners, hoping to save electricity. They fear that, if they waste it, there won't be enough energy to run the incubators in a week. They haven't told the worried mothers why the air conditioning is off, but most of them know that Lebanon's fuel supply is running out.

"We put fans in the rooms and hallways, but I'm not sure if that will be enough," said Saadiah Aziz, a nursing supervisor, who looks exhausted from lack of sleep. "We can't open the windows because dust and flies will harm the babies. ... Every day, we pray that we can make it through this."

Dozens of hospitals throughout Lebanon have enough fuel to last only one or two more weeks, according to health officials. The hospitals are receiving electricity from government-owned power stations for 10 to 16 hours a day but must rely on their own generators for the rest of the time. Since war broke out July 12, Israel has imposed air, naval and land blockades on Lebanon. There have been no shipments of fuel into the country since the blockades began.

"The situation is dire and it could endanger the lives of thousands of patients," said Mohammad Khalifeh, Lebanon's health minister. "Many hospitals will be forced to close if we do not receive fuel soon."

Two ships filled with heavy fuel used by electrical power stations are docked off the Mediterranean island of Cyprus, 100 miles from Beirut. Khalifeh and other Lebanese officials say the ships are waiting for assurances from the Israeli military that they will not be attacked if they try to enter Lebanese waters.

"We have been trying to assure these ships safe passage through the humanitarian corridor set up by the United Nations," Khalifeh said.

If the country's power stations shut down, most hospitals will be forced to close. Health officials are developing a contingency plan to divert most available fuel to the five largest hospitals in Beirut, including the American University. But, even under that plan, the five remaining hospitals would have to discharge many patients and shut down large sections of their facilities.

The situation has been further complicated because Lebanon's energy minister, Mohammad Fneish, is a leader of Hezbollah, the militant Shia group fighting Israel. Fneish oversees the government's electricity and water agencies. In negotiations to allow the fuel ships through the blockade, Lebanese officials say Israel has argued that the fuel could fall into Hezbollah's hands. Lebanese officials have offered to allow United Nations or Red Cross observers to monitor the shipments.

"There is no way this shipment could get into the hands of Hezbollah fighters," said Nadim Cortas, dean of the American University of Beirut Medical Center. "This kind of fuel oil is only used in power stations and big generators. What are the fighters going to do with it?"

Lebanese officials say the electricity agency has enough fuel to last for a week to 10 days.

"As long as there is no fuel coming into the country, then the fuel is going to run out," Cortas said. "You're talking about a week plus or a week minus."

Without a constant supply of electricity, hospitals cannot treat the most dire cases: premature infants in incubators, patients living on respirators and those who need surgery. "How do you sterilize things? How do you run the operating rooms? Do you light a candle and operate?" Cortas asked. "You can eat raw food, but you can't operate with dirty equipment."

The five large hospitals are considering pooling their resources in a worst-case scenario. For example, Cortas said, all patients who require respirators would be moved to a wing of one hospital, while premature infants would be moved to another hospital.

Still, hospitals would have to discharge hundreds of patients. At the American University, 200 of the 325 available beds are occupied. Of those, about 50 are life-threatening cases. The rest would have to leave the hospital before their care is finished.

"At the end of the day, if everything stops, then you have to discharge your patients. It's one of the most sordid things that you can think of," Cortas said. "If they die out of sight, they are out of mind. ... If we're forced to do this, then it is premeditated murder."

The American University of Beirut Medical Center has been open for 100 years. It survived Lebanon's 1975-90 civil war, including the 1982 Israeli invasion. Even as Israeli troops besieged Beirut for 70 days, hospital officials were able to secure fuel to run their generators. They got help from Philip Habib, who was a special envoy for then-President Ronald Reagan. According to Cortas, Habib "ordered" the Israelis to allow fuel shipments in.

"I've been at this university for 42 years, through the entire civil war, and this is the worst situation we've had," said George Tomey, the acting university president. "The hospital never closed through all those difficult years. But I'm not sure if we can keep it open now."

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As war affects power supply, they might have to reject patients

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