“Nothing but a jar of mlukhiye”: Trauma, mental health in Lebanon | Beirut explosion

Beirut, Lebanon – It was a hot day in September when Jinane started looking for an international money transfer office near her home in the district of Ain el Remmaneh in the east of Beirut.

Jinane, 32, had previously visited at least four offices, but none were on duty due to chronic power outages that have plagued Lebanon for months.

The weekend was approaching and the young translator was strapped for money. With only a few lire in her purse, she was getting restless at not being able to receive a transfer for an editing job she had just completed.

Since the collapse of the Lebanese banking sector in 2019, many people have relied on international currency transfer offices, such as Western Union, to receive money from abroad.

In doing so, they avoid exorbitant bank transfer fees and bypass a confusing maze of exchange rates for the local currency as the spread between official and black market rates against the dollar continues to fluctuate.

The Lebanese pound has lost more than 90 percent of its value against the US dollar on the black market in two years, hitting more than 20,000 Lebanese pounds to the dollar over the summer. However, the central bank, the Banque du Liban, maintains a rate introduced in 1997, which fixes the pound to the dollar at 1,500.

As Jinane directed his taxi driver to an office near Jnah, in south Beirut, a dark-haired man sitting behind the wheel of a nearby car honked incessantly.

All roads were blocked as cars lined up for half a kilometer (0.3 mile) outside a gas station. Due to severe fuel shortages in Lebanon, people have been forced to wait hours at gas stations to refuel.

As the driver honked, Jinane was visibly distressed by the noise. She turned in her seat to wave through the cab window. “Why are you beeping? You don’t see the roads are blocked, ”she shouted.

But the dark haired man kept screaming, then he started to get aggressive, spitting curses at Jinane.

Within moments, she had gotten out of the cab and was standing in the middle of the road screaming back.

What started as a feud quickly escalated into a serious confrontation.

When the man finally accelerated in his expensive car, Jinane remained furious as she approached a panic attack.

Vehicles in the right lane adjacent to the gas station line up for fuel during severe fuel shortages [File: Joseph Eid/AFP]

Loud noises

A few hours later, Jinane calmed down. She sat down to recount the incident.

“Since the explosion, I can’t stand hearing loud noises,” she said, referring to the devastating events of August 4, 2020 – the day one of the largest non-nuclear explosions in history hit the city.

The detonation of nearly 3,000 tons of ammonium nitrate in the port of Beirut killed more than 200 people, injured 6,000 others and devastated entire neighborhoods.

When the explosion struck at 18:08 (03:08 GMT) local time, Jinane was in his kitchen preparing “mlukhiye” – a Middle Eastern garlic dish made from jute leaves and chicken – for the meal. having dinner.

“Before I knew it, I was on the ground, my windows and doors smashed,” Jinane said. “Then everyone ran into the streets. People were bleeding, screaming and hysterical.

“But most of all, I remember the sound of the sirens of the car alarms and the beeps,” she said slowly, as she raised her hands to her ears and let her head drop between them.

“So many beeps,” she repeated slowly. She closed her eyes as if it was in pain.

Then, as if a light bulb had lit in her head, she realized why she had reacted so strongly earlier in the day. The beep was a trigger, bringing her back to the traumatic experience of the explosion.

On this disturbing day, Jinane found transportation to the northern city of Tripoli, where his family resides. Before getting in the car, she walked back to her apartment, giving him one last look.

“Have we made war on Israel? Has the world ended? she asked. “I had no idea what was going on or if I would ever come back.”

But she took nothing. “No family photos, no money,” Jinane said. “Nothing.”

“Just that jar of mlukhiye,” she said, remembering how she had carried it on her lap as the car drove 80 km (35 miles) north of the capital.

A local investigation into the blast has so far failed to identify those responsible for the devastating blast or to result in any significant arrests. Survivors and relatives of the victims have repeatedly called for an independent investigation to hold those responsible.

A family member of a victim of the Beirut port explosion last year carries a photo during a demonstration demanding justice, near the Beirut courthouse [File: Mohamed Azakir/Reuters]

Trauma on trauma

Like many Lebanese citizens who suffered the blast, Jinane complains of anxiety, insomnia, nightmares and a constant fear of death – typical symptoms of untreated trauma, according to the Beirut psychiatrist. Yara Chamoun.

Jinane appeared to have been in a “state of shock” when she took the dish, Chamoun said, without making a diagnosis. “When someone experiences trauma, their first reaction is numbness. She was not aware of what she was doing.

“With post-traumatic stress disorder (PTSD), some things can be triggers or reminders of the trauma,” she explained, referring to Jinane’s reaction to the beep, adding that people with PTSD tend to avoid such signals.

Two days earlier, another event had triggered the already nervous nerves of the young woman.

Israeli warplanes attacking positions in Syria used Lebanese airspace for the second time in less than two weeks. Lebanese citizens heard the roar of low-flying Israeli planes at dawn on September 3.

The whole of Lebanon is constantly going through trauma and stress. Are we supposed to treat the whole population? [Yara Chamoun, Beirut-based psychiatrist]

Although this happens regularly in the small Mediterranean country, the last time Jinane was not in Beirut, where the sound is sometimes cut off.

Instead, she spent the night on top of a mountain where “the planes were right above us,” she said. “I ran around crying hysterically. I collapsed thinking I was dying.

Over the past 40 years, a 15-year civil war, an Israeli occupation in the south, the July 2006 war with Israel and a series of bombings and assassinations – as well as the more recent explosion of Beirut and a spiraling economic crisis – have put millions of Lebanese at high risk for PTSD, recent study finds.

At least 200 people killed and more than 6,000 injured in the Beirut explosion [Wael El Hamzeh/EPA]

Exacerbated conditions

Over the past year, about 74 percent of the population has fallen below the poverty line, according to the United Nations Economic and Social Commission for Western Asia (ESCWA). Basic food, electricity, fuel and medicine have been unavailable or unavailable for months.

According to ESCWA, about 82 percent of the population today suffers from poverty on several fronts. This means that they cannot afford at least a basic service like electricity or health care. This figure was 42% in 2019.

Although there are no official figures to reflect the effect of an unprecedented socio-economic crisis on mental health in Lebanon, Chamoun said it was “like swimming against the tide”.

“People were already suffering from the financial collapse, the pandemic and the explosion, but now there is the social and economic crisis which worsens mental health every day,” she told Al Jazeera.

Like many Lebanese citizens, Jinane struggled to cope.

Every day, she receives heartbreaking calls from family and friends who need help: a mother who cannot afford cancer treatment for her son, an elderly woman who cannot afford cancer treatment for her son. hasn’t had electricity at home for days; or a disabled man who cannot access any assistance.

“Every phone call is a trigger,” said Jinane, who also lost her mother to cancer last year. “But I can’t but don’t try to help.”

Children rummage through garbage cans in Beirut as power shortages and economic downturn plague the country [File: Francesca Volpi/Bloomberg]

Sharp increase in cases

Crises at multiple levels across the country have resulted in a “sharp rise” in the number of people suffering from serious mental health problems, said Hiba Dandachli, communications director at Embrace, an organization that runs the National Lifeline, a support service. emotional and suicide prevention. hotline.

“It’s a catastrophically deteriorating situation,” said Dandachli, explaining that their helpline, 1564, has witnessed a threefold increase in calls over the past two years.

“We have received over 6,000 calls so far this year. Over the whole of 2019, we received 2,000, ”she said.

The most serious increase is in the number of cases involving PTSD, anxiety, depression, suicidal thoughts, insomnia and substance abuse, said Chamoun, who also supports a mental health facility set up by Embrace. .

The abuse of cannabis and alcohol as “coping mechanisms” has skyrocketed as people attempt to escape their difficult realities, Chamoun told Al Jazeera.

A recent study by the Institute for Development, Research, Advocacy and Applied Care (Idraac), an organization focused on mental health in Lebanon and the Arab world, reported that one in 20 people in Lebanon has seriously considered suicide. One in 50 has tried it.

“The whole of Lebanon is constantly going through trauma and stress,” Chamoun said. “Are we supposed to treat the whole population?

A volunteer with Embrace’s 1564 hotline, a national helpline that provides emotional support and fights suicide in Lebanon, takes calls during one of his shifts [Courtesy of Embrace/Al Jazeera]

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