Situation Report: Lebanon

Written By Saira Gallo

Introduction and Overview

On the 30th of September 2024, Cyrine Farhat from Positive on Glucose, alongside team members, conducted a rapid needs assessment of four shelters hosting internally displaced persons (IDPs) in Beirut and Mount Lebanon. This assessment was focused on identifying urgent diabetes medication needs among the displaced population, given the ongoing military escalation and its impact on healthcare delivery systems in Lebanon. The findings highlight significant gaps in medication stock, with an urgent need for life-saving diabetes treatment, including insulin, for patients at the shelters.

2. Shelters Visited

2.1 Lycee Abdel Kader School, Zokak Al Blat, Beirut

The Lycee Abdel Kader School in Zokak Al Blat is currently hosting 1,000 IDPs. Among them, 72 individuals have been identified with diabetes, including one who is insulin-dependent. The shelter has been operational since the escalation on the 23rd of September 2024 and is overcrowded. As of the 30th of September, no representatives from the Ministry of Health have visited the shelter to assess the needs. All diabetes-related medications have been provided by smaller initiatives, with no official stock from the Ministry. The shelter is in urgent need of sustained medication supplies. The shelter has also requested a blood sugar testing machine as there are none available at the moment.

2.2 Hammana High School, Hammana, Mount Lebanon

Hammana High School, located in Mount Lebanon, began operating as a shelter on the 30th of September 2024. It currently hosts 274 IDPs. Among the displaced population, three individuals are in critical need of diabetes medication, including two who are insulin-dependent. Similar to other shelters, it relies on daily donations and has no stable stock of essential diabetes medications.

2.3 Rene Moawad School, Hamra and Hawd Al Wileye School, Basta, Beirut

Rene Moawad School in Hamra and Hawd Al Wileye School in Basta were also visited as part of the assessment. While local initiatives are providing some medications for non-communicable diseases (NCDs), limited information was provided regarding diabetes-specific needs. Patients are referred to close PHCCs to test their blood sugar levels, as there are no machines available at the shelter and to request medications not available at the shelter. 

3. Medication Needs

The following key medications have been identified as urgently required by diabetes patients across the shelters:

- Glucophage (500 mg, 750 mg XR, 850 mg, 1000 mg XR)
- Januvia
- JanuMet (50/1000 mg)
- Gliclazide (60mg)
- Amaryl (2 mg)
- Trajenta 5 mg
- Diamicron
- Insulin (Tresiba, Lantus Solo Star, Novorapid, Novomix, Trajenta)
- Meters
- Test strips

None of the shelters have a stock of these medications, and they depend on daily donations. Patients with Type 1 diabetes are at particularly high risk, with some expected to run out of insulin within one week, posing life-threatening risks.

4.  Shelters Supported:

4.1 Lycee Abdel Kader School, Zokak Al Blat, Beirut: 56 beneficiaries

  • 1050 pill provided

  • 1 insulin vial

  • 50 test strips

  • 1 glucometer

4.2 Hammana High School, Hammana, Mount Lebanon: 5 benefitiaries

  • 120 pill

  • 5 insulin pens

  • 1 insulin vial

5. Current Operation: 

  • One new Shelter has been identified, Al Hlaliya Public School, Mount Lebanon with 5 individuals needing access to diabeter medication

  • We are trying to liaise with local CSOs and volunteers at shelter to identify shelter needs in:

  • Furn Chebbak, Mount Lebanon

  • Ain El Remmene, Mount Lebanon

  • Abey, Mount Lebanon

6. Challenges and Gaps

Several critical gaps in the delivery and availability of diabetes medications have been identified:

  • The Ministry of Health has mandated that all medication distribution should occur through its channels, yet no Ministry assessments or distributions have been made at the shelters visited.

  • Local initiatives and NGOs are attempting to fill the gap, but their resources are limited, and they can only provide over-the-counter medications.

  • Multiple Primary Health Care Centers (PHCCs) across South Lebanon, Nabatieh, and Mount Lebanon have been shut down due to the ongoing military escalation, further exacerbating the medication shortage and disruption in medical services.

  • There is a lack of clinical guidance regarding insulin switching for patients facing shortages, and no hotline has been set up for NCDs, particularly Type 1 diabetes patients.

7. Recommendations

To address the urgent diabetes medication needs in the shelters, the following actions are recommended:

  • Create a dedicated hotline for diabetes patients, especially those dependent on insulin, similar to the system established in Ukraine.

  • Expedite Ministry of Health assessments and ensure a clear system for delivering diabetes medications to shelters, either through PHCCs or mobile clinics.

  • Enhance collaboration among local NGOs and international organizations to ensure a stable supply of essential diabetes medications.

  • Provide clear guidance on insulin switching protocols to patients and healthcare workers to mitigate life-threatening risks due to insulin shortages.

  • Care coordination across all stakeholders including MoH, WHO with a technical working group.

Saira Gallo
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