The economic crisis in Lebanon is never-ending and now it’s ravaging the hospitals where medicines are running out.
On the oncology outpatients ward we meet four-year-old Rudayana.
She is fighting leukaemia but she still finds the strength to wipe a tear from her father Fawaz’s eyes.
Image: The problems in healthcare are a symptom of much wider crisis
He kneels beside her with his head in his hands.
It is a portrait of desolation.
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Making sure she has enough medication has left him at breaking point.
“I feel despair but at the same time, I get up every day for her,” he tells me.
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Image: Rudayana is fighting leukaemia, but there is not always enough medicine
“We have just about 10% of the minimum needs for our daily life. You can’t put her in school, get her medicine, or do anything for her.
“You can’t even guarantee her nutritious food to help her after chemo. There’s no money and no work.”
In the next bed at the Rafik Hariri University Hospital, Beirut, another family is facing the same struggle.
Helen Kazazian was diagnosed with ovarian cancer four months ago and worries there won’t be the drugs to finish her treatment.
She’s had four sessions of chemotherapy so far, but still has two left.
“Sometimes the doctor said ‘Inshallah, Helen you will get it’.
“We don’t know, we have to go and see, I have to go, or Robert [her husband] by myself to see if they will give us the medicine, or not yet. This time it was ok, thank God”
Image: Helen Kazazian, and her husband Robert, are worried she will not get her medicine
Lebanon used to rank highly for medical care but standards have plummeted, along with a currency which has lost 90% of its value, making essentials unaffordable – the state is badly in debt, inflation is rampant and unemployment is becoming normal.
We visit the hospital’s pharmacy and the empty shelves tell their own story.
Even drugs like penicillin are in short supply.
But the crisis affecting the healthcare system is really a symptom of a much wider crisis, or series of crises, compounded by corruption and bad governance.
For doctors on the frontline it is like walking through an abyss every day.
Head of oncology, Dr Issam Chehade, says the problems are getting worse, with drug shortages and patients not receiving care in his department.
Image: Dr Issam Chehade says the problems are getting worse
Step outside the hospital and there’s no escaping this crisis.
It has the country in a vice-like grip.
On the way across town to a private hospital, to see if the situation is any better, we pass the endless fuel queues.
People wait in their cars in the sweltering Mediterranean sun for a few gallons.
Some are turned away before they manage to fill up.
It’s estimated by the United Nations that 78% of Lebanon’s population is now living in poverty, leaving some scavenging for whatever they can find.
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July: Lebanon plunged into economic crisis
The number of people rooting through bins, or begging on the streets is growing all the time.
But it doesn’t matter what walk of life you are from, for everyone survival is difficult.
And when we arrive at St George hospital we find there are no exceptions.
Retired pharmacist Dickran Kaprelian has a type of blood cancer.
The drugs he was on have run out and he’s now starting a different treatment.
His wife Mary is also sick with ovarian cancer.
“The medication he takes doesn’t exist anymore – I don’t know, that’s what they say so they just switched to another medication so we’ll see what will be the result,” she said.
Image: Mary Kaprelian and her husband Dickran both have cancer
“We are fighting for everything – even a little bit of breath. Even if we want to eat, even if we want to go somewhere we don’t have gasoline.
“It’s [a] very very bad situation. I don’t think any country [has] such a state like we do – that’s what I think.”
What’s happening here has left many questioning their future.
Already many medics have emigrated – acute staff shortages add to the list of problems.
In this economic crisis, the worst for more than 100 years, even the hospitals have now become casualties.
The leaders went home buoyed by the knowledge that they’d finally convinced the American president not to abandon Europe. He had committed to provide American “security guarantees” to Ukraine.
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0:49
European leaders sit down with Trump for talks
The details were sketchy, and sketched out only a little more through the week (we got some noise about American air cover), but regardless, the presidential commitment represented a clear shift from months of isolationist rhetoric on Ukraine – “it’s Europe’s problem” and all the rest of it.
Yet it was always the case that, beyond that clear achievement for the Europeans, Russiawould have a problem with it.
Trump’s envoy’s language last weekend – claiming that Putinhad agreed to Europe providing “Article 5-like” guarantees for Ukraine, essentially providing it with a NATO-like collective security blanket – was baffling.
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0:50
Trump: No US troops on ground in Ukraine
Russia gives two fingers to the president
And throughout this week, Russia’s foreign minister Sergei Lavrov has repeatedly and predictably undermined the whole thing, pointing out that Russia would never accept any peace plan that involved any European or NATO troops in Ukraine.
“The presence of foreign troops in Ukraine is completely unacceptable for Russia,” he said yesterday, echoing similar statements stretching back years.
Remember that NATO’s “eastern encroachment” was the justification for Russia’s “special military operation” – the invasion of Ukraine – in the first place. All this makes Trump look rather weak.
It’s two fingers to the president, though interestingly, the Russian language has been carefully calibrated not to poke Trump but to mock European leaders instead. That’s telling.
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4:02
Europe ‘undermining’ Ukraine talks
The bilateral meeting (between Putin and Zelenskyy) hailed by Trump on Monday as agreed and close – “within two weeks” – looks decidedly doubtful.
Maybe that’s why he went along with Putin’s suggestion that there be a bilateral, not including Trump, first.
It’s easier for the American president to blame someone else if it’s not his meeting, and it doesn’t happen.
NATO defence chiefs met on Wednesday to discuss the details of how the security guarantees – the ones Russia won’t accept – will work.
European sources at the meeting have told me it was all a great success. And to the comments by Lavrov, a source said: “It’s not up to Lavrov to decide on security guarantees. Not up to the one doing the threatening to decide how to deter that threat!”
The argument goes that it’s not realistic for Russia to say from which countries Ukraine can and cannot host troops.
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5:57
Sky’s Mark Stone takes you inside Zelenskyy-Trump 2.0
Would Trump threaten force?
The problem is that if Europe and the White House want Russia to sign up to some sort of peace deal, then it would require agreement from all sides on the security arrangements.
The other way to get Russia to heel would be with an overwhelming threat of force. Something from Trump, like: “Vladimir – look what I did to Iran…”. But, of course, Iranisn’t a nuclear power.
Something else bothers me about all this. The core concept of a “security guarantee” is an ironclad obligation to defend Ukraine into the future.
Future guarantees would require treaties, not just a loose promise. I don’t see Trump’s America truly signing up to anything that obliges them to do anything.
A layered security guarantee which builds over time is an option, but from a Kremlin perspective, would probably only end up being a repeat of history and allow them another “justification” to push back.
Among Trump’s stream of social media posts this week was an image of him waving his finger at Putin in Alaska. It was one of the few non-effusive images from the summit.
He posted it next to an image of former president Richard Nixon confronting Soviet leader Nikita Khrushchev – an image that came to reflect American dominance over the Soviet Union.
Image: Pic: Truth Social
That may be the image Trump wants to portray. But the events of the past week suggest image and reality just don’t match.
The past 24 hours in Ukraine have been among the most violent to date.
At least 17 people were killed after a car bombing and an attack on a police helicopter in Colombia, officials have said.
Authorities in the southwest city of Cali said a vehicle loaded with explosives detonated near a military aviation school, killing five people and injuring more than 30.
Image: Pics: AP
Authorities said at least 12 died in the attack on a helicopter transporting personnel to an area in Antioquia in northern Colombia, where they were to destroy coca leaf crops – the raw material used in the production of cocaine.
Antioquia governor Andres Julian said a drone attacked the helicopter as it flew over coca leaf crops.
Colombian President Gustavo Petro attributed both incidents to dissidents of the defunct Revolutionary Armed Forces of Colombia (FARC).
He said the aircraft was targeted in retaliation for a cocaine seizure that allegedly belonged to the Gulf Clan.
Who are FARC, and are they still active?
The Revolutionary Armed Forces of Colombia, a Marxist guerrilla organisation, was the largest of the country’s rebel groups, and grew out of peasant self-defence forces.
It was formed in 1964 as the military wing of the Colombian Communist Party, carrying out a series of attacks against political and economic targets.
It officially ceased to be an armed group the following year – but some small dissident groups rejected the agreement and refused to disarm.
According to a report by Colombia’s Truth Commission in 2022, fighting between government forces, FARC, and the militant group National Liberation Army had killed around 450,000 people between 1985 and 2018.
Both FARC dissidents and members of the Gulf Clan operate in Antioquia.
It comes as a report from the United Nations Office on Drugs and Crime found that coca leaf cultivation is on the rise in Colombia.
The area under cultivation reached a record 253,000 hectares in 2023, according to the UN’s latest available report.
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