Conflicts change the day-to-day lives of civilians, and access to healthcare becomes increasingly important for survival.
Pharmacists are one of the frontline health workers who can provide medication to help those with injuries, while still dispensing people’s prescriptions as best as they can, as they themselves are caught up in the same conflict.
C+D spoke to Diana Chawki, a pharmacist who has been working in Beirut, Lebanon.
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Since the attack launched by Hamas into Israel on October 7, 2023, Israel has also been engaged in hostilities with Hezbollah, a military and political organisation based in Lebanon.
Hezbollah has fired rockets into Israel, which has retaliated against them. From October 1, 2024, an Israeli ground invasion saw its troops enter Lebanon to fight against the group.
A ceasefire between Israel and Hezbollah took effect on November 27, 2024, bringing an end to fighting.
“Very scary”
Chawki has been working at Lunapharm Pharmacy for three years, having studied clinical pharmacy before applying to work in community pharmacy after her studies.
It’s based in Ain Al Mraiseh, a coastal suburb in the north west of Beirut, but the pharmacy has not been directly hit by Israeli airstrikes into the city.
It’s still near the danger, and Chawki says she has to “make sure the pharmacy is running correctly” even when she hears the airstrikes happening close by in the next neighbourhood.
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“After every airstrike, we have to make sure our family members were safe,” she says.
She even hears drones, with voices played out of them as well.
“Everything we were hearing, the voices, the airstrikes … that was all day, all night above our heads,” says Chawki.
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“Some days we have to shut the pharmacy because we had several threats around us, so we didn’t if they were true or not.
“We’re watching the news to know where the threats are. We didn’t know what was safe or what was true at this point.
“It was very scary because we have to make sure that all the patients are having their medication.”
Panic
When a pharmacy has been damaged by airstrikes, special measures have been introduced by the Order of Pharmacists of Lebanon – the national pharmacy organisation – so they can sell the medication in another location.
“For the pharmacies that were affected, they gave them permission to get their medications out of the pharmacy, whatever they can do, and send them to another pharmacy.”
When people have evacuated into Ain Al Mraiseh where Lunapharm is based, it has also generated more work for Chawki to have the medication that people want.
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“The new people who evacuated their homes and came to the neighbourhood, they were used to their pharmacists so it was difficult to convince them to take the medication, especially that most of the medication were out of stock so we had to give them the substitute [and] convince them to take it.”
The low stocks of medication has added to the intense atmosphere in Ain Al Mraiseh.
“They were aggressive because they were stressed because of the displacement and the new places they were living in. The people, especially the elderly when they don’t have their medication, they freak out and they panic.”
Lack of access to medication
She says people often use the pharmacy in the morning to get their medication but by the afternoon, people stay at home as this when more threats come through.
“Most of the time, the roads were empty because people were afraid to get out of their houses,” Chawki says.
The whole apartment building Lunapharm is located in has been evacuated before due to the threats and no one is able to return until it has been cleared as safe.
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There has been supply issues with getting access to medication, as Chawki says she “could not order on a daily basis as we did before the attack” as the warehouses where it is kept have also been under threat as well.
Some patients subsequently haven’t had the medication they need.
“There were a lot of delays and a lot of medications out of stock most of the time.
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“The biggest issue we were facing was most of the people were using drugs not given without prescriptions, so they didn’t have access to go to their physicians or anywhere to get prescriptions for their them.”
Chawki said this happened a lot for drugs like Xanax that people cannot buy over the counter, and they sometimes became out of stock too.
When possible, most people have been ordering their prescriptions before they evacuate out of the area to the “mountains” or to “relatives out of the country”.
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Chawki has also worked with other evacuated people in other affected areas around Beirut and Lebanon.
“I was working with NGOs to get medications for people that were in schools and other shelters.
“That was very painful, to see people that don’t have any house, access to medication, physicians, or anything.”
