In the only unit that treats severe burn victims during the war in Lebanon: “We have never seen so many patients or such serious patients” international

To escape, they loaded their belongings into the car. But while Fatima was preparing breakfast, her daughters, Rahaf, seven, and Ivana, 22 months, went out to play on the balcony of their home in Deir Qanoun in Nahr, near Tyre, southern Lebanon. Then an Israeli missile fell very close and the fire engulfed the girls. Fatima and her husband Mohammad reached the terrace. The father grabbed Ivana and jumped with her onto another balcony of the building; The woman grabbed Rahaf and ran towards the door of the house, but it was stuck and she could not open it. Frustrated, Fatima threw her daughter out of the window and then jumped out herself. This was the first floor and the following survived: parents, safe; Burnt girls. Rafa, on the face and hands; Ivana, over 70% of her body and in third grade.

The house, car and life that Ivana Sziczky’s family had had disappeared on September 23. That day, nearly 600 people were killed in the deadliest bombings in Israel’s open war in Lebanon so far. Mohammed, a carpenter, and Fatima, a housewife, fled with their worn-out belongings and their badly injured daughters. Both were admitted to a hospital in the Chouf area, southeast of Beirut. Ivana, who was on the verge of death, was transferred two weeks later to Lebanon’s only major burn unit: the Lebanese Geitaoui hospital of the Maronite Sisters of the Holy Family in Beirut.

Fatima recalls, Ivana “didn’t move, didn’t speak.” She was admitted unconscious, with burns, without bandages and with a fever, remembers nurse Toni Zieter, who described the girl’s evolution as “a miracle”. Less than two months later, Ivana, with her head and half her body still bandaged, claps her hands on her bed in the hospital’s pediatric ward. The nurse says that the skin graft that has been performed has “taken root 100%”.

The girl had spent the first several weeks in the basement of the hospital. The head nurse of the Major Burn Unit, Lenny Mehna, opens some automatic doors on floor-3 with a card. In a sterile facility, doctors, nurses and residents—Gitaoui is a university hospital—work in a room surrounded by rooms occupied by victims of Israeli bombings.

in one of them boxes, The patient is a small child, who is bandaged from head to toe. He is four years old, has one leg amputated mid-thigh and third-degree burns on 25% of his body. “He will need skin grafts on his face and neck,” the nurse explains. He then says that the bombing that caused the boy to become like this also killed his mother.

Like that pediatric patient, patients with severe burns in this war often enter the service in appalling conditions. Health workers explain that not only because of burns, but also because of “severe trauma, brain hemorrhage, open fractures and shrapnel.”

—Where do you start when you see a person in that state? What’s the first thing you do?

– pray.

And, as she says this, the nurse crosses herself.

Some screams mixed with crying come from the other room. A woman of about thirty years of age is lying there with most of her body covered in bandages. His face is burnt and the skin on his knuckles looks dead, dry and with dark spots. The nurse says that the patient tried to save his five-month-old son with those hands in another bombing. The child “died on arrival at the hospital.”

fourth grade

Some patients are admitted when nothing else can be done for them except pain relief. Plastic and reconstructive surgeon Ziad Sleiman remembers a young man injured in the bombing who arrived with fourth-degree burns on both legs. This degree, the most severe, indicates that the burn has destroyed the skin, muscles, tendons, and nerves until reaching the bone; That whatever the fire has consumed has remained as “wood”.

– Did they have to amputate?

– Dissection no. geek out.

To detach a part means to separate it completely from the joint which connects it to the body; In the case of the legs, from the pelvis.

Didn’t have to do this. This 54 year old surgeon says that the young man died earlier. Fourth-degree burns are rare under normal circumstances, says Sleeman, because “when they get burned, people always try to escape the flames by any means possible.” It is impossible to avoid missile explosion. A large number of the major burns that Gitaoui staff have treated these weeks have been third and fourth degree burns. Since September, bomb blast victims have come to this hospital with burns on up to 95% of their body surface.

“We have never treated such large or severe burn injuries,” confirms Dr. Naji Abi Rached, the hospital’s medical director. Still, he emphasizes that the survival rate for patients in the unit where they are supported is “84%.” One in four of the injured was a child. “A big personality,” he laments.

In mid-September, the hospital had already activated a crisis room with the Lebanese Ministry of Health in anticipation of the outbreak of war. The massive influx of patients began on September 17, when Israel fired thousands of beepers walkie talkie The Lebanese reportedly have ties to the Shia militia party Hezbollah, which they have designated as their enemy in Lebanon. Large-scale bombing began on 23 September. Since then, Gitaoui staff have treated “dozens” of severe burn injuries, says Dr. Abi Rached.

Injuries who survive suffer far more than the functional, physical, aesthetic, and psychological consequences of severe burns. When they are discharged, some have no place to return to. Like Ivana’s parents, Israeli strikes have destroyed their homes. The hospital has provided temporary shelter to many of them even after their recovery. In Lebanon, the war has displaced 1.2 million people, one in every five of the country’s residents.

a sinking ship

From Dr. Abi Rached’s office you can see the red and blue cranes of Beirut’s nearby port. The French-trained cardiologist said that, like many of his colleagues, he has declined offers to work in Europe. If he has not joined the brain drain that threatens to escalate the war, it is by not abandoning “a ship that could sink in a storm.” That “ship” is Lebanon.

The history of Gitaui Hospital is seen in the mirror of our country. Established in 1927, before Lebanon’s independence (1943), the center has had to endure “a series of crises” that have shaken the small Arab nation, believes its co-director general, Dr. Pierre Yared. The major burns unit was created in 1992, two years after the end of the civil war, when the center’s staff realized that many of the people injured in that conflict had suffered burns. By 2000, southern Lebanon was occupied by Israel, and in 2006, the hospital treated victims of that year’s war and Israeli invasion.

In 2019, the Lebanese currency was devalued by 90% playpen Banking. One year later, the COVID-19 pandemic. In August 2020, the hospital was semi-destroyed by the explosion of an ammonium nitrate warehouse in the nearby port of Beirut. Nurse Toni Zeiter was seriously injured. He was never compensated. Nor the hospital, which was rebuilt thanks to private donors. And now, “this war against Lebanon,” says Dr. Yared.

Israel says its war is not against Lebanon but only against Hezbollah, which in October 2023 began launching rockets into northern Israel again in solidarity with the Gaza war. But the official death toll since then, at more than 3,600, more than 15,000 injured, and the extent of the country’s destruction refute that argument. “The injured children we have here are not militiamen,” says Gitaoui’s co-director.

As soon as the doctor speaks, the lights go off. Electricity from the state grid is a gift here, unpredictable as it almost never comes. The Lebanese—and this hospital—get light thanks to generators and buy the fuel that powers them. In Gitaoui that bill alone amounts to about $200,000 (186,000 euros) a month.

The Lebanese state, in ruins, does not bear even half the costs of treating serious burn injuries from the war. He only pays – “and late” – $450 (426 euros) out of a minimum of $1,000 (about 926 euros) per patient per day, Dr. Yared explains. Medical insurers are also delaying payments to hospitals. Many Lebanese, who are out of work and displaced, cannot pay their health insurance premiums.

Gitaoui is a private, non-profit center, stresses its other co-director, nun Hadiya Abi Chebli, but what is at stake now is its survival. Dr Abi Rached has warned that the large burns unit will only be able to operate for “a month or two” unless international financial support is provided.

In the pediatric ward, Ivana’s father, Mohammed, shows photos on his cell phone before and after the bombing and of the lives lost on September 23. Before that are photos and videos of Ivana and her sister Rahaf, two healthy girls, obviously happy, playing and singing. Ivana smiled at the camera with her flawless complexion and dark hair glowing.

Mohammed believes there is “spookiness” after this. The injured girl, whose burnt skin is like a map. His face and hands were disfigured by the explosion; Her pain and her bound body. Those bandages still cover his head and one of his arms. His mother looks away so that the scars are not visible when the toilets are changed. Ivana turned two years old on 8 November. The doctor was about to discharge him.