As soon as Lebanese physician Ayman Obeid received a job offer in Iraq, he bought a one-way ticket from Beirut to Sulaymaniyah, in the Kurdistan region.
“You don’t have to think about it twice. It’s not just doctors. Anyone in Lebanon who gets an opportunity to work abroad will leave,” the 40-year-old surgeon said.
Dr Obeid is one of more than 40 Lebanese medical staff who joined Faruk Medical City in Sulaymaniyah in the last few months, driven abroad by Lebanon’s financial upheaval.
The mass departure of medical professionals, doctors say, is hastening the slow-burn decline of Lebanon’s health care sector, once a leading light in the Middle East.
The Lebanese Order of Physicians estimates that about 1,000 of the 15,000 registered doctors have left the country since 2019. A source at the American University Beirut Medical Centre, one of the country's foremost hospitals, says that 40 per cent of emergency staff and 50 per cent of nurses had left for jobs abroad.
For decades, Beirut has been a leading destination for Middle Eastern patients seeking high-quality treatment close by with few visas restrictions. Prior to the crisis, around 60,000 people travelled for treatment every year from across the wider region, especially from Iraq, according to data from the Syndicate of Hospitals in Lebanon. But now this trend could be reversed as more and more physicians like Dr Obeid move overseas and treat patients in their home countries.
The main driver is the country's economic crisis. Since 2019, the Lebanese pound has lost more than 90 per cent of its value slashing living standards and leading to shortages of medicine, basic goods and electricity. Doctors paid in Lebanese pounds will have seen their salary reduced to a few thousand dollars a year in real terms as the cost of living skyrockets.
“Healthcare has been deteriorating in Lebanon for the past 10 years. But now, it is crumbling,” said Dr Obeid, who has worked at the Rafik Hariri University Hospital, Lebanon's biggest public hospital, and at Bahman Hospital in Beirut.
Lebanon's economic crisis was, in part, triggered by a lack of foreign currency. In a country that relies heavily on imported goods, this problem hit every sector. But in the medical industry, this led to shortages of drugs, healthcare equipment and medical tools because Lebanon imports at least 80 per cent of its medication. As things got worse, the flow of medical tourists was reduced to a trickle.
"We have much less foreigners seeking medical treatment in Lebanon since the crisis," Sulaiman Haroun, who heads the Syndicate of Hospitals, said. "I wouldn't be surprised if the number of Iraqis, who constitute half of all foreign patients, was cut in half, but we do not have recent data."
While many Lebanese have traditionally sought work in the Gulf, it has become more difficult for them to secure visas. As living conditions deteriorate, many are now considering moving to Africa and Iraq for work, doctors told The National.
“There is no doubt the crisis is pushing Lebanese to come here for work,” said Mustafa Hariri, who represents the Lebanese community in Erbil, the capital of Iraqi Kurdistan.
The number of Lebanese in the region has risen from 2,000 before 2019 to 3,000 now, Mr Hariri told The National.
About 15,000 lived in Kurdistan in the early 2010s but most of them left after the onslaught by ISIS in 2014.
“Now, they are coming back,” he said.
A new trend in Iraq
With the Kurdish region now relatively secure, Faruk Medical City is attracting physicians like Dr Obeid, who studied at the American University of Beirut.
It is the first Iraqi hospital to seek out Lebanese recruits and may set a new trend in the country.
“Private hospitals in Kurdistan are looking at this experience as a pilot study. If they see results, then other hospitals may also begin hiring Lebanese doctors and staff,” Dr Obeid said.
“This is a pioneer hospital."
The US-led invasion of Iraq in 2003 and the civil conflicts that ensued forced thousands of Iraqi medical practitioners to flee – ruining the country’s health care sector.
Nearly two decades later, Iraqi hospitals still struggle to overcome this brain drain and to convince Iraqi patients who usually seek treatment in Lebanon or Jordan to stay at home.
Doctors now say Lebanon may suffer the same fate as Iraq in the early 2000s as medical staff leave and the standard of health care deteriorates.
The hospital's chief executive, Ali Elhaj, said they are seeking to attract accomplished professionals from Iraq and the wider region, with the goal of becoming a model for the entire country.
Mr Elhaj is himself an American-educated Lebanese national – fitting their recruitment profile perfectly. He moved from Beirut to Sulaymaniyah five months ago after managing hospitals in Lebanon and the US.
“Due to the unstable situation, Lebanon has become a human resource factory for the world,” he said.
Many Iraqi patients who considered going abroad for their medical procedures are now going to FMC, he said.
About 60 to 70 per cent of FMC patients are not from Sulaymaniyah and at least half of them are from outside the Kurdish region.
“Some of our Lebanese physicians already had Iraqi patients in Beirut who now seek treatment in Sulaymaniyah instead,” Mr Elhaj said.
The drop in the number of Iraqi patients visiting Lebanese hospitals is substantial, the head of the Order of Physicians told The National.
Charaf Abou Charaf said that the number of Iraqis seeking treatment in the country had fallen by at least 50 per cent since the onset of the economic crisis.
“They are driven away by the crisis and by shortages of medicines and medical equipment,” he said.
What worries Dr Abou Charaf the most, he said, is the accelerated emigration of doctors.
“Doctors who leave for Arab countries are really half-emigrants, they come back home often. Those leaving to the West are harder to bring back,” he said.
“But wherever they go, these doctors are lost talents that Lebanon cannot retrieve easily.”
For generations, Lebanese medical staff who were trained in some of the region’s best medical colleges have passed on their expertise to newcomers. They are the backbone of Lebanon’s standing as a medical centre in the Middle East, Dr Abou Charaf said.
But now, their departure is preventing this exchange of knowledge and depleting hospitals of highly-skilled workers, while medicine shortages threaten the well-being of patients.
“We are pleading with authorities to take action and stop the brain drain,” he said.
“If the medical sector is crushed, we cannot bring it back.”