At first, Souraya Torbey didn’t understand what she was seeing. A huge plume of smoke, then an explosion.
The second time she watched the video, she understood: “This is the port. This is Beirut. I started sobbing.”
Across the world, a massive explosion had rocked her hometown. Was her family okay? What about her brother, who had sent her the video in a text message?
Beirut’s port blast, one of the largest non-nuclear blasts in history, would leave 200 dead, thousands injured and many more psychologically traumatized. It occurred when a fire ignited an abandoned cargo of 2,750 tons of fertilizer stored in a port warehouse. Doctors, many of them trained in Baltimore, struggled to keep pace with the casualties as their own hospitals lost electricity.
Torbey, a child and adolescent psychiatrist at the Kennedy Krieger Institute, said the blast affected Lebanese expatriates like her deeply. Many are in daily contact with relatives, and already facing immense pressures.
To study the effect of the Aug. 4, 2020, blast on them, Torbey, with collaborators in both the U.S. and Lebanon, embarked on a survey of Lebanese people around the world, from the United States to the United Arab Emirates. Through an online questionnaire, they aim to measure symptoms of post-traumatic stress disorder in Lebanese nationals abroad.
Gaëlle Rached, a researcher on the study who was in Beirut at the time of the blast, said she realized that the event — broadcast to the world via news and social media — had left an invisible mark on Lebanese friends overseas who viewed the horror through news reports and social media. In conversations with others, she said, “I could tell that they were also impacted by the explosion as much as I was.”
Since helping launch the study, she said she’s received appreciative text messages from participants.
“Studies don’t really give an importance to expats’ mental health in case of crisis,” she said.
One year later, the survey has generated over 1,000 responses. One survey question asks expats whether they would consider returning to Lebanon.
“It’s quite sad,” Torbey said. “The majority of them answer they would not go back.”
By some estimates, more than 14 million Lebanese people live outside the country, double the population that lives within its borders. The exodus of Lebanese has accelerated in the wake of last year’s blast and amid a historic financial crisis that wiped out many families’ savings accounts and rendered salaries practically worthless. Among them are doctors who studied medicine in Baltimore.
Their exits leave the future of Lebanon’s private health care system, previously a source of regional pride, in question. In the past year, half of the nursing staff and 40% of faculty have left the emergency department at the American University of Beirut Medical Center, said Eveline Hitti, the department chair and a Hopkins alum.
Without a massive infusion of funding, Hitti said, “it’s on the verge of collapse.”
On the evening of the blast, Nour Al Jalbout, who did her residency at Johns Hopkins before moving back to Lebanon in 2019, was two hours into her shift at the American University of Beirut Medical Center’s emergency department. The force of the blast made the ceiling fall; the lights turned off and sirens turned on.
With rubble and shattered glass everywhere, motorbike delivery drivers grabbed injured people from the streets, taking them to area hospitals, Hitti recalled. Her department treated 500 casualties on Aug. 4, a remarkable feat for the 40-bed facility. But Hitti said she and others are haunted by those they couldn’t save. In an essay, she reflected on “the burden of imperfect decisions” made in crisis scenarios when needs far exceeded resources.
“[W]e had never experienced this scale of tragedy, never faced this unrelenting flood of blood-drenched casualties,” she wrote.
As an expat, Torbey said, “It’s demoralizing and sad to see this country that we love so much really unravel... Every time we don’t think it can get worse, it does get worse.”
This summer, Hitti will drop her daughter off in Baltimore to begin her freshman year at Johns Hopkins University.
Back in Beirut, Hitti plans to continue her work, even as she watches colleagues flee and the financial crisis continue.
In a video interview shared on social media, Al Jalbout said she had grown exhausted with Beirut.
“I’m fed up of being resilient…,” she said. “I want to live a decent life and not be having to face a bomb and a civil riots and a war every couple of years.”
In the aftermath of the explosion, Al Jalbout began exploring options to emigrate. She recently accepted a position at Massachusetts General Hospital.
“The day I left, I hugged my dad and I told him, ‘I’m sorry I’m leaving you behind,’” she said, her voice breaking into a sob as the sound of an ambulance siren filled the Boston streets.