BEIRUT: AsHamid Bou Dibdrives to work, he shudders at the thought of the day ahead. The doctor and administrative director, has run the Haykel hospital just south of Tripoli for three years.

It's not easy to stay strong, near all the staff in the hospital, and give them the power to keep going, Dib told The Daily Star.

Since last October, the jobs have become more stressful as he juggles salaries and patient care and the cost of medical supplies which has skyrocketed.

In theory, Dibs financial worries should be partially alleviated by the Central Bank, which has been subsidizing 85 percent of the cost of medical supplies.

The problem is the Central Bank pays 85 percent of the cost of medical supplies to hospitals at the official exchange rate of LL1,507 to the dollar, but the supplier demands the entire amount to be paid in dollars or the equivalent amount of Lebanese pounds at the black market rate.

Subsequently, Dib said the money provided by the Central Bank is covering far less than 85 percent of the cost of medical supplies.

On top of the rising costs of imports, Dib said public medical insurance and most private medical insurance companies are paying the hospital at the official rate of LL1,507 to the dollar rate.

When other costs such as food for patients and hospital maintenance are factored in, hospitals face an overwhelming combination of cost increases.

Facing this dire financial situation Haykel hospital has not been able to increase staff salaries and has even reduced many staffs weekly hours even as the cost of basic commodities increases rapidly.

Staff salaries in a number of private and public hospitals in the Bekaa Valley where Saleh works have been reduced even more. Saleh told The Daily Star that several hospitals have cut the nurses salaries in half.

Salehs own salary arrived late and due to the devaluation, his once confortable lifestyle has vanished.

Despite hospitals stagnating or reducing salaries, they are increasingly struggling to afford necessary medical equipment.

Head of the Syndicate of Private Hospitals Sleiman Haroun called Tuesday for an urgent meeting on July 7 to discuss the increasing shortage of essential medical supplies across the country.

Saleh said that he was being forced to ration equipment and deny patients certain medical treatment in order to leave them for patients in more serious conditions. Other doctors spoke of a less severe situation but told The Daily Star that access to medical supplies and personal protective equipment were increasingly in short supply.

Dr. Khairat al-Habbal, a family doctor who is often the first point of contact with the health care system told The Daily Star that she was increasingly admitting patients straight to intensive care because they had delayed going to hospital. She said that many of these patients' conditions would have been less serious if their condition had been identified earlier.

Habbal believes that the cost of preliminary check-ups which she said are often more than LL100,000 are driving patients away. Who can afford this now? she said.

Saleh painted a bleak picture in the Bekaa Valley where patients are only coming into hospitals when they cant suffer anymore adding you can feel the sorrow among the people.

Wages, equipment and patients in desperate situations are making their jobs a far more draining experience.

One employee at AUBMC speaking anonymously to The Daily Star said last summer work felt like being in the Garden of Eden. Now understaffed, his salary is worth far less and with barely any medical equipment he spends his shifts "internally screaming."

Dib is concerned that current working conditions in the countrys health care system and the wider turmoil in the country, will lead to a brain drain in the sector.

All medical workers who spoke to The Daily Star said a significant proportion of their colleagues were looking to move abroad.

Saleh believes 80 percent of staff he works with would leave the country if they could. Saleh himself was certain. If I get offered work away from Lebanon I will go, Im even regretting becoming a doctor he added.

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