“I hope we can return to our houses; if there are houses to go back to,” says Alia*, who is displaced in Barja, Mount Lebanon.

Lebanon is currently experiencing the most significant escalation of conflict since the 2006 Lebanon War. Close to 1,300 people have been killed over a span of 16 days, between 16 September and 1 October, according to Lebanon’s Ministry of Public Health. The intense Israeli bombardments have forced more than one million people to flee their homes, according to national authorities. Médecins Sans Frontières (MSF) has scaled up an emergency response and mobilised teams across the country to provide urgent medical and mental health support to people who have been displaced.

In the early hours of Monday 23 September, the Israeli army launched a large-scale military operation, targeting dozens of towns across Lebanon’s governorates, including South Lebanon, Nabatieh, Baalbek-Hermel, and the densely populated southern suburbs of Beirut. More bombardment on 27 September led to mass displacement from these areas, as well as parts of Mount Lebanon, as residents sought safety elsewhere.

The intense bombardments have forced many people to flee multiple times, including since clashes began in October 2023. People often leave with little time to gather essential items.

Across Lebanon, there are currently 875 shelters for displaced people, with over 70 per cent already full, according to national authorities. Most displaced people urgently need assistance, having fled without basic necessities, while the communities and shelters hosting them are also in dire need of support.

“Families are fleeing their homes in search of safety. Many of them are seeking refuge in underprepared and overcrowded shelters,” says Dr Luna Hammad, MSF medical coordinator in Lebanon. “People who have been displaced are very vulnerable – children, women, elderly people, and people with physical disabilities – living in terrible conditions, including limited access to clean water, sanitation, and basic healthcare services. The needs are huge.”

MSF responding via mobile clinics, essential aid, mental health support

In response to the dire situation, we have scaled up our emergency response and sent mobile medical teams, including doctors, nurses, psychologists, counsellors and health promoters, to schools and other shelters across the country. These teams have already provided over 1,780 general medical consultations over the past week, and continue to provide assistance to displaced people. More teams are on the way to reach areas in need of support.

Additionally, MSF is donating essential items such as mattresses, blankets, and hygiene kits to displaced families in locations including Saida, Tripoli, and several sites in Beirut and Mount Lebanon. We are also distributing meals and drinking water, as well as delivering large quantities of washing water to shelters in Beirut and Mount Lebanon to ensure basic hygiene standards in structures that are often not equipped to house people. As of 2 October, we have donated 6,523 hygiene kits, 16,118 litres of drinking water, 643 mattresses, 699 blankets, 7,000 litres of fuel to hospitals, and 713,000 litres of water to shelters across the country.

“My children tell me they would rather die under bombing than to live like this,” says Alia, the displaced woman. “The school was shaking all night. We consider ourselves safe here for now, but what if Israel decides to target schools?”

To support healthcare facilities, MSF has previously prepositioned over 10 tonnes of medical supplies in hospitals since the beginning of last November. We have been sending a mobile medical unit to provide basic healthcare, mental health first aid, and health promotion to displaced and affected communities in south Lebanon. Our teams have also conducted mass casualty preparedness training to 117 health care staff in hospitals across the country.

Displaced communities facing trauma

In Baalbek-Hermel, where we have been running a project for over 13 years with two basic health care clinics, the recent escalation in violence forced the closure of one clinic due to heavy bombardment. Our clinic in Arsal continues to operate at limited capacity. Despite the challenging conditions, teams provide essential medications for chronic disease patients, aiming to supply a two-month stock. Many of our staff in the governorate, like thousands across the country, are still sheltering as airstrikes fall around them. Our clinic in Burj Al-Barajneh, south of Beirut, has also been closed due to bombardment of the area.

MSF mobile medical teams on the ground in Beirut, Mount Lebanon, and Tripoli are seeing patients with chronic diseases who fled their homes without their medications and have been unable to access treatment for days.

“Many of the displaced people are children,” says Dr Hammad, “dealing with trauma from the violence, fear of bombings, and the loss of their homes.”

MSF’s mental health teams are witnessing immense needs for mental health support. Our psychologists and counsellors are providing mental health first aid to people who have been displaced. Our helplines are receiving over 100 calls daily from people struggling with rising mental health challenges amid fear and displacement.

Protecting civilians and healthcare workers

MSF is gravely concerned about the ongoing bombing campaign, much of which targets densely populated urban areas. We urge the protection of civilians, healthcare workers, medical facilities, and ambulances. According to WHO and the Ministry of Public Health, over 50 health care personnel have been killed in the clashes since last October. Many MSF staff in Lebanon are displaced themselves; some have lost loved ones or have family members who have been injured.

“We risked our lives to get out,” says Jabine, who fled from Jibsheet in southern Lebanon and is now taking refuge in an abandoned office building near Beirut’s downtown.

She is one of over 3,500 people currently sheltering in these structures, where up to 30 people share a single bathroom, and many are still waiting to be assigned rooms. Many of the shelters people are residing in are abandoned structures or makeshift schools that lack basic amenities, with some having no doors or windows to shield the people within from the elements.

The current crisis has put immense pressure on Lebanon’s healthcare and humanitarian response capabilities, already strained by years of economic crisis.

With many people still on the streets, in open areas, and even seeking refuge on the beach in Beirut, humanitarian needs continue to grow. As winter approaches, the harsh conditions put these people at even greater risk of illness. MSF teams in Lebanon remain committed to providing urgent medical and mental health support to those affected.