Assessment of Injuries, Disabilities, and Medical Response after the Beirut Blast

WHO Retrospective Hospital-Based Review (2021)

Partner: World Health Organization (WHO) – Lebanon
Role: Medical researchers & hospital coordination
Lead contributor: Dr. Nagi Souaiby, MD, MPH, MHM
Location: Beirut, Lebanon
Timeline: January–July 2021
Report completed: July 2021

Project Overview

In 2021, our team was commissioned by the World Health Organization (WHO) to conduct a retrospective medical assessment of individuals injured during the Beirut Port explosion on August 4, 2020. The study aimed to document clinical outcomes, impairments, and potential disabilities among victims, using hospital records from 16 healthcare facilities in Greater Beirut and Mount Lebanon. This work was critical to understanding the nature of trauma sustained, the extent of long-term disability, and the capacity of Lebanon’s hospital system to manage mass casualty incidents during an unprecedented crisis.

Our Role

As lead researchers and field coordinators, our team:

  • Designed a two-phase data collection and follow-up methodology in collaboration with WHO and the Lebanese Ministry of Public Health (MOPH)

  • Developed structured questionnaires for both general hospital data and individual patient follow-up

  • Collaborated with focal points in 16 hospitals and conducted follow-ups with a representative sample of 564 inpatients and 410 outpatients

  • Conducted data cleaning, coding, and analysis to identify trends in trauma care, types of injuries, post-discharge disability, and system-level challenges

  • Provided WHO and MOPH with actionable recommendations to strengthen emergency preparedness, follow-up systems, and injury surveillance

Our Approach

The assessment was carried out in two main phases:

  • Phase 1: Collection of aggregated data from hospitals that received casualties during the Beirut blast, including number of patients treated, surgeries performed, ICU admissions, deaths, amputations, and early disability indicators.

  • Phase 2: In-depth follow-up of a subset of inpatients and outpatients using detailed clinical questionnaires. This included analysis of injury types by body region, ICU vs. ward admissions, residual disabilities, toxic inhalation symptoms, and mental health outcomes.

Our methodology relied on:

  • Review of medical records and ICD-10 coding

  • Direct communication with hospitals and staff

  • Ethical clearance from multiple IRBs and endorsement from the MOPH

  • Coordination with syndicates, NGOs, and hospital administration

Key Areas of Impact

This medical assessment revealed:

  • Extremity injuries were the most common (49% of inpatient cases), followed by injuries to the head/face (19%) and multiple body regions (20%)

  • A relatively low in-hospital death rate (3.9%), with most deaths occurring upon arrival or within the first 24 hours

  • 12.2% of inpatients reported residual disabilities post-discharge — including loss of limb function, eye trauma, and neurological symptoms

  • Limited mental health and psychological support services, with only 6.25% of hospitals reporting psychiatric evaluation of admitted patients

  • The presence of systemic gaps in disaster response, including lack of standardized triage systems and incomplete medical records

The study also underscored the necessity of long-term follow-up to confirm cases of permanent disability and to assess delayed effects such as PTSD and respiratory conditions from toxic exposure.