logistics

Pharmaceutical logistics in demand as war rattles supply chains

BY JEAN-PHILIPPE LACOUR

  • In the therapeutics sector, cancer and weight management treatments show the highest growth prospects, according to the LBBW bank.
  • Medicines can stop pain, fight cancer and save lives but are worthless if they get lost in the mail, spoil in a hot warehouse or are stuck on a ship. 
  • In the therapeutics sector, cancer and weight management treatments show the highest growth prospects, according to the LBBW bank.
Medicines can stop pain, fight cancer and save lives but are worthless if they get lost in the mail, spoil in a hot warehouse or are stuck on a ship. 
This is where pharmaceutical logistics comes in -- a fast-growing sector in a world where key supply chains have been shaken by war, pandemic and trade chaos.
One of its European hubs is what Germany's DHL calls its health logistics campus near Frankfurt, dedicated to ensuring drugs and other crucial medical products reliably get to where they're needed.
As fears of medicine shortages grow amid the five-week-old Middle East war, its task is to ensure steady shipments to hospitals, pharmacies, labs and other customers across Europe and worldwide.
The company's facility -- the size of 14 football fields, with its roofs covered in solar panels -- is located in Florstadt outside Frankfurt, itself a transport centre in the middle of Europe. 
Products passing through the giant site range from insulin capsules and lifestyle drugs to medicated sunblock and drums of sulphuric acid.
Strict temperature controls and workers in protective suits ensure that medicines are handled under sterile conditions and in guaranteed cold chains.
"Our 600 employees are specially trained because they know that, ultimately, the patient is at the end of the supply chain and no errors are allowed," said Katrin Hoelter, head of DHL's logistics division in Germany and the Alpine countries.
As the US-Israeli war against Iran has impacted global shipping, "we are seeing that some customers are requesting increased storage volumes here, which are essential for their production, in order to ensure the availability of raw materials", she told AFP during a visit to the site.

Super-cold storage

The fragility of global supply chains remains a constant concern, even though Hoelter said the Florstadt site is less dependent on shipping through the troubled Strait of Hormuz than on the Suez Canal, which remains open.
Despite repeated global crises, the logistics sector continues to expand, as does the drug industry.
According to healthcare data analytics firm Iqvia, the global pharmaceutical market could exceed $2.6 trillion by 2030, driven by the United States as well as major emerging markets.
In the therapeutics sector, cancer and weight management treatments show the highest growth prospects, according to the LBBW bank.
For the DHL Group, also known as Deutsche Post, the logistics business -- particularly in the pharma sector -- is helping to offset losses from the decline in mail and disruptions to trade caused by conflict and tariff wars.
In Florstadt, automated procedures coexist with manual handling at fixed workstations, such as preparing a single contact lens ordered by an optician for a specific patient for further shipping.
Strict safety and hygiene standards are key. Behind the glass of a sterile room, two employees in full protective suits could be seen extracting an insulin component from a large vat to send a test sample to a customer.
"We are able to simulate any regulatory requirements here," said Hoelter. 
"This covers all possible temperature ranges," she said, adding that they can be dropped "as low as minus 80 degrees (Celsius) to account for the varying sensitivities of individual products".

US investment rush

The first warehouse at the site opened in 2015, dedicated to distributing medications from a laboratory of the pharmaceuticals firm STADA.
It has since grown into a four-building complex with storage capacity for 140,000 pallets and room for more.
DHL plans to invest two billion euros ($2.3 billion) worldwide by 2030 in pharmaceutical logistics, about a quarter of it in Europe.
Half will go to North America, mainly the United States, where European drugmakers are relocating some production in response to President Donald Trump's tariffs and his efforts to lower drug prices.
In five years, the DHL division's revenue is expected to double, reaching 10 billion euros, compared to 84 billion euros for the group last year.
Hoelter said this growth reflects a broader trend among drugs companies to outsource logistics and other work, so that they can "focus on their core businesses: pharmaceutical research and production".
jpl/bst/fz/giv/lga

nutrition

In the online 'maxxing' era, what's the deal with fiber and protein?

BY MAGGY DONALDSON

  • Perhaps most importantly, no nutrient is a cure-all -- those "fiber-rich" chips probably won't change your life.
  • First it was protein, now it's fiber: the "maxxing" mindset has permeated social media, as wellness influencers insist that loading up on certain nutrients is the key to vitality and a life-changing gut glow-up.
  • Perhaps most importantly, no nutrient is a cure-all -- those "fiber-rich" chips probably won't change your life.
First it was protein, now it's fiber: the "maxxing" mindset has permeated social media, as wellness influencers insist that loading up on certain nutrients is the key to vitality and a life-changing gut glow-up.
These viral diet trends rooted in extreme optimization are impacting how people eat and what companies sell -- but are they actually healthy?
The concept of "proteinmaxxing" insists that more is better when it comes to the macronutrient found in foods like meat, dairy and nuts, which is essential to a vast array of bodily functions such as repairing tissue or enhancing immune function.
Meanwhile dietary fiber is on track to be 2026's online trend of choice: ingest as much as possible and you'll be less hungry and more regular, say online advocates who wave bowls of chia seeds and oats at the camera.
Brands have taken note: if you can buy it, there's probably a protein-boosted version of it -- even the sugariest cereals are touting their high protein content.
And blue chip companies like PepsiCo and Nestle along with newer firms like Olipop are jumping on the bandwagon, highlighting the fiber content in prebiotic sodas or chips.
"I think fiber will be the next protein," said PepsiCo CEO Ramon Laguarta in an earnings call late last year.
A survey from the consulting firm Bain & Company showed nearly half of US consumers are trying to eat more protein.
Across the United States, Europe and Asia, it's Gen Z and Millennial consumers primarily driving the fad, according to the survey.
The same goes for fiber: according to London's GlobalData, 40 percent of Gen Z and 45 percent of Millennials reported they're trying to improve their gut health.

More not always best

Nutritionists say there are grains of truth to the fiber craze.
Andrea Glenn, an assistant professor of nutrition at New York University, called the movement surrounding fiber a "pretty tame wellness trend compared to the other things out there."
Samantha Snashall, a registered dietitian at Ohio State University's medical center, said protein has been "the special child" in recent years -- and fiber has been "pretty undervalued."
"I'm glad it's having some light shed on it."
But those experts along with Arch Mainous -- a professor of community health and family medicine at the University of Florida, who has researched the use of social media in health communication -- said more isn't always best, especially when it comes to protein.
Mainous said eating according to the recommended daily values is one thing -- but "if you say one's good, five's better? I'm not really for that."
He voiced concern that people are putting too much stock in the one-size-fits-all health advice of influencers.
It's part of a broader trend that has resulted in a "lack of trust in health experts," he said -- a "I'll do my own research" mentality that has also been fueled by the likes of US Health Secretary Robert F. Kennedy Jr, who has spread anti-vaccine misinformation for years.
Few influencers are trained scientists, Mainous said, and many have brand deals or agendas of their own, including products to sell.

No 'silver bullet'

So what's an eater to do?
First, talk to your physician, Mainous said. 
As a general guideline, the American Heart Association says that for many people, a day that includes a combination of foods like a glass of milk, a cup of yogurt, a cup of cooked lentils, and a piece of cooked lean meat or fish approximately the size of a deck of cards will be in the ballpark of the average daily protein target.
Fiber-wise, Glenn said 25-38 grams depending on age and sex is a good goal. 
High-fiber foods -- such as beans, fruits, vegetables, nuts and whole grains like oats or quinoa -- are linked to lower rates of certain cancers, and can help keep cholesterol and blood sugar in check.
Generally, Glenn said, people can eat some whole grains or fruit at breakfast, and then should try to fill half their plates with vegetables at lunch and dinner.
With that visualization, "you'll easily hit that target without needing to meticulously count how much fiber you're consuming," she told AFP.
But if you're not currently eating much fiber -- most people aren't -- "maxxing" is not a good course, Snashall warned.
Shake things up overnight and "your GI system is going to have a strong reaction," she said. "Slow and steady wins the race."
And Glenn noted that powders and supplements can't serve as a replacement for whole, real foods.
Perhaps most importantly, no nutrient is a cure-all -- those "fiber-rich" chips probably won't change your life.
"I think it's important to never view these things as a silver bullet to all your problems," she said.
mdo/sst

environment

Blood clots, burning eyes: pollution chokes north Thailand

BY CHAYANIT ITTHIPONGMAETEE

  • But parts of northern Thailand are seeing haze that even hardened locals say is exceptional.
  • After hours spent in the thick pollution-choking parts of northern Thailand, Pon Doikam gets home and blows her burning nose to find blood clots spattered across the tissue.
  • But parts of northern Thailand are seeing haze that even hardened locals say is exceptional.
After hours spent in the thick pollution-choking parts of northern Thailand, Pon Doikam gets home and blows her burning nose to find blood clots spattered across the tissue.
"It's suffocating," the 36-year-old coconut seller told AFP in Chiang Mai, a tourist destination among the areas affected by dangerous pollution levels this week.
"It feels like you're trapped in the smoke constantly."
Seasonal agricultural burning, forest fires and weather patterns produce an annual pollution season across much of Southeast Asia.
But parts of northern Thailand are seeing haze that even hardened locals say is exceptional.
"I've lived in Chiang Mai since I was a kid, and this is the worst it has ever been," said Pon, who works outdoors all day.
"I don't have a choice," she added. "I have to come out, making a living day to day."
This week Thailand's second city, Chiang Mai, regularly topped the IQAir monitor website's most polluted big cities list.
The situation is even worse to the west in Pai, a backpacker destination known for its greenery and mountains.
Some monitors there recorded levels of PM2.5 -- particles small enough to enter the bloodstream and linked to diseases like cancer -- of over 900 micrograms per cubic metre.
That is 60 times higher than the World Health Organization's recommended 24-hour average exposure.
The area's mountainous geography makes it doubly vulnerable. Smoke is easily trapped, and the forested hillsides are hard to access when fires start. 

'Very disappointed'

AFP saw multiple blazes burning on hillsides and along roads between Pai and Chiang Mai, lighting up patches of otherwise pitch-black countryside.
Volunteer firefighters like Maitree Nuanja do their best to bolster limited local capacity, relying heavily on donations such as drinking water and face masks.
"The fire control centre gave us 20 litres of fuel and lent us leaf blowers. Once the season ends, we have to return them," he told AFP, standing before a blackened, ash-strewn stretch of land.
"Everyone can see how serious it is now. It's so dark and hazy you can't see a thing, and it's gone on for far too long."
He worries about his home next to a forest, and his health.
"We now live with this smoke, breathing it in every day."
On Wednesday, a volunteer firefighter was found dead from suspected exhaustion linked to heat and underlying health conditions, officials told AFP. 
Pollution is particularly dangerous to those with existing health problems, the elderly and children.
In Chiang Mai, the government has installed hundreds of "dust-free rooms" -- equipped with air purifiers and positive pressure systems that keep out the polluted air -- including at the retirement facility that Watwilai Chaiwan now calls home.
The retired nurse, 82, said the pollution made her afraid to go out and aggravated her dizziness and migraines.
"It's a real problem for the elderly. You have to wear a mask the entire time you're breathing this air," she told AFP.
Thailand's government held talks this week on the haze, and some districts in Chiang Mai have issued disaster declarations to help speed up financial support.
But clean air activists say more is needed, and are pushing for the government to move quickly on clean air legislation that stalled last year with the dissolution of parliament.
"A normal government would have been concerned about clean air not only now but a long time ago," said Kanongnij Sribuaiam, legal team leader at Thailand Clean Air Network, which pushed for the legislation.
If no action is taken by May 13, the legislation will expire and the process will have to start from scratch, she added.
"The public is very disappointed."

'This is shocking'

In Chiang Mai, doctor Thanakrit Im-iam was wearing a heavy-duty respirator to protect himself.
He warned that the long-term health consequences of the pollution are "devastating".
"It affects everyone because these toxins and heavy metals enter the body directly," he told AFP, describing "burning eyes, phlegm, and nasal inflammation."
The mask is his only protection, he said.
"We can't control the rest. That's up to the government."
The pollution is also increasingly a deterrent for tourists, who form a key pillar of the region's economy.
"Usually, Chiang Mai is buzzing in March and April, but this year, it's just quiet," said tuk-tuk driver Chakkrawat Wichitchaisilp.
At a viewpoint overlooking Chiang Mai, the city skyline was almost entirely obscured, with only faint outlines of hills visible through a dense grey haze and a dim orange sun hanging in the sky.
"I've taken photos from this very spot, and it's just a beautiful blue sky -- and you can see as far as the horizon," said Martin Astill, 57, a Briton who previously lived in Thailand and was visiting with his family.
"This is shocking. Never seen it as bad as this."
ci/sah/lga/fox

Mangione

Mangione federal trial over CEO murder delayed to January

  • The federal trial originally scheduled for September was delayed on Wednesday until October, and has now been pushed to January 25, 2027.
  • The federal trial of Luigi Mangione in the killing of healthcare CEO Brian Thompson has been delayed further to January 2027, according to court documents filed on Thursday.
  • The federal trial originally scheduled for September was delayed on Wednesday until October, and has now been pushed to January 25, 2027.
The federal trial of Luigi Mangione in the killing of healthcare CEO Brian Thompson has been delayed further to January 2027, according to court documents filed on Thursday.
The December 2024 shooting outside of a New York City hotel, captured on security cameras, shocked Americans while highlighting deep public anger over the country's private, often costly, healthcare system.
Mangione, 27, faces charges in both federal and New York state courts.
Both trials were delayed on Wednesday. The state trial, originally scheduled for June, was postponed until September. 
The federal trial originally scheduled for September was delayed on Wednesday until October, and has now been pushed to January 25, 2027.
Mangione's lawyers requested the delays because they argued the tight turnaround would make it impossible to prepare adequately for both.
The scheduling order filed on Thursday by US Judge Margaret Garnett said the decision was made "in light of the... decision in the defendant's state court case to adjourn the state trial to September 8, 2026." 
Defendants in the United States can be tried at both the state and federal level for the same crime, although the charges tend to differ -- as they do for Mangione. 
In New York court, Mangione is charged with murder. In federal court, he is charged with interstate stalking.
Mangione has denied all charges.
If convicted in either court he faces life imprisonment without parole.
Mangione was arrested five days after the shooting, at a McDonald's in the state of Pennsylvania -- some 230 miles (370 kilometers) from the crime scene.
pnb/mjf/mlm

Health

Armenia's underground salt clinic at centre of alternative medicine debate

BY MARIAM HARUTYUNYAN

  • At the bottom of the Avan salt mine, a dim tunnel carved from grey rock salt leads to the Soviet-era centre.
  • A mining cage drops deep beneath the Armenian capital, carrying asthma patients in helmets down into a salt cave clinic -- an alternative treatment centre whose future is now at risk.
  • At the bottom of the Avan salt mine, a dim tunnel carved from grey rock salt leads to the Soviet-era centre.
A mining cage drops deep beneath the Armenian capital, carrying asthma patients in helmets down into a salt cave clinic -- an alternative treatment centre whose future is now at risk.
State funding for the speleotherapy centre in the Avan salt mine was recently cut as the small Caucasus nation rolls out a new universal healthcare system that does not cover alternative medicine.
The fate of the facility is a snapshot of a global debate over the effectiveness and role of alternative treatments in modern healthcare, a particularly pressing issue in developing countries.
Speleotherapy -- where patients spend several hours a day in caves breathing mineral-rich underground air believed to reduce respiratory irritation -- has been practised for decades in parts of Eastern Europe and the former Soviet Union.
At the bottom of the Avan salt mine, a dim tunnel carved from grey rock salt leads to the Soviet-era centre.
"We are 235 metres (770 feet) underground, and yet this is a hospital," doctor Anush Voskanyan said as she guided visitors into a vast chamber illuminated by rows of electric lamps.
Opened in 1987 inside a former mine, the centre spans about 4,000 square metres of tunnels converted into treatment and recreation areas. For decades, patients received therapy for free under the state's healthcare programme.
But in 2019, Armenia's health ministry stopped financing the clinic, arguing that speleotherapy does not meet evidence-based medical standards required for public funding.
Annual patient numbers dropped from more than 300 to around 50.
"We struggle to pay salaries and cannot renew equipment that has not been replaced since opening," clinic director Gurgen Hakobyan told AFP, saying its future was "uncertain."

Global strategy

Globally, supporters of traditional or complementary remedies say they have been overlooked by Western medicine.
The World Health Organisation's members have called for a global effort to build a solid evidence base, regulate practitioners and integrate treatments that are proven safe and effective.
Supporters of speleotherapy say the cave environment, free from dust and allergens and with a constant temperature of around 19-20C, helps ease symptoms of asthma and allergies.
Voskanyan, the doctor, said she had seen children make full recoveries after treatment.
But the scientific evidence remains limited.
"Since 1985, only two dissertations have been written on the subject," said Lamara Manukyan, chair of the Armenian Association of Internal Medicine. 
"We lack statistics and large-scale research."
She said speleotherapy "helps conventional medicine ease a patient's condition" and should be considered a "complementary therapy rather than a standalone treatment."

'Salvation'

Armenia's health ministry said its decision to stop the clinic's funding reflects broader healthcare priorities as the country transitions toward universal medical insurance.
"At this stage, priority is given to diseases with high mortality rates such as cancer and cardiovascular illnesses," ministry spokeswoman Mariam Tsatryan told AFP. 
"Alternative and wellness treatments cannot be included in insurance coverage."
Many of the centre's patients -- and its doctors -- lament the decision to strip funding.
Armen Stepanyan, a 63-year-old engineer from Russia's Siberian city of Kemerovo, has travelled to Yerevan annually for more than a decade after developing severe asthma.
"I tried everything -- sanatoriums, treatments -- nothing helped," he said. "Here I felt improvement after the first course."
Supporters argue the centre's significance extends beyond medicine. 
Manukyan, the chair of the internal medicine association, described it as part of Armenia's tradition of natural therapies, including mineral springs and spa resorts.
"There is no reason to dismantle an existing structure and lose a valuable tradition."
The government, which holds a stake in the centre, is trying to privatise its shares, raising hopes that private investment could preserve or repurpose it as a research or medical tourism centre.
"It would be really sad if the clinic had to shut down because it simply ran out of funding," said Stepanyan, the patient.
"I realised this was my salvation. This is the only place where I see real results."
mkh-im/jc/gv

LGBTQ

US Supreme Court rules against ban on 'conversion therapy' for LGBTQ minors

  • But in a 8-1 decision, the court ruled in favor of Kaley Chiles, a licensed mental health counselor who invoked her Christian faith and challenged the law, arguing that it violated her First Amendment right of free speech.
  • The US Supreme Court ruled Tuesday against a Colorado state law banning "conversion therapy" for LGBTQ minors, siding with a Christian therapist who challenged it on the grounds of free speech.
  • But in a 8-1 decision, the court ruled in favor of Kaley Chiles, a licensed mental health counselor who invoked her Christian faith and challenged the law, arguing that it violated her First Amendment right of free speech.
The US Supreme Court ruled Tuesday against a Colorado state law banning "conversion therapy" for LGBTQ minors, siding with a Christian therapist who challenged it on the grounds of free speech.
At issue is the constitutionality of a 2019 Colorado law that prohibits licensed practitioners from conducting "conversion therapy" on patients under 18.
Proponents of the treatment claim to change the sexual orientation or gender identity of LGBTQ people.
The therapy has been discredited by major medical organizations, including the American Psychiatric Association and the American Medical Association, and is banned in more than 20 US states and much of Europe.
Research has shown that it is ineffective and even harmful, leading to depression and suicidal thoughts.
But in a 8-1 decision, the court ruled in favor of Kaley Chiles, a licensed mental health counselor who invoked her Christian faith and challenged the law, arguing that it violated her First Amendment right of free speech.
"Colorado's law addressing conversion therapy does not just ban physical interventions. In cases like this, it censors speech based on viewpoint," wrote conservative Justice Neil Gorsuch in the decision on behalf of the majority of the Court.
"As applied to Ms. Chiles, Colorado’s law regulates the content of her speech and goes further to prescribe what views she may and may not express, discriminating on the basis of viewpoint," he argued.
The First Amendment, Gorsuch wrote, is a "shield against any effort to enforce orthodoxy in thought or speech in this country."
As a result, the Supreme Court sent the case back to the lower courts to review their decisions in light of this ruling.

'Can of worms'

Only the liberal Justice Ketanji Brown Jackson expressed dissent, accusing her colleagues of opening "a dangerous can of worms" by undermining states' ability to regulate medical practices that "risks grave harm to Americans' health and wellbeing."
"The Constitution does not pose a barrier to reasonable regulation of harmful medical treatments just because substandard care comes via speech instead of scalpel," she wrote.
Chiles' lawyer, James Campbell, of the conservative Alliance Defending Freedom, hailed the ruling in a statement as "a significant win for free speech, common sense, and families desperate to help their children."
But Equality California, an LGBTQ civil rights organization, condemned the ruling, saying in a statement, "The Supreme Court is moving our country backward and into dangerously uncharted territory."
Children who have undergone conversion therapy "were taught to feel shame and self-hatred. Survivors continue to suffer from PTSD, anxiety, and suicidal ideation. As one survivor put it, conversion therapy came close to killing me," the statement said.
The group also warned that the ruling could have a "far broader" impact if "extended to vaccines, psychiatric medicine, and abortion and contraception."
After taking office for his second term in January, President Donald Trump said the US government would only recognize two genders -- male and female -- and signed an executive order restricting gender transition medical procedures for people under the age of 19.
In June, the Supreme Court voted 6-3 to uphold a Tennessee state law banning hormone therapy, puberty blockers and gender transition surgery for minors.
Conversion therapies are banned, at least partially, in many countries, with the support of health organizations such as the Royal College of Psychiatrists in Great Britain. 
The UN has called for a global ban, describing them as discriminatory, humiliating and a violation of individuals' bodily integrity.
sst/ube/mjf/bgs

US

In Beirut's largest stadium, displaced people with disabilities face 'ordeal'

BY MARGAUX BERGEY

  • More than a million people have been displaced and Israeli strikes have killed more than 1,200 people, including 124 children, Lebanese authorities say.
  • In the stands of Beirut's largest stadium, it is the shouts of children displaced by war that echo, not the songs of fans. 
  • More than a million people have been displaced and Israeli strikes have killed more than 1,200 people, including 124 children, Lebanese authorities say.
In the stands of Beirut's largest stadium, it is the shouts of children displaced by war that echo, not the songs of fans. 
Beneath the concrete steps, more than a thousand people fleeing Israeli bombs on Lebanon sleep in tents, including around 50 wheelchair users and people with other mobility challenges. 
The vast sports complex is one of the few shelters able to take in people with disabilities, despite being poorly adapted to their needs. 
"If there's a strike, the people around me could run away and leave me behind; I can't get up and move if no one helps me," said 62-year-old Fatima Nazli, who uses a wheelchair. 
The state has not put in place any strategy to evacuate people with disabilities, said Sylvana Lakkis, head of the Lebanese Union for People with Physical Disabilities. 
"We submitted a policy and proposal" to the government, but "they never listened", she told AFP. 
"Every time there is a crisis, we, people with disabilities pay the price." 
Nazli and her husband had to leave their apartment in Beirut's southern suburbs, an area that has been struck repeatedly by Israel since Lebanon was pulled into the Middle East war on March 2. 
They are living in a tent in a section of the stadium where she is forced to ask Red Cross volunteers for help to get down the flight of steps leading to the only bathrooms she can access. 
– 'Living in constant fear' –
The couple expects to move to another section of the stadium, where two access ramps and four accessible toilets were recently installed. 
In the meantime, Nazli and her husband, Abu Ali, who did not wish to give his full name, go back to their apartment from time to time to take a shower and pick up clean clothes, gripped by fear because the neighbourhood "could be bombed at any moment" by the Israeli air force.
The Camille Chamoun Sports City Stadium, on the edge of Beirut's southern suburbs, has witnessed the twists and turns of Lebanon's troubled history. 
Destroyed by bombing during the Israeli invasion in 1982 and rebuilt after the end of the civil war in 1990, it has fallen into disrepair due to a lack of funds for its upkeep.
Football legend Pele once trod its turf, and international sporting competitions have been held there. 
But the stadium has also served as a warehouse for food supplies, and Hezbollah held the lavish funeral there for its former leader Hassan Nasrallah, who was killed by Israel in September 2024. 
– 'An ordeal' –
"This place was not built to be lived in," said stadium director Naji Hammoud, who opened its doors "the next day" after the first evacuation warnings issued by the Israeli army in the southern suburbs in early March.
More than a million people have been displaced and Israeli strikes have killed more than 1,200 people, including 124 children, Lebanese authorities say.
Many displaced people are sleeping on the streets of the capital or in their cars, and Hammoud said he wants the facility to take in "as many as possible".
Around the tents, workers are busy renovating the unsanitary restrooms, installing showers and connecting them to the water supply, and hooking up electricity.
"I can't wash myself on my own, I need help," said Khodr Salem, a shopkeeper from the south of the country, who has difficulty walking and uses a crutch because of an infection in his leg. 
"We lived like kings in our homes. Our life has become an ordeal," the old man said through tears, sitting on a mattress in his tent. 
For Lakkis, Lebanon doesn't have enough accessible shelters: the few schools able to receive people with disabilities fill up quickly.
She called on authorities "to make at least one inclusive shelter in each district".
Lacking options, many displaced people therefore have to find relatives who can host them or pay exorbitant rents to landlords, explained Fadi Al-Halabi, executive director in Lebanon of the Ecumenical Disability Advocates Network. 
"The international community must take into account the needs of people with disabilities" and allocate a share of the international aid budget to them, he said. 
vid-mby/ris/lg/ser