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10 MCI lessons from the Beirut port explosion

The Beirut incident commander, Dr. Shawky Amine Eddine shares insights from the largest non-nuclear explosion in history

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In August 2020, Shawky S. Amine Eddine, MD, became the EMS commander for the Beirut port explosion – the largest non-nuclear explosion in history. The blast killed 200, injured 6,500, and resulted in excess of 300,000 people suffering home damages and losses.

In terms of medical facilities in the blast area, four hospitals we rendered totally out of action, with eight further healthcare centers damaged.

The explosion added to an already pressurized healthcare system, as the country was at the height of the pandemic, as well as hosting over 900,000 refugees from war-torn Syria.

In this episode of EMS One-Stop, Dr. Amine Eddine joins host Rob Lawrence to discuss the backstory and devastation of the explosion, as well as the challenges to access, hospital capacity, communication, record keeping and the management of the dead.

Tune in as Dr. Amine Eddine shares 10 takeaways and lessons for responding to a large-scale MCI both identified from that eventful day (discussed in full in the broadcast):

  1. Don’t fish in the same lake
  2. Factor emotions
  3. Leadership tokens are earned in management and spent in command
  4. Even in crisis … plan
  5. The importance of data
  6. Decision making
  7. You are not alone – coordinate and communicate
  8. Rescuers’ wellbeing is a priority
  9. Don’t forget yourself and don’t lose yourself amidst the crisis
  10. We make mistakes

Tune in to the latest episode

About our guest

Dr. Shawky Amine Eddine, MD, is a medical doctor with special interest in prehospital care, healthcare quality management and disaster management. He has served as an EMT in the Lebanese Red Cross (LRC) since 2007 and as head of station for Damour EMS Station, and is currently acting as LRC director for learning and development, assistant EMS director for training and quality, and COVID-19 response coordinator.

Dr. Amine Eddine has commanded multiple crises including Lebanon fires in 2019, Lebanon floods in 2019, protests in 2019-2020, COVID-19 outbreak in 2020 and the Beirut port explosion in 2020. He has led the real-time evaluations of COIVD-19 response. Dr. Amine Eddine is also a disaster management instructor in the Humanitarian Leadership Diploma, offered by Global Health Institute at AUB, an assistant professor at the Faculty of Nursing of the Lebanese Red Cross and a consultant for multiple local, regional and global NGOs.

Connect with Dr. Amine Eddine:


1:00 – Introduction Shawky S. Amine Eddine, MD

1:30 – Description of EMS in Lebanon

04:43 – The role of Jerry Overton in the development of EMS in Lebanon

06:18 – Setting the 2020 scene in Lebanon.

09:00 – Ammonium Nitrate – a bomb in the warehouse

12:00 – Gathering the situation: The fog of war!

14:00 – Loss of medical infrastructure due to the blast

17:00 – EMS resources deployed

18:00 – Command and control: The UK GOLD, SILVER and BRONZE system

23:00 – Lessons identified versus lessons learned

23:50 – Don’t fish in the same lake

28:00 – Factor emotions

30:00 – Leadership tokens are earned in management and spent in command

33:00 – Even in crisis … plan

37:00 – The importance of data

40:00 – Decision making

41:40 – You are not alone: Coordinate and communicate

43:00 – Rescuers’ wellbeing is a priority

45:30 – Don’t forget yourself and don’t lose yourself amidst the crisis

48:00 – I make mistakes

Additional resources

Photos/Major Rab Crawford RLC British Army

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.