"Wounded people bleeding out in the middle of the street, others lying on the ground in the hospital courtyard -- it reminded me of my missions with Doctors Without Borders (MSF) in Afghanistan many years ago," he said of his volunteer stint with the medical charity. 

The surgeon was among more than 4,000 wounded people who staggered or were taken into badly damaged and massively crowded hospitals across the devastated Lebanese capital on Tuesday evening.

The huge explosion has piled even more pressure on Lebanon's strained health sector, which before the disaster was already struggling with a wave of coronavirus cases and a severe economic crisis.

"It was Armageddon," Qurban, who is in his late sixties, told AFP outside the Hotel Dieu Hospital in central Beirut.

The facility is normally his place of work, but on Wednesday he was among throngs of patients, following up on a gash he suffered Tuesday night.  

Qurban was at a nearby coffee shop when the blast hit around 6:00 pm local time, flinging him some 20 meters (60 feet) across the room.

His own hospital was overflowing within minutes with wounded, so a stranger on a motorcycle zipped him to another facility. 

After an hours-long wait, a medic stitched up his head wound in the street.

 

'She's already dead' 

The scenes were no less chaotic on Wednesday, as people wounded overnight by falling shards of glass sought treatment, weaving between smashed equipment and piles of debris in Hotel Dieu's hallways. 

Mothers asked desperately about the fates of their wounded sons. An elderly man begged for news of his wife, who had been transferred from another hospital.

A cacophony of cellphones rang, and fragments of exhausted conversations could be heard, usually retelling survival stories. 

"A miracle kept him alive," one woman was heard saying, while a man with a bandaged leg handed a blinking cellphone to his sister, telling her simply that "I can't talk anymore".

Hotel Dieu treated at least 300 wounded Tuesday and registered 13 dead, according to its medical director Dr George Dabar, who was a medical student there during Lebanon's 15-year civil war.

"Even then, I didn't see anything like what I saw yesterday," he said.

His voice cracking with emotion, Dabar told AFP the hardest moment was telling families their loved ones had died, with nothing left to be done. 

"It's so hard to tell a father carrying his young daughter and trying to save her that she's already dead."

According to Lebanon's health ministry, two hospitals were rendered completely out of service and two more were partly unusable.

At least five nurses died, and several medics and patients were severely hurt. 

"The medical teams were already exhausted by everything that has happened in this country and by the coronavirus pandemic," Dabar said.

"But to face yesterday's crisis, they came together with amazing solidarity."

From cooks to maintenance workers, Dabar said, the entire staff was working side by side so Hotel Dieu could stay open.

 

Evacuating COVID-19 patients 

The St. George Hospital was not so lucky. The blast left the facility, one of Beirut's oldest, with collapsed ceilings and electrical wires hanging over beds showered with glass. 

"We are not in service anymore," said St. George Hospital's chief of staff Eid Azar.

"Amid the current economic situation, I don't know how much time it will take to repair," he told AFP.

Staff worked until just before dawn to evacuate patients, equipment and files.

"We did a hospital evacuation, which very rarely happens," and which included the highly sensitive transfer of 20 patients being treated for COVID-19, he said.

Azar said the emergency operation reminded him of Hurricane Katrina, the devastating natural disaster that hit the US in 2005. 

The courtyard was turned into a field clinic, where doctors in bloodied medical robes treated shell-shocked people in the open.

"There's nothing harder than evacuating a hospital filled to the brim with patients while even more wounded are coming," said Azar. 

"The hospital staff itself was wounded and we needed to transfer our own employees."

Medics carried patients from nine separate floors one by one on stretchers, as the blast had knocked out the elevators.

Without electricity or water, nurses took great risks to provide whatever life-saving support they could. 

"The hospital lights are usually on 24 hours a day -- it was completely dark," said clinical nurse specialist Lara Daher. 

"We stitched up patients by the light of our cellphones last night. I don't know how we did it. I've never seen anything like it."