Support  for  Renal  Care  by  NGOs

13.05.2017

Nabil  Karah

M.D.,  Ph.D.Umeå  University,  Sweden

Norwegian  Aid  Committee,  Norway

Norwegian  Aid  Committee

http://www.norwac.no/

Demographics  of Lebanon

• Lebanese  population:  4.4  milion

• Palestinian  refugees:  450.000

• Population  density  (persons  per  square  km):  424.4

• Rate  of  natural  increase  (per  1.000  population):  7.9

• Syrian  refugees:  >1.7  million

• Palestine  refugees  from  Syria:  45.000

Highest  per-­‐capita  concentration  of  refugees  

worldwide

Huge  load  on  the  host  country’s  economy  and  

infrastructure

Refugee  life  in  Lebanon

• Low  living  conditions,  especially  for  the  most  vulnerable  refugees

• Major  obstacles  when  accessing  healthcare  facilities

Health  status  and  health  needs  of  older  refugees  from  Syria  in  Lebanon

• A  majority  reported  their  health  as  poor  (54%)  or  very  poor  (12%).

• A  majority  indicated  that  their  health  has  gotten  worse  since  coming  to  Lebanon  (66%).  

Strong  et  al.  Conflict  and  Health   (2015)  9:12  

Renal  Care  Program

Target:  Refugees  in  Lebanon  (Syrians  and  Palestinians  from  Syria)

Beneficieries:  197  patients  (182 Syrians  +  15  Palestinians  from  Syria)

MEU-­‐17/0001LBN-­‐16/0013LBN-­‐15/0017

22.09.2015  – 30.09.2016   01.10.2016  – 28.02.2017 01.03.2017  – 28.02.2018

http://www.norwac.no/

Renal  Care  Program

Implementing  partners:  

• Union  of  Relief  and  Development  Association  (URDA)

• Health  Care  Society  (HCS)

Lebanon-­‐wide  distributionDar  Al-­Shifaa  HospitalAl-­Bashaer  Medical  CenterAl-­Koura  HospitalSir  El-­Diniyyeh  Hospital

Makassed  General  HospitalRafik  Hariri  University  Hospital

Saida  State  HospitalAl-­Hamshari  Hospital

Iklim  Health  Foundation  HospitalSiblin  Hospital

Elias  Haraoui  State  HospitalShtoura  Hospital  

Sep-­‐15        Oct-­‐15      Nov-­‐15        Dec-­‐15        Jan-­‐16          Feb-­‐16      Mar-­‐16        Apr-­‐16        May-­‐16        Jun-­‐16          Jul-­‐16          Aug-­‐16        Sep-­‐16   Oct-­‐16          Nov-­‐16          Dec-­‐16        Jan-­‐17

1,558  sessions

14,796  sessions

Sep-­‐15        Oct-­‐15      Nov-­‐15        Dec-­‐15        Jan-­‐16          Feb-­‐16      Mar-­‐16        Apr-­‐16        May-­‐16        Jun-­‐16          Jul-­‐16          Aug-­‐16        Sep-­‐16   Oct-­‐16          Nov-­‐16          Dec-­‐16        Jan-­‐17

Syrians

Palestinians  from  Syria

Syrians

Palestinians  from  Syria

• Causes  of  end-­‐stage  renal  disease!

• Prevalence  of  smoking,  diabetes,  hypertension,  and  dyslipidemia!

• Funding  -­‐ 1,300  USD  (1  patient,  1  month)-­‐ 1,500,000  USD  (100  patients,  1  year)

• Cooperation  &  coordination-­‐ UNHCR  -­‐ Norwegian  embassy  in  Beirut-­‐ Lebanese  Ministry  of  Public  Health-­‐ Syrian  American  Medical  Society-­‐ Qatar  Red  Recrecent  Society

• Finding  the  right  local  partner(s)

Challenges

Challenges

• Low  rate  of  occurrence!  -­‐ 170  /  1.500.000

• Not  optimal  treatment-­‐ Two  sessions/week

• Medication  (phosphate  binders,  vitamin  D)

• Kidney  transplantation

Challenges

• Awareness  of  patients  and  their  families-­‐ Self  care  at  home  (diet)

• Prevention  of  end-­‐stage  renal  failure-­‐ Diabetic  nephropathy-­‐ Hypertensive  nephropathy

• Mortality  rate,  unnecessary  death,  overall  health  condition,  HCV,  anemia-­‐ Syrians  vs.  Lebanese

• Funding  -­‐ 1,300  USD  (1  patient,  1  month)-­‐ 1,500,000  USD  (100  patients,  1  year)

• Cooperation  &  coordination-­‐ UNHCR  -­‐ Norwegian  embassy  in  Beirut-­‐ Lebanese  Ministry  of  Public  Health-­‐ Syrian  American  Medical  Society-­‐ Qatar  Red  Recrecent  Society

• Finding  the  right  local  partner(s)

Challenges

The  management  of  non-­‐communicable  diseases  is  of  greatest  need  in  a  7-­‐years-­‐old  crisis