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Support for Renal Care by NGOs
13.05.2017
Nabil Karah
M.D., Ph.D.Umeå University, Sweden
Norwegian Aid Committee, Norway
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Norwegian Aid Committee
http://www.norwac.no/
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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
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Refugee life in Lebanon
• Low living conditions, especially for the most vulnerable refugees
• Major obstacles when accessing healthcare facilities
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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
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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/
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Renal Care Program
Implementing partners:
• Union of Relief and Development Association (URDA)
• Health Care Society (HCS)
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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
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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
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Syrians
Palestinians from Syria
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Syrians
Palestinians from Syria
• Causes of end-‐stage renal disease!
• Prevalence of smoking, diabetes, hypertension, and dyslipidemia!
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• 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
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Challenges
• Low rate of occurrence! -‐ 170 / 1.500.000
• Not optimal treatment-‐ Two sessions/week
• Medication (phosphate binders, vitamin D)
• Kidney transplantation
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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
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• 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
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The management of non-‐communicable diseases is of greatest need in a 7-‐years-‐old crisis