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

Highest per-capita • Lebanese : 4.4 milion concentration of refugees • : 450.000 worldwide

• (persons per square km): 424.4

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

• Syrian refugees: >1.7 million Huge load on the host country’s economy and • Palestine refugees from : 45.000 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)

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

22.09.2015 – 30.09.2016 01.10.2016 – 28.02.2017 01.03.2017 – 28.02.2018

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

http://www.norwac.no/ Renal Care Program

Implementing partners:

• Union of Relief and Development Association (URDA)

• Health Care Society (HCS) Lebanon-wide distribution

Dar Al-Shifaa Hospital Al-Bashaer Medical Center Al-Koura Hospital Sir El-Diniyyeh Hospital

Makassed General Hospital Rafik Hariri University Hospital Elias Haraoui State Hospital Shtoura Hospital

Saida State Hospital Al-Hamshari Hospital

Iklim Health Foundation Hospital Siblin Hospital

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

1,558 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 Palestinians from Syria

Syrians • Causes of end-stage renal disease!

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

Palestinians from Syria

Syrians Challenges

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

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

• Finding the right local partner(s) 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 Challenges

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