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 Highest per-capita • Lebanese population: 4.4 milion concentration of refugees • Palestinian refugees: 450.000 worldwide • Population density (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 Syria: 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 Beirut - 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 .