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Henrietta Wilkins

Fighting cancer in Lebanon

The poor in Lebanon need help to afford healthcare [AFP]

Date of publication: 30 March, 2015

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Feature: One German association is battling the high cost of healthcare needed for deprived Syrian refugees arriving in Lebanon.

Dealing with childhood cancer is traumatic for anyone, but even more so when there is no money to pay for treatment.

Acute Support for Children and Adolescents in Lebanon (ASCAL) http://www.ascal.org/ is a German association that provides support for sick children and adolescents of any nationality permanently or temporarily based in Lebanon.

Established in October 2012, the association raises funds from organisations and private donors to pay for the medical treatment of those aged under 18 suffering from severe illness.

"Our focus is on cancer because it is very expensive to treat, which means people are less willing to cover the cost. However, the cure rate for children and adolescents suffering from cancer is high if they receive proper treatment," explains Mariam Younes, one of the association's founders.

The association was formed after the one-year old niece of a friend of Mariam was diagnosed with juvenile myelomonocytic leukemia, a rare form of cancer. ASCAL raised thousands of dollars for a bone marrow transplant for Myriam. The operation was successful and she celebrated her fourth birthday last month.

Lebanon has good infrastructure and medical facilities for treating individuals; the only issue is expense. The high cost of healthcare means many children and adolescents from poorer backgrounds are unable to access the necessary medical treatment.

     We have to turn away cancer patients with poor prognoses because caring for them is too expensive. 

- Paul Spiegel, a doctor working with refugees


ASCAL is cooperating with three hospitals in Beirut – the state run Rafik Hariri hospital  and the private hospitals – Geitawi hospital and the American University of Beirut Medical Center (AUBMC). Rafik Hariri and Geitawi hospitals offer good prices to those treated through ASCAL, while AUBMC gives money to help pay the children's medical fees from its own fund. It is more expensive but some treatment can only be carried out there.

The German-registered association has supported seven children directly through private funders, especially from Germany and Switzerland. Money has been raised through social media networks – especially Facebook as well as by making emails and phone calls.

Refugees from Syria

With the growing crises in Syria and the influx of refugees, the problem has become acute. Last year ASCAL heard of 43 Syrian children in Lebanon that fell ill with cancer but could not afford the healthcare.

This has created a need to change the structure of the organisation, so that it moves beyond raising money for individual cases to providing more comprehensive treatment for those in need.

In 2015, ASCAL's Lebanese volunteers will establish a similar organisation in Beirut called "Karma" to raise money through private donations and events in Lebanon and the Arab world. For example, by selling small items such as lollipops on social media or in shops and bars around Beirut and by organising garage sales, as ASCAL has already been doing.

In May 2014 UNHCR called for more to be done to help Syrian refugees living with cancer. It highlighted the fact that as well as Lebanon the number of refugees with cancer is overwhelming health systems in Jordan and Syria. This is forcing doctors to make life and death decisions over who they will and will not treat.

"We have had to turn away cancer patients with poor prognoses because caring for them is too expensive. After losing everything at home, cancer patients face even greater suffering abroad – often at a huge emotional and financial cost to their families," Paul Spiegel, a doctor who has documented hundreds of refugees in Jordan and Syria denied cancer treatment due to limited funds, quoted in a report by the Lancet Oncology.

In Jordan from 2010-2012 the UNHCR’s Exceptional Care Committee (ECC) could only fund 48 percent of refugees who applied for cancer treatment. The main reason patients were denied treatment was due to a poor prognosis, but some patients were not treated if the cost was too high however good their outlook.

UNHCR suggests new approaches to fund treatment could include mobile and online information campaigns focusing on preventative health, and new financing models such as crowd-funding.

In May 2014, Amnesty International also published a report entitled "Agonizing Choices: Syrian refugees in need of health care in Lebanon" highlighting the high number of refugees from Syria who lack access to vital healthcare due to a severe shortage of international funding.

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