The Crisis of Dialysis Patients in Lebanon: Promises and Pending Payments

2023-09-28 13:05:00

The crisis of dialysis patients has returned to the forefront. This crisis quickly subsides and flares up again. More than 4,000 patients are hostage to “promises” that are still pending, while doctors can no longer continue with this approach, and hospitals are raising their voices more to obtain their late payments.

Since the beginning of the year 2023, we have been revolving in a vicious circle. The head of the Lebanese Society of Nephrology has not given up on continuing to call for help and take action. He says: “Patients are between life and death, and all we receive are promises that remain ink on paper. Only reality exposes their fragility.”

Majed Deeb is one of thousands of patients who live with the sound of the dialysis machine pumping life into his body. He meets with 11 other patients in one of the towns of Zgharta to go to the hospital to receive treatment.

Deeb explained to Al-Nahar, “The suffering is great. I live on donations and humanitarian aid, and I fear that this aid will stop, which may deprive me of the opportunity to live. I am unable to work, and my brother suffers, like me, from kidney disease that forces us to undergo continuous dialysis sessions.”

Deeb talks about the differences he has noticed since the beginning of the crisis until today, “In the past, I used to undergo 3 sessions a week that cost $100, but today the number of sessions has decreased, as the cost of two sessions per week is about $240, not to mention the medicines and vitamins that we need, and if it were not for I would not have been able to pay the cost of any session.”

Deeb is one of the patients who are at the expense of the Ministry of Health, which has not paid the dues for the year 2023 so far, while it promised that within the next two weeks it will pay the dues for 5 months.

Deeb has his real concerns. He knows very well that “the situation is going from bad to worse, and this is what really worries us. My life is attached to a machine and what controls it decides our fate to live or die. We live on the impact of disagreements and promises, and we wait for the state to have mercy on us because we do not have the luxury of waiting nor the luxury of time.” A kidney patient cannot give up his sessions. I had to reduce the number of sessions and bear the burdens of this waiting, psychologically and physically, so that my condition does not get worse, but for how long?

The head of the Lebanese Society of Nephrology, Dr. Robert Najm Al-Mashhad, sums up the problem by describing the problem as “false promises. If the state adhered to its decision, it would pay all the dues due to it in the year 2023, in addition to the delay in the dues for the year 2022. The agreement was with the Minister of Health 5 months ago to dollarize the session and pay the bills.” Within a month of delivery, however, the reality is completely different, and each party, whether the Ministry of Finance, the Ministry of Health, or the Audit Bureau, is throwing the ball in the other’s court.”

What is clear is that those concerned are trying to evade paying because the government simply does not have the money and what is happening is a waste of time, according to Najm. Most importantly, no one will dare to announce and reveal this fact, and bear the responsibility of removing support for dialysis patients, and therefore what is happening on the ground is that hospitals refuse to receive new patients for dialysis. In the end, the patient, as well as the doctor, pays the price for these promises and the results of the policies followed.”

The danger today is for new dialysis patients who are at risk of death in their homes as a result of hospitals refusing to receive them. Not to mention the migration of doctors that has affected the medical sector, and the fear that the new generation of doctors we need in the future will not return to treat patients.

Najm believes that we need to see “a good faith step that reveals the truth about efforts to improve the reality of patients. We are fed up with the promises that remain ink on paper. The new agreement reached 70 percent payment in advance and 30 percent in the back, but nothing yet on the ground, and we hope that it will not happen.” The pretexts shall be ready and present when applied.”

The head of the Private Hospitals Syndicate, Suleiman Haroun, shares the same pain and the same distress with those launched by Najm, and refutes the health reality of dialysis patients by saying: “The first problem is the delay in paying dues to hospitals, and the inability of dialysis centers to receive new cases after reaching the maximum capacity, which… This means its inability to receive new patients, especially after the rise in costs, as the prices of supplies have increased more than 4 times what they were previously.”

As a result of this reality, new kidney patients suffer great difficulty in being accepted into dialysis centers, and Haroun confirms that “we are working with the Minister of Health to resolve the issue of dues and confine them to a reasonable range, in addition to adjusting the cost so that it is compatible with the new prices. Today we are negotiating with the Minister of Health and the guarantors on “The price of a dialysis session is waiting to see how things will turn out. After the cost of one session was $53, it rose to $62 after the subsidy on medical supplies was lifted, while we demand that it be raised to $68.”

The second problem that Haroun refers to is that the guarantors pay the dues in Lebanese pounds through transfers to banks that cannot be converted into dollars, while the hospital’s payments to importers are all in dollars. Therefore, today we call for accelerating its payment within a period not exceeding a month so that hospitals can buy dollars and pay importers.

It is worth noting that the Social Security Fund and Military Medicine paid the hospital dues until March 2023, while the Ministry of Health has not paid anything since the beginning of 2023, and there is a promise to pay the dues within two weeks, which will cover the five months. This means that the delay in paying dues to hospitals ranges from five months to more than a year.

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