Chronic Disease Program in Palestina
December 21st, 2009 | 
Author: Introduction:
Chronic diseases are the leading cause of death worldwide, and continues to impact on the health of the world’s population is increasing. Die approximately 17 million people around the world each year as a result of chronic diseases.
In the past, rich and civilized communities are most at risk of high blood pressure, high cholesterol, tobacco use and excessive consumption of alcoholic drinks and the prevalence of obesity and lifestyle based on lack of exercise and physical activity. However, these risks and associated diseases is spreading in middle-income countries or low,
No longer limited to rich countries as it was widely believed in the past. Even more than that, it cause the double burden of developing countries is added to the burden of infectious diseases that continue to affect strongly on the poorest countries in the world.
Can be for one or more of the risk factors listed above contribute to the onset of any chronic diseases, which include diabetes and cardiovascular disease (including hypertension and strokes), cancers and chronic lung diseases. The increasing prevalence of these diseases are responsible for about 60% of deaths in the world (31.7 million deaths) and 43% of cases of the disease in the world. The share of middle-income countries or low 77% of the total deaths and 85% of the total conditions linked to chronic diseases. The mortality and morbidity of these has been growing in the world with what was done to the inherent dangers of the economic and social development of the various peoples of the world, along with the cause of disability and mortality of millions of people. It is clear that the increasing impact of these diseases is linked to the change on the patterns of global nutrition and increased consumption of processed foods with a high content of fat, salt and sugar. The noted Palestinian Ministry of Health in its annual report for 2003 that it considered that chronic diseases caused by nutrition, unhealthy eating habits are no longer as serious as diseases resulting from lack of nutrition.
The development of chronic diseases in Palestine:
Palestine undergoing transition in terms of epidemic diseases, as well as in terms of food consumption patterns, which accompanies the aggravation of the impact of chronic diseases on Palestinian society, especially diabetes, hypertension, cardiovascular disease, cancer and others. While this continues, it is still suffering from the traditional communicable diseases and environmental problems.
The risk factors related to chronic diseases common in the Palestinian society. Tobacco consumption is one of the highest in the world, as well as spreading food intake rich in saturated fats and simple sugars, as well as lower consumption of foods rich in fiber and whole grains and complex carbohydrates.
There is evidence of high prevalence of some chronic diseases in Palestine. The prevalence of type II diabetes is estimated at about 10%. In the absence of any detailed and reliable data on the prevalence of chronic diseases and risk factors of injury in Palestine, the data collected through medical relief services are frighteningly relevant to the prevalence of these diseases. These data were the result of five years of work in the Ramallah area (mainly in the villages), where a team of a program for the prevention of chronic diseases will collect data on these diseases and risk factors related to it. Frequency of the service people over the age of 35 years on a voluntary basis were examined sugar in their blood, as well as the level of fat, blood pressure, weight, height and other risk factors. After collecting data for about 6000 people and analyzed (Fig. men 69% of the total and women 31%), the data indicate the presence of hypertension in 27% of them, and type II diabetes in 18% of them, with the back of disorder level of fat in 40%.
Chronic diseases are the leading cause of death among adults in the Palestinian society. The report of the Ministry of Health in 2001 indicates that diabetes, cancers, cardiovascular diseases, including hypertension and stroke, contribute to more than 50% of the causes of death among adults. If we take into account the current situation of health services and high levels of poverty, it becomes clear to us how much is imperative that special attention is paid to disability resulting from chronic diseases.
Chronic disease program in medical relief:
Established a medical relief program in 1999 in response to the growing need to combat chronic diseases. The program focuses on early detection of chronic diseases and improve the practices used in dealing with them. It was in 2000, and the generous support of the Austrian Government, the establishment of pilot follows an integrated approach in dealing with chronic diseases. In 2005, the Austrian Government supported a new phase in the work of the Centre and the Programme of chronic diseases. This represents an extension phase of the achievements that have already been achieved in the past five years, which will expand chronic disease management services to include new centers for primary health care. The evaluation team felt that the values of the Austrian program in 2004 that medical relief has largely succeeded in building a health model for prevention of chronic diseases can be implemented and integrated in all primary health care centers easily.
The program provides its services through:
• mobile clinic, which focuses on screening and early detection of chronic diseases and risk factors. Working in the Ramallah area and contribute to the delivery of services to the villages and sites disadvantaged and remote areas or those living in difficult circumstances closures and curfews.
• Centre of chronic diseases in Ramallah, which works to adapt a holistic approach in the management of chronic diseases.
• Dealing with chronic diseases in primary health care centers of medical relief in various parts of the West Bank, with the hope of expanding this service to include the Gaza Strip as well.
The number of visits to the beneficiaries of the program’s services to primary health care centers 7000 visit of both sexes. The program began implementation of the plan to better control diabetes in three locations, is the authorization and Aboud, Sinjil. Within the plan, to be followed up 400 patients in these three clinics, and hold them to check your blood sugar free, as are follow-up cases, depending on community participation in the Plan of case management.
Accordingly, the formation of groups of patients and their families and their members to work together to improve awareness and control of the disease in these patients. Although it is too early to judge the experience, but that the results of tests after three months and six months indicates an improvement in the situation of patients compared with the results of preliminary tests.
Centre for Chronic Diseases:
The Center is one of the best-equipped health centers in the Ramallah area and has the technical capacity available to serve as a diversion for patients with chronic diseases. The work of the Centre on prevention, early detection and proper management of chronic diseases.
The members of the crew of the center of scientific competence and the overall experience required by the program. They received the necessary training to their work, and they keep in touch with an academic at the Institute of Community and Public Health at Birzeit University.
Strategy:
The overall objective of the program: to contribute to reducing economic and social burden of chronic diseases on Palestinian society.
End of the program: develop the capacity of 60 clinics to primary health care in the prevention of chronic diseases, early detection and management to become a model in the proper handling of chronic diseases in Palestine.
Output of the program:
1. Develop the capacity of 60 doctors and a doctor and 120 nurses and health worker in the 60 clinics (including the centers of primary health care of the Ministry of Health and institutions of another civil), including help to improve the treatment of chronic diseases through a holistic approach and provide guidance for patients with chronic diseases.
2. System for transfer of patients to the center of chronic diseases.
3. Raise the level of community awareness about chronic diseases in 60 locations in four large-scale campaigns.
4. The introduction of chronic disease management programs in the policies and strategies of the main subject (the other parties to provide health care) in a clear and explicit.
The program will seek to build on the accomplishments already achieved in the period 2000-2004 through the work of medical relief on the implementation of the previous phase of the program. During that period, the medical relief succeeded in building a model for the prevention of chronic diseases and provide care for the target groups. Also succeeded relief to build on the rich experience in working with rural and urban populations using a holistic approach that combines preventive and curative services at primary, secondary and promotion of healthy lifestyles, taking into account the circumstances of psychological pressure constant caused by the political situation an emergency and cultural considerations of the Palestinian society.
Components of the second phase of the program:
Program strategy consists of three major components contribute to jointly build the capacity of primary health care centers to deal with chronic diseases.
Focus of the first component of the program to build technical capacity and logistics in 60 clinics over three years. This includes providing support and training for doctors, nurses and health workers on best practices in dealing with chronic diseases. In addition, the program will contribute to provide clinics target equipment, equipment, manuals and medical reference on prevention and early detection of chronic diseases.
The program will also transfer system for cases that can not be dealt with at the level of the targeted clinics, so it is converted to the center of chronic diseases in Ramallah. It is worth mentioning that the program has developed a computerized management information system to improve communication, reporting and collection of data regarding the management of chronic diseases.
The second component includes activities aimed at raising community awareness about domestic measure of chronic diseases. The implementation of these activities in parallel with capacity-building activities to ensure coordination and complementarity in the efforts to achieve the overall objective of the program.
The third component aims to improve the level of coordination among the providers of health care in Palestine will contribute to the improvement of dealing with chronic diseases. This coordination aims mainly to facilitate the transfer of knowledge accumulated by the medical relief during the past five years in the management of chronic diseases so that the benefit of primary health care facilities run by other national health institutions. This will be coordinated with the component-oriented activities to build capacity.
Heart disease in children (congenital heart disease):
It is estimated that one child out of every 1000 children born alive to suffer from congenital heart disease. Although the magnitude of this health problem and cause suffering, but it does not exist in Palestine of a specific policy to deal with them.
Our program has sought to deal with this issue since 2002 in order to alleviate the suffering of sick children and their families, through the introduction of specialist visits and sending children for treatment abroad.
Has been since the beginning of this year, the organization of the jurisdiction of a monthly clinic to serve these patients, offering early detection of congenital heart disease, diagnose, and assist in providing opportunities for surgical treatment and provide follow-up mechanisms. To this end, the Palestinian doctor from the city of Nazareth, a specialist heart disease in children visited the center in Ramallah for the detection of these children.
This service has helped reduce the burden on the families of these children and provided them traveling to Nazareth in order to detect when the doctor in charge. This doctor detects 10 to 14 children at each visit. Is also providing the necessary services to a number of additional patients by heart disease clinic run by the Centre within his habitual