Les soins palliatifs au Liban, un essor freiné mais une résilience à toute épreuve

Abstract

The history of palliative care in Lebanon is marked by resilience and perseverance. Supported by personal initiatives, legislative battles and private donations, Palliative Care has managed to gradually anchor itself in the medical landscape, despite the meager means offered by the State. The delivery of Palliative Care in Lebanon has the particularity of being supported mainly by non-profit NGOs, whose operation is halfway between French HAD (Home hospitalization) and EMSP (Mobile palliative care units) and which offer free care to patients. More than 30% of patients followed by the NGO BALSAM suffer from chronic non-cancerous diseases. Pediatric palliative care is almost non-existent, with BALSAM being the only NGO providing support for children in their homes. Faced with the major financial difficulties facing the country, these NGOs are now turning to international partnerships, both to ensure the means to pursue their missions, and to reserve a place on the world stage. The Lebanese model developed by BALSAM is presented in developing countries as a possible example of operation in a crisis context. A delegation from the Medical-Chirurgical Center for Rehabilitation of Massues (CMCR) in Lyon also intervened at the Rafik Hariri Hospital Center in Beirut to discuss three themes: management, rehabilitation and palliative care. The same difficulties that we encounter in France regarding the temporality of intervention in care could be noted: It is uncommon for Lebanese medical colleagues to seek palliative care support early. The place of palliative care within the hospital institution is still new, and the resources allocated are too low, both in terms of nursing time and suitable premises. The road remains long, but everything is being done to ensure that palliative care continues to be talked about and extends ever deeper within the Lebanese health system.