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黎巴嫩境内流离失所的癌症儿童:对一场前所未有危机的持久应对。

Displaced children with cancer in Lebanon: A sustained response to an unprecedented crisis.

机构信息

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee.

出版信息

Cancer. 2018 Apr 1;124(7):1464-1472. doi: 10.1002/cncr.31273. Epub 2018 Feb 28.

Abstract

BACKGROUND

The unrest in Syria has resulted in an escalating refugee crisis. The postwar lack of health care infrastructure in Iraq has also resulted in Iraqis seeking health care in neighboring countries. Pediatric cancer is largely curable, although its treatment is expensive and complex. Strategies to implement pediatric cancer care with curative intent in these vulnerable populations are lacking.

METHODS

To assess the feasibility of a collaborative approach for the provision of care to displaced children with cancer, this study reviewed the experience of the authors over the past 6 years in Lebanon, the country with the highest number of refugees per capita in the world.

RESULTS

The American University of Beirut Medical Center and the Children's Cancer Center of Lebanon Foundation, in partnership with St. Jude Children's Research Hospital and the American Lebanese Syrian Associated Charities, established 3 successive funding programs to treat displaced children with cancer along with a continuous assessment of resource utilization. Between 2011 and 2017, 575 non-Lebanese children suspected to have cancer were evaluated. Of those, 311 received direct medical support, with 107 receiving full-treatment coverage and 204 receiving limited-workup/specialty services; the remaining 264 patients received medical consultations.

CONCLUSIONS

In addition to providing lifesaving humanitarian support, the coordination of care delivery, including the establishment of guidelines for prioritization, can help direct future efforts. Many patients continue to be in dire need of support, and this should be addressed via collaboration among governmental, nongovernmental, and health care organizations. Cancer 2018;124:1464-72. © 2018 American Cancer Society.

摘要

背景

叙利亚动乱导致难民危机不断升级。伊拉克战后缺乏医疗基础设施,也导致伊拉克人前往邻国寻求医疗服务。儿科癌症的治疗效果很好,但治疗费用昂贵且复杂。在这些弱势群体中实施以治愈为目的儿科癌症治疗的策略还很缺乏。

方法

为评估为流离失所癌症儿童提供关怀的合作方法的可行性,本研究回顾了作者过去 6 年在黎巴嫩的经验,黎巴嫩是世界上人均难民人数最多的国家。

结果

贝鲁特美国大学医学中心和黎巴嫩儿童癌症中心基金会与圣裘德儿童研究医院和美国黎巴嫩叙利亚慈善协会合作,先后设立了 3 个供款方案,为流离失所的癌症儿童提供治疗,并对资源利用情况进行持续评估。2011 年至 2017 年,有 575 名非黎巴嫩籍疑似癌症儿童接受了评估。其中 311 人接受了直接医疗救助,107 人获得了全面治疗,204 人接受了有限检查/专科服务;其余 264 名患者接受了医疗咨询。

结论

除了提供拯救生命的人道主义支持外,协调医疗服务的提供,包括制定优先排序指南,也有助于指导未来的工作。许多患者仍迫切需要支持,这应通过政府、非政府和医疗机构之间的合作来解决。癌症 2018;124:1464-72。© 2018 美国癌症协会。

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