AMMAN, 22 July 2007 (IRIN) - Despite the fact that a quarter of the health supplies budget of the UN Agency for Palestinian Refugees (UNRWA) is spent on diabetes and cardiovascular drugs, the cost of a secondary drug used to treat complications, called statin, is too high. Any refugee requiring this drug is obliged to try and purchase it privately.

"Anyone in Jordan who seeks treatment in an UNRWA-run clinic could be gambling with his life," said Ahmed Abdullah, 53, a Palestinian refugee from Baqaa camp near the Jordanian capital, Amman. He recalled how he almost died when he could not get proper treatment.

Abu Hamdi is diabetic and has regularly been visiting the Baqaa health clinic for the past eight years. During that period he had three heart attacks; one almost cost him his life.

"After having treatment for eight years I was told by several doctors that the medication I received at an UNRWA clinic was insufficient," he said.

Statin

When Abu Hamdi was rushed to hospital suffering from chest pain, doctors told him he should have been given a medicine called statin - an essential drug prescribed alongside insulin to reduce the amount of fat in the body to avoid serious complications, including heart attacks.

When Abu Hamdi asked UNRWA doctors for the medicine, he was told the clinic did not provide this medication and he must buy it from a private pharmacy.

"I trusted the doctors with my life, but they never told me I needed this medicine, even if they did not have it," he said.

Patients who wish to purchase this essential drug must pay US$56 a month. For Abu Hamdi this is an astronomical amount as he struggles to feed his seven children by selling vegetables in a local market.

"I cannot afford to buy other medications. I will have to continue relying on what UNRWA gives me. I have no choice," he said.

UNWRA health programme

The UNRWA health services programme, which is basically community health-oriented, caters for nearly 1.2 million Palestinian people in refugee camps and towns around the kingdom.

The programme provides comprehensive primary healthcare services to eligible refugees, including preventive and curative medicine, environmental health services and a family planning service.

Tens of thousands of patients flock to UNRWA clinics every month from various refugee camps around the kingdom, seeking free medication and treatment. Treatment in the private sector is out of reach for many impoverished refugees, leaving them without any choice but to rely on what they are offered by UNRWA.

Officials from UNRWA conceded that statin was not provided to chronically ill patients or those with heart conditions. They said the cost was too high.

"One quarter of UNRWA's total expenditure on medical supplies was spent on medicines used for diabetes and cardiovascular diseases. However, a lipid lowering agent [statin], an important medicine used for secondary prevention of complications of these diseases, has not been introduced yet due to financial reasons," said Abdullah Qudsi, an assistant information officer at UNRWA.

He said UNRWA's list of drugs preferred for use was last updated in 2005 and was consistent with World Health Organization (WHO) recommendations.

The UN allocated around US$21 million annually for health services at 24 health centres around the kingdom in Amman, Zarqa, Irbid and Jerash, and Aqaba. Most health centres are located in 13 camps for Palestinian refugees, while others are located in towns and major cities across the kingdom.

Figures show the agency paid more than $1.2 million for the treatment of refugees in government-run hospitals. UNRWA does not have its own hospitals, so it refers more serious cases to public hospitals.

Dr Usama Akeh, chairman of the Atherosclerosis and Hypertension Society, part of the Jordan Medical Association, said UNRWA is morally and legally obliged to dispense all necessary medication to diabetic patients and to those suffering other chronic conditions. He said any patient suffering from diabetes must be given statin to prevent blood clotting and heart attacks.

"We call on UNRWA to live up to its responsibility and treat its patients with the best care possible," Akeh said.

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