Most of us take it for granted that we have access to our medical supplies, but in large parts of the world the possibility to perform ISC is extremely limited. As a result, many young people with spinal injuries in poor countries die prematurely due to kidney failure.
Hassan Balhas, a 34 year old man living in southern Lebanon, is one of lucky ones. A group of friends from Norway provide him with regular shipments of LoFric, an action that has changed his life and perhaps also saved it.
Hassan is wheelchair-bound and paralyzed from the chest down since he was shot at a military checkpoint in the harbour city of Tyr in 1989. Ever since then he has used an uridom and pressed his bladder to empty it. This has led to many urinary infections with high fevers and a more or less constant use of antibiotics, which are sold without prescription at pharmacies in Lebanon.
Hassan explains:
"When I was using the uridom I had to beat and press my bladder to get the urine out. I used the uridom constantly, carrying the bag of urine at the side of my leg - visible for everyone. The signs that my bladder was full were also visible for everyone: The spasms started in my legs…Very embarassing when I was with strangers.
The most serious result of using the uridom was the numerous urine and kidney-infections meaning I used antibiotics almost constantly. I got fever and lost weight, and the situation was some times critical.
The skin on my penis was often sore and sensitive, but was really badly hurt during the war in 2006. During the severe Israeli shelling my home was damaged for the third time in some years. In 2006 we had to evacuate from my home and live in a lousy shelter 4 weeks. There was almost no water and I had only 3 uridoms during all that time."
In 1994 when Physiotherapist Sigrid Ann Mortensen visited Lebanon on a mission for the Norwegian humanitarian help organization NORWAC she got to know Hassan. On one of her subsequent visits she brought a number of LoFric-samples with her.
Here is her description of the meeting:
“During my visit I wanted to inform Hassan and his urologist about the advantages of ISC. Since Hassan has two strictures in his urethra only a soft hydrophilic catheter can pass the strictures. A nurse talks us through the technique of ISC, by telephone from Norway . Hassan and I are smiling and making jokes when we are handling the catheters and reading brochures, and relatives and neighbours are watching with a great deal of interest. The first time is a little bit difficult but the second attempt is a success and Hassan is very pleased with the result, as all he had tried before has been stiff plastic catheters.
Both Hassan and his urologist are very positive about ISC but the big question is how to handle the cost of catheters in such a poor part of the world. Fortunately for Hassan he has the support of a group in Norway .
Since he has started ISC he does not have urinary infections and he does not have to use his uridom. He catheterizes himself with LoFric five times a day and his life is much easier and more comfortable.”