The Pediatric Clinic thrives to embrace children of all ages with expert pediatric care. Our team offers a wealth of services to patients with careful attention to their medical histories, individual needs, as well as the needs of their immediate family.

We provide one-to-one education to the parents of the children, preventive campaigns such as vaccination and treatment for the children who need immediate counseling by the pediatrician.

In the clinic, we serve children from birth to young adulthood, providing them with access to cuttingedge diagnostic and treatment resources, as well as a total commitment to family-centered care and the management of both every day and terminal illnesses.

Through its evidence-based holistic approach, the clinic offers the following services:

• Health maintenance care, including postnatal care, well-child exams, screening developmental delays, and immunizations
• Management of chronic health conditions in children
• Care for acute illnesses
• Referral to specialists, when needed, and care coordination
• Patient education and follow-up
• Malnutrition screening and assessment for all children below 5 years of age

In this unit we provided service and care to 24,270 patients visit during 2019 including our outreach services inside the Armenian schools by providing health checkups for the students.

Based on our community needs and our doctors’ recommendations, new pediatric sub-specialists joined our team: pediatric neurology and general surgery, added to our pediatric cardiologists and dermatologist. We started the year with only 9 pediatricians and ended it with a very dedicated team of 13 pediatricians.

The Registered Nurses played a very important role in this unit as they were empowered to vaccinate the children alongside the pediatricians because of the high load of daily cases

The Obstetric and Gynecologic Clinic provides a wide array of services that cater to the needs of every woman at every age. We believe women need to take an active role in staying healthy through preventative care and specialized medical treatments.

The clinic strives to offer quality services to women seeking professional health care. These services emphasize preventative measures besides the curative ones. Along with prenatal and preventive care, the clinic also plays a major role in promoting the concept of family planning. The services we offer include the following:

• Antenatal care for pregnant women and neonatal genetic screening and counseling
• General gynecologic care and routine primary care for women of reproductive age
• Postpartum care, PAP smear and mammography
• Counseling and prescriptions for different types of family planning methods, including emergency contraception
• Early detection of fertility problems and care for menopausal women
• Health education and promotion through educative campaigns
• Sexual dysfunction screening, counseling and treatment
• Lactation counseling
• Sexually transmitted infections screening and treatment

These services were provided to women of all backgrounds, religions and ethnicities, all the while respecting the privacy of each individual, and her cultural and social norms.

The OB-GYN Clinic has touched the lives of many women, and continues to remain loyal to its core mission: offering high-quality care for women through its holistic approach.

Our midwives, Ghada Gabriel Hanna and Iman Chacour added tremendous value and care in this unit as they followed up on the cases, provided one-to-one counseling and care, educated women about the importance of breast feeding, family planning, post-partum depression, antenatal care, referred new born babies to our pediatric and vaccination unit, followed up and trained the students coming from the school of midwifery from USJ and the Lebanese University, helped and followed up with the OB-GYN residents.

Family planning counseling improved through the last several years. This was attributed to many factors that was offered in the center. The main cornerstone was the counseling that was done by the medical team including doctors, our midwife and nurses from one side and the supporting stakeholders from the other side. Nevertheless, many educational charts were present in the unit that helped in spreading the new culture among the clients in the center. Another important aspect was the initiation of counseling from the time of pregnancy, in which this will lead to an easy decision in the post-partum period. In addition, and abiding to the international recommendation’s ultrasounds were done before and after each intrauterine device insertion. Nevertheless, risk assessment for oral contraception is done before prescribing any medication.

Feto-maternal Medicine in K-PHC

The center is equipped with a well formed ultrasound that can help the department of obstetrics and gynecology perform the regular morphology scans. This will help in easier detection of anomalies or any high-risk pregnancy. It is important to note that the center is recruiting feto-maternal medicine doctors who can make the diagnosis easier and more rapid.

Women’s Health Screening at K-PHC

In addition to the obstetric care, the center focuses on the gynecological health of women in which it screens for gynecological cancers as cervical cancer through Pap smears. Besides, it screens for breast cancer through mammography and breast ultrasound. The center also through the ultrasound may help in diagnosis of associated malignant signs of both ovarian and endometrial cancer. To note, as success stories, HIV was detected in a patient through regular screening. Moreover, the center screens for other health issues as osteoporosis, diabetes, dyslipidemia and others.

OB-GYN Clinic’s Role in Education

The center does not only provide medical service, yet it also provides an extra educational service for many universities as Beirut Arab University (BAU) and American University of Beirut Medical Center (AUBMC). This is through the shadowing of BAU students with the doctors of the center and through the practice of the OB-GYN AUBMC residents in the center, which added value to our services provided.

OB-GYN Clinic and Refugees

After the Syrian crisis, the majority of the patients are Syrian refugees. This has given the center a big boost of work, in which it appealed for many refugees as a referral center. Yet, this did not stop the attraction of other nationalities to visit the center. This was due to several plans that was assigned by the administration for keeping this appeal and not shifting the image of the center to a refugee center.

Family Medicine doctors at K-PHC are divided into 6 Family Medicine Physicians and 19 Family Medicine Residents who are referred from 3 medical schools (American University of Beirut, University of Balamand and the Lebanese University).

The collaboration with these renowned medical schools has benefits both for their residents through teaching activities and for our center and beneficiaries for the high quality of care they are receiving through expert opinions, evidencebased medicine and awareness and educational campaigns.

FM doctors are the ones who see the patients coming for the first time to Karagheusian. They have to deal with all their complaints (acute and chronic) besides checking all their prior conditions / medications / laboratory tests… and properly documenting everything in the chart before deciding the need to refer to a specialist.

One doctor for all

Eighty percent of the patients’ conditions are diagnosed and completely treated by the family medicine doctors without the need for any referral. K-PHC is implementing the concept of primary care gatekeeping to decrease the burden on specialists and provide each patient with holistic medical care.

Home care

The Family Medicine Physicians also conducted Home care outreach services by providing primary care consultation services for the people with disabilities and elderly population who are either bed ridden or are unable to visit our center. During 2019 we were able to do 154 home visits providing care for the disabled and the elderly.

Diagnostic tests

The Family Medicine physicians, after consulting the patients, are responsible for ordering the necessary diagnostic tests to diagnose properly the patients’ condition. At K-PHC, we can provide basic laboratory tests for patients (CBCD, Creatinine, liver functions, lipid profile…) and ultrasound services from a diagnostic radiologist who comes weekly. Thanks to our collaboration with Saint Marc Diagnostic Center, we are able to provide patients with the rest of their needed blood tests, imaging and more advanced investigations (stress test, EEG, MRI…). All results are communicated between St Marc and our medical director to ensure proper follow up on critical cases.

Referrals to our chronic department

When needed, patients are referred from the FM clinic to the Chronic Care Unit which includes the following specialties:

Cardiology: 4 cardiologists come once a week each to perform cardiac patients’ consultations and echocardiograms for adults when needed.

Endocrinology: 2 endocrinologists are covering 3 consultation days weekly.

Gastro-Enterology: 3 doctor comes twice weekly and performs gastroscopies for adults when needed.

Nephrology: 2 nephrologists are coming 2 times per month.

Musculoskeletal Clinic / Joint Clinic / Sports Medicine Clinic: 3 doctors come twice per month to assess patients with chronic joint pains and perform joint injections when needed. This new clinic has been added this year to the already existing 4 units of the chronic department.

The daily presence of the FM residents and the FM doctors and chronic specialists enables the center to receive more patients by having daily morning and afternoon clinics, to provide them with timely quality of care, and open collaborative opportunities to the special or critical cases.

Referrals to outside secondary specialists

Sometimes FM doctors need to refer patients to specialists that are not present at K-PHC (Orthopedist, Neurology, Dermatology…). In this setting we formed more collaborations with university hospitals to receive our patients for reduced fees. K-PHC developed a special referral sheet where all the details of our patient are filled and sent to the specialist at another institution. This sheet resumes the case and permits K-PHC doctors to know what happened at the other institution when the patient consults a specialist there.

The current collaborations are with:

• American University of Beirut Medical Center (AUBMC) Out Patient Department (OPD)
• University of Balamand (UoB) Out Patient Department (OPD)
• Hôpital Libanais Geitaoui – Centre Hospitalier Universitaire

Referrals to secondary care – Hospitals

Despite all doctors’ efforts to keep the patients in good health, sometimes patients, mainly the elderly population, need to be admitted to the hospital for complications of diseases.

To be able to follow up on our patients, collaborations happen at all levels:

1. FM doctor and medical director / administration team
2. FM doctor / medical director and social team
3. K-PHC and patients’ family in charge
4. K-PHC and Governmental Hospitals

The special referral form is used to send the patient with all the needed medical information, results of tests already done, suggestions for work up at hospital… The patient, with the help of our social department, is sent to one of the governmental hospitals nearby that we have collaborations with:

• Karantina Governmental Hospital
• Baabda Governmental Hospital
• Daher El Bachek Hospital
• Rafic Hariri University Hospital

The social department is in charge of following up on the status of the patients during their stay at the hospital and after their discharge, to organize the follow up visit with our doctors and the needed interventions to continue the hospital’s instructions (walking aid, physical therapy, wound care…).

Preventive and Educational Campaigns

The specialty of family medicine or primary care, is the one in charge of advocating for prevention of diseases. Our FM physicians apply the pillar of primary health care stated by the World Health Organization (WHO) as “Primary care and essential public health functions: through prevention and early detection of diseases”.

FM Physicians at K-PHC are involved throughout the year, in educational and awareness campaigns done for our community and beneficiaries, regarding multiple health issues that could lead to prevention of diseases. They are also involved in keeping the students healthy by participating to school health check-ups (general examination, dental, visual, immunization…) and following up on the diagnosed cases.

Non-Communicable Disease (NCD) Screening

Non-communicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors. The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, diabetes and dyslipidemia.

Those dysregulations in blood sugar, blood lipids (Triglyceride and Cholesterol), and blood pressure are the cause of 71% of all deaths globally as per the WHO.

Detection, screening and treatment of NCDs are key components of the prevention of death due to cardiovascular diseases, cancers, respiratory diseases and diabetes.

As part of our work as a primary care center in preventing diseases, K-PHC actively performs daily screening of the Non-Communicable diseases systematically to all visitors of K-PHC who are above the age of 40. Patients who are identified as being at moderate to high risk of having NCDs are directly referred to our FM physicians for proper education, evaluation and order of necessary investigation

The mission of the Dental Clinic is to promote oral health through preventive screening methods and treatment as well as through educational campaigns. Experience has revealed that dental care has a huge impact not only on individuals’ physical health but also on their psychological and social well-being. For this reason, we have developed our skills, updated our equipment, and collaborated with leading educational institutions to offer high quality care to our community.

Dental caries, the disease process that causes tooth decay, is the most prevalent childhood disease. According to the United States Centers for Disease Control and Prevention (CDC), it affects children aged 2 to 5 and half of those aged 12 to 15. Numerous factors besides income and ethnicity can determine oral health status: educational level, age, language barriers, cultural factors, oral health literacy, the ability to perform daily oral health care, unhealthy behavior such as neglecting to brush and floss, and bad nutrition also can adversely affect dental health.

Based on the recommendations of CDC, our clinic offers its services in two ways:

• Preventive and screening care through education about oral hygiene and dental health care using creative methods and during school health supervision.
• Curative care through dental assessment and treatment of oral diseases.

The Dental Clinic operates in collaboration with the Faculty of Pediatric Dentistry at l’Université Saint-Joseph. Through their unique ways, the pediatric dentistry doctors have changed the perception of dentists and dental check-ups in the minds of our children, which has led to an increase in the number of visits to the Dental Clinic.

Parallel to its work at the Center, the Dental Clinic plays a major role in our school health supervision. Beside performing assessments, the dental team provides students with toothpaste and toothbrushes as well as health sessions to promote dental health in schools.

We believe that every child has the right to smile confidently. It is their right but our responsibility to make sure that they know how to take care of their teeth and when to consult us to receive the best care.

In recent years, the Ophthalmology Clinic has emphasized the importance of comprehensive eye examinations and vision screenings by promoting high quality ophthalmic care in schools and in the clinic.

For children especially, eye health plays an important role in normal development, since vision is closely linked to the learning process, and children who have trouble seeing or interpreting what they see will often have trouble with their schoolwork.

In addition to caring for students who seek our clinic following our school health supervision visits, we also treat adult patients who are generally referred by their primary care physician for comprehensive eye examinations.

Our ophthalmologists offer individualized treatment plans that include eyeglasses or contact lenses, eye exercises for muscle problems, medical treatment for eye diseases, screening for complications resulting from chronic diseases (diabetes, hypertension…) and surgeries when indicated (in the cases of glaucoma, cataract…).

Our ophthalmology unit consists of 4 part-time doctors who cover a total of 4 shifts per week (2 hours each) and 1 senior Ophthalmology resident who comes twice per month and is always supervised by faculty members at the Ophthalmology department at LAU.

Eye Exams During School Health Visits

As part of the school health program that we conduct yearly in more than 14 schools between November and May, we provide all students with comprehensive eye examinations to detect eye diseases of childhood that could be treatable and reversible with a tremendous outcome on improving the child’s quality of life and learning capabilities.

We examine all students for visual impairment through Snellen chart testing, accommodated for their age and level of literacy. We can detect untreated strabismus and lazy eye syndromes (amblyopia). All students whose results are not within the normal range have their parents informed and referred to receive more care at our premises.

Visual screenings are done by promoting high-quality ophthalmic care in schools and for patients referred to our clinic.

Referral of Critical Cases to LAU-Rizk Medical Center (LAUMC)

The presence of senior ophthalmology residents at our center enables us to receive more patients and to provide them with timely quality of care, and more importantly to open collaborative opportunities to the special or critical cases, in cooperation with the prestigious LAU medical center and their Ophthalmology Out Patient Department (OPD). Our patients can receive all kinds of advanced eye testing at the OPD of LAUMC where all the latest technologies are available for free to be able to diagnose severe and critical eye conditions, and moreover, receive the appropriate care to their eye diseases provided by renowned eye sub-specialists at LAUMC (retina, glaucoma, oculo-plastic specialists…).

A complete individualized plan of care is done for every patient according to his disease and shared between the medical director at K-PHC and the ophthalmology specialist at LAUMC, through an advanced excel sheet on Google Drive to be able to follow up on our patients at all times.

Preventive and Educational Campaigns

Our ophthalmology department is very active in providing patients and their families with preventive and educational campaigns at the center, at schools and also during our community meetings. Doctors, residents, students and staff were all involved in teaching beneficiaries about health eye care, screen time for children, the impact of chronic diseases on the retina (diabetes…) and the need to follow up regularly with ophthalmologists

Moreover, through our campaigns of screening for Non-Communicable Diseases (NCDs), patients who are found to have a moderate to high risk of diabetes and hypertension are directly referred from our staff or Family Medicine and Chronic unit doctors to our Ophthalmology unit for retina and general eye check-ups.

The Nutrition Unit at Karagheusian Primary Healthcare Center has been playing an important role in improving the health and wellbeing of the individuals that the Center serves. Many individuals have benefited from the services of the Unit on a clinical level through one-on-one consultations, and on the community level through nutrition awareness and nutrition education.

The Center’s dietitian, Houry Babahekian, works with patients of various ages, struggling with obesity and various nutrition-related conditions including diabetes, heart disease, and others. She performs nutrition assessment and provides medical nutritional therapy by guiding the patients in changing their diet and lifestyle to improve their health outcomes.

In addition to the clinical work, nutrition awareness has been raised among the community through group presentations, school health, and nutrition education material development, with the collaboration of universities including the American University of Beirut, University of Balamand, and Notre Dame University, where nutrition students and dietetics interns have shown their active participation, with the coordination and mentorship of Houry Babahekian.

“Establishing healthy behaviors during childhood is easier and more effective than trying to change unhealthy behaviors during adulthood. Schools play a critical role in promoting the health and safety of young people and helping them establish lifelong healthy behavioral patterns.” (CDC: School Health, 2012).

Health surveillance in schools is a community-based approach designed to address the unique health needs of the students and their respective communities. Through the years, we have witnessed the critical role that our interventions in schools play in public health by promoting not only the health of the students and their families but also of their communities.

The mission of the School Health Services is to improve the overall health and well-being of students by offering comprehensive health services that include health screenings and diagnosis of acute and chronic illnesses.

To achieve even better results, HKCC Lebanon has recently adopted a coordinated school health model that is based on four main services: medical, psychological, and social services, as well as health education. These services are provided by qualified professionals, such as physicians, nurses, dentists, ophthalmologists, psychologists, social workers, and special educators.

The Health Supervision in Schools program saw children in 14 schools and focused on the following services:

• Assessment of development delays, preventable and manageable diseases
• Dental and ophthalmological screening
• Referral and follow-ups
• Health education and workshops about different health topics

Medications at the Karagheusian Association Primary Healthcare Center are provided by MoPH, and through the International Medical Corps. The medications donated by IMC serve in filling the gaps of MoPH acute medications, and they are given to patients free of charge.

Our pharmacy unit promotes the rational use of antibiotics and adherence to the Essential Medication List as per MoPH and WHO policies, IMC staff cooperate with PHC staff to ensure having an updated medication list in consultation rooms in the PHC to make sure that physicians abide by the medications available in the pharmacy to reduce the cost on beneficiaries and prevent them from buying medications from outside pharmacies.

More than 500 patients per day receive their medications from K-PHC Pharmacy Unit.

Today, primary healthcare plays a central role in sustaining not only healthy individuals but a healthy community as well. As it aims to improve the conditions of public health to make it attainable to all, it focuses on promoting a healthy population and minimizing the effects of diseases. Besides its medical goals, public health care also enables individuals to increase their productivity, which in turn provides economic and social benefits to society.

At the heart of public health care, ethos is preventive care that can improve health outcomes, as well as reduce medical costs. Education campaigns are especially useful at raising awareness regarding health care practices, providing preventive care information and tips to large groups of people, and stressing the importance of early disease detection, among others.

At K-PHC Lebanon, we focus our efforts on the two major principles of public health:

• Focusing on prevention rather than treatment of diseases
• Addressing the health needs of populations as a whole instead of individuals

With these guidelines, we are able to work in a complementary fashion to clinical medicine, as well as plan campaigns that emphasize health promotion, disease prevention, and health assessment.

Currently, the Karagheusian Center has various Women Empowerment initiatives consisting of 400 members who regularly attend weekly awareness sessions and discuss issues concerning social, psychological, ethical, spiritual, and physical health. The organizing team is adept at assessing needs, interpreting evidence and research that guide the development of health programs and working with a variety of partners to address population health issues.

The themes of the awareness sessions are chosen according to the national and international health schedules of the World Health Organization (WHO). Centering our services on evidence-based medicine and statistical data analysis allows us to provide our audience with high-quality awareness sessions through which we observed behavioral changes, women empowerment, early detection of diseases, and community development.

Additionally, our holistic approach led to significant collaborations with higher educational institutions in Lebanon. Senior students, instructors, and various healthcare professionals from the University of Balamand, American University of Beirut, Lebanese American University, Lebanese University, Saint Joseph University, Notre Dame University, La Sagesse University, and Haigazian University, cooperated with us to organize and execute health day campaigns.

Besides our collaboration with universities, our experienced physicians and various guest speakers play an important role in the awareness sessions. Based on the needs of the women we reach; 83 unique sessions were given. Those covered different topic areas, from human rights issues to medical problems. Sessions about dental health and oral hygiene, osteoporosis prevention, non-communicable disease prevention (hypertension, diabetes, cardiovascular diseases, gastric disorders), cervical cancer prevention, were among the many in 2019. Additionally, special awareness sessions were organized regarding vaccination, first aid management, and different developmental disorders that any child may face. Also, lectures concerning various topics, such as stress management, food handling, alcohol abuse, post-traumatic stress disorder, effective communication, and critical thinking, were featured in the year’s campaign.

Public health and clinical medicine are vital partners in a well-functioning health care system, which is imperative to both individual and population health. Our team has gained the trust of the community throughout the years, giving us renewed motivation to continue our mission.