Amid the trauma of war, chronic diseases should not be forgotten

The conflicts of 2019 are likely to see more people dying, not from bullets or starvation, but from chronic conditions such as cancer, asthma or heart disease.

Conflicts 21:44 17.01.2019

From starving children in Yemen to bombed-out hospitals in Syria, today’s media offers many images depicting the impacts of conflict on health. Where conflicts occur, international and local aid workers rush to treat the wounded and assist with essential food supplies and vaccinations.

However, many people in humanitarian crises also suffer and die from chronic diseases, which now account for 7 in 10 of all deaths worldwide. Conflicts contaminate the air and water, reduce access to nutritious food and create stressful living conditions. This makes people sicker and more susceptible to chronic illness. At the same time, health workers flee, hospitals are targeted and there are medication shortages.

An increasing challenge…

Humanitarian systems were not designed to provide the long-term care required for chronic diseases. As more middle-income countries – with large pre-existing chronic disease burdens – are affected by conflicts, this is a growing challenge. In addition, the length of conflicts has increased, creating protracted complex situations with no clear demarcation of where humanitarian needs stop and development needs start.

Despite the amount of trauma in Syria, half of all deaths are due to a chronic disease. Surveys have identified that at least 1 in 5 Syrian refugees have a chronic disease, although this figure is much higher in elderly populations. Many have unmet chronic health needs and cite a lack of access to healthcare as the main barrier to getting those needs met. This is not a problem limited to conflicts in the Middle East, as NGOs working with the displaced Rohingya populations in Bangladesh have found.

The risk factors that are associated with the global epidemics of smoking-related disease and obesity (including poor diets, lack of physical activity and stress) escalate in conflicts. Prevention efforts to slow illness progression by promoting healthy lifestyles may not be possible in environments when food, water and space for exercise are limited and not prioritized. Meanwhile, treatment usually involves long-term therapies, careful monitoring by trained healthcare workers and, often, daily access to medications that may not be available.

…With no simple solution

Interruptions in medication – an asthmatic without inhalers, a diabetic without insulin, a cardiac patient with no access to heart medications – ­are life-threatening, and management of complications requires access to health centres capable of performing specialist investigations and surgery. In unstable settings, providing continuity of care is especially difficult when access routes become dangerous or are blocked: supplies cannot arrive and people may be forced to flee.

Médecins Sans Frontières has created health passports for patients in Lebanon to monitor treatments over time at their clinics. The next steps may include sharing data between organizations and creating electronic records that cannot be lost or destroyed.

In pre-conflict Syria, pharmacists played an important role in managing hypertension. In humanitarian situations, this is a role usually undertaken by doctors. However, by understanding local contexts and the local workforce, these activities could be shifted to pharmacists in Syria, a model that may be applicable in other contexts.

Ensuring access to drugs such as insulin that require refrigeration is a challenge in disrupted settings. Innovations such as heat-stable insulin may offer a solution to provide consistent access to this life-saving medication, both in conflict and other resource-limited settings.

Close cooperation between humanitarian agencies, development organizations and governments will be required to manage chronic illness sustainably in protracted crises. The World Health Organization is promoting joint planning and programming between sectors to improve access.

However, the cost of managing chronic needs for long periods is significant, and who pays for long-term care (the cost of which exceeds humanitarian budgets) in conflict settings is not clear. Momentum around chronic diseases in the wider global health world has not yet reached those living in conflict, who are still being ‘left behind’ from progress towards universal health coverage and other UN Sustainable Development Goals.

Within the biggest ongoing conflicts, chronic diseases receive the least attention but represent one of the most important health issues for populations. To save lives and prevent further suffering, they must become more of a priority.

Azerbaijan takes measures to turn Khankandi into safe city - VİDEO

News line

Isaac Herzog: Israel has no greater friend than US, and US has no greater friend than Israel
Isaac Herzog: Israel has no greater friend than US, and US has no greater friend than Israel
16:45 28.03.2024
Nigerian army eliminates over 200 militants in 2 weeks
16:30 28.03.2024
Armored Vehicle Coalition for Ukraine launched in Poland
Armored Vehicle Coalition for Ukraine launched in Poland
16:15 28.03.2024
Russia strengthens transport security measures after terror attack at Crocus City Hall
Russia strengthens transport security measures after terror attack at Crocus City Hall
15:55 28.03.2024
Türkiye plays an important role between Russia and Ukraine - says political scientist Ismail Cingoz
15:45 28.03.2024
2 schoolchildren detained in France on suspicion of sending bomb threats
15:35 28.03.2024
Ski resort in Georgia hit by avalanche
Ski resort in Georgia hit by avalanche
15:26 28.03.2024
Another protest against French colonialism held in New Caledonia, Azerbaijani flag raised
Another protest against French colonialism held in New Caledonia, Azerbaijani flag raised
15:15 28.03.2024
Media: US did not transfer all information about terrorist attack in Crocus City Hall to Russia
15:00 28.03.2024
Movement ‘Together’ calls on Armenia’s parliamentary forces to express vote of no confidence in Pashinyan
14:41 28.03.2024
Azerbaijan to participate in international trade fair in Istanbul
Azerbaijan to participate in international trade fair in Istanbul
14:32 28.03.2024
Le Pen accuses French government of fraud
14:22 28.03.2024
Armenian Government Grapples with Internal Division on Village Return Issue - Ishkhan Verdiyan talks on Ednews
14:12 28.03.2024
Ammunition found along route of Crocus City Hall terrorists
Ammunition found along route of Crocus City Hall terrorists
13:41 28.03.2024
Expert Ilyas Huseynov Predicts Peaceful Return of these territories to Azerbaijan
13:20 28.03.2024
Azerbaijan weather forecast for March 29
Azerbaijan weather forecast for March 29
12:55 28.03.2024
Russian MFA concerned about upcoming Armenia-US-EU meeting
12:23 28.03.2024
Secret Points of Pashinyan's Meeting with French Representative: Is Peace Agreement Signing Imminent?
12:00 28.03.2024
Armenia announces recruitment of border guards to work at Zvartnots
Armenia announces recruitment of border guards to work at Zvartnots
11:47 28.03.2024
The US-Armenia-EU Joint Conference is a part of the pressure plan on Azerbaijan - MP Konul Nurullayeva
11:30 28.03.2024
Azerbaijan’s central bank reduces discount rate
Azerbaijan’s central bank reduces discount rate
11:23 28.03.2024
CSTO chief: ‘Yerevan doesn’t participate in our work, but there are no statements about suspension’
11:13 28.03.2024
Ammunition found in Khankandi
Ammunition found in Khankandi
11:00 28.03.2024
Russia had been aware of preparation for terrorist attack at Crocus - says intelligience chief
10:46 28.03.2024
Scholtz reveals date of his last telephone conversation with Putin
Scholtz reveals date of his last telephone conversation with Putin
10:33 28.03.2024
Head of the SSS: France is inciting Armenia to a new war
10:21 28.03.2024
Are we in the brink of World War III? - Pundit talks on Ednews
10:10 28.03.2024
Azerbaijan's National Security: Reflecting on 105 Years of Defending Sovereignty
09:55 28.03.2024
Hikmat Hajiyev: Rasmussen fell in forgetfulness to attach payment to his report
09:35 28.03.2024
Hand grenades found in Kalbajar
09:25 28.03.2024
Titanic 'door' prop that kept Rose alive sells for $718,750
Titanic 'door' prop that kept Rose alive sells for $718,750
08:50 28.03.2024
Twitch's biggest streamer diagnosed with cancer diagnosis at 32
23:55 27.03.2024
Azerbaijan's former Minister of National Security passes away
22:41 27.03.2024
Russia has no unfriendly states, only unfriendly elites — Putin
22:25 27.03.2024
Erdogan vows to make efforts for implementation of UN resolution regarding Gaza
Erdogan vows to make efforts for implementation of UN resolution regarding Gaza
21:44 27.03.2024
Russian MFA: France's presence in the Caucasus is of an intelligence nature
21:00 27.03.2024
Record numbers of migrants arrive in UK in 2024
20:42 27.03.2024
Leo Docherty appointed new UK Minister of State for Armed Forces
Leo Docherty appointed new UK Minister of State for Armed Forces
19:34 27.03.2024
MFA: ‘We reject anti-Azerbaijani allegations in the report prepared by Friends of Armenia Network’
19:00 27.03.2024
Armenian Speaker: We are looking for people who consider those villages to be Armenian territory
18:42 27.03.2024
Hamısı