The challenges of a refugee living with diabetes

Of the more than 120 million forcibly displaced people worldwide, several million are living with diabetes, having fled war, conflict or persecution in their home country.

This year, World Refugee Day focuses on solidarity with refugees – for a world where refugees are welcomed.?Solidarity with people forced to flee also means finding solutions to their plight – ending conflicts so they can return home safely, ensuring they have opportunities to thrive in the communities that have welcomed them, and providing countries with the resources to include and support refugees.?

On World Refugee Day, we look at the challenges refugees with diabetes face globally in accessing diabetes medication, supplies and care. The sudden upheaval caused by such crises carries an added burden, particularly for people with diabetes treated with insulin, living with diabetes-related complications or pregnant women.

In a humanitarian setting, children with diabetes, like Refaat in Lebanon, need uninterrupted access to diabetes medication, care and education to prevent life-threatening complications. Learn his story and that of displaced people living with diabetes.

Disruption during a conflict

Conflict and war profoundly disrupt supplies, services, and healthcare systems. In emergency and humanitarian settings, healthcare systems can falter, leaving people with diabetes without access to essential diabetes care and supplies to manage their condition. Attempts to send crucial provisions to conflict zones can fail due to destroyed roads, curfews and looted pharmacies, making it a race against time to access life-saving medication like insulin.

The disruption can impact medical facilities and patient records, potentially worsening a person's health for up to two years post-disaster due to treatment mistakes, injuries, infections and emotional distress. Lack of timely intervention and access to diabetes care can lead to serious long-term, possibly fatal, health consequences.

Additionally, emergency settings present practical challenges in controlling diet and lifestyle factors, as access to suitable dietary options and safe spaces for exercise is often limited, affecting diabetes management.

Creating a diabetes care kit

Planning is an essential part of emergency preparedness. In addition to having basic emergency supplies, people with diabetes should pack a diabetes care kit in an easy-to-carry waterproof bag or storage container for emergency evacuation.

Read our Diabetes Voice article to learn more about how people with diabetes can prepare for emergencies, including insulin storage and management.

The disaster scenario

In a disaster scenario, a delicate web of support services, volunteers, clinical bodies, and government agencies work together to safeguard people with diabetes. Central to this network are diabetes associations, people living with diabetes and their families, and their communities.

One key consideration during evacuation or sheltering is that first responders may lack sufficient diabetes knowledge or resources. People with type 1 diabetes need to continue their insulin treatment, but these supplies are often overlooked in emergency dispatches.

NGOs are pivotal in disaster response, often focusing on different healthcare needs. Their contributions include volunteer skills like local knowledge and translation and distributing local supplies before aid shipments arrive.

Organisations like Médecins Sans Frontieres (MSF) provide comprehensive NCD care at the primary healthcare level in refugee camps, essential in addressing the needs of refugees with diabetes.

Insulin: be prepared... expect the unexpected

IDF humanitarian relief

In addition to spearheading essential diabetes initiatives, the International Diabetes Federation (IDF)?engages in humanitarian activities to tackle the challenges of?living with diabetes during natural or human-made disasters.

In April 2023, the IDF Middle East and North Africa (MENA) region's Disaster Committee joined?Direct Relief and its local partners?to address the urgent need for essential diabetes medicines and supplies for people living with diabetes in Sudan and Sudanese refugees in neighbouring countries. Likewise, MENA medical associations are collaborating with Direct Relief to source and deliver insulin through the Egyptian Red Crescent to Palestinian people with diabetes in Gaza.

Learn more about the importance of preparedness to ensure people with diabetes have a stable supply of insulin in emergency situations.

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Direct Relief Médecins Sans Frontières (MSF) UNHCR, the UN Refugee Agency