Health in the midst of a
HUMANITARIAN CRISIS

Worldwide, 500 million people live in fragile and conflict-affected situations1. In addition to traditional emergency healthcare services, such as war surgery and care for infectious diseases, many people affected by humanitarian crises require access to care for chronic conditions. These conditions are also known as non-communicable diseases (NCDs).2

70.8 million

people have been forced to flee their homes and communities due to persecution, violence and human rights violations.4

As many as 95% of these displaced people live in LMICs and more than half have been forcibly displaced for more than four years.5 Moreover, NCDs disproportionately affect people in low- and middle-income countries (LMICs).6 It is estimated that 25–35% of adults in LMICs have an NCD such as hypertension or diabetes.7

NCDs tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors.3 These chronic conditions have common characteristics that can make affected people more vulnerable during an emergency.

Anbar province, IRAQ

Markazi camp for internally displaced persons

60-year-old Abda sits outside her tent. Abda has diabetes and has developed gangrene in her left foot. She was displaced from Ramadi a few months ago and has no access to healthcare.

© Magnum Photos for ICRC/SAMAN, Moises

of all deaths globally are due to NCDS 3

Health in the midst of a
HUMANITARIAN CRISIS

Worldwide, 500 million people live in fragile and conflict-affected situations1. In addition to traditional emergency healthcare services, such as war surgery and care for infectious diseases, many people affected by humanitarian crises require access to care for chronic conditions. These conditions are also known as non-communicable diseases (NCDs).2

Main Types of NCDs

70.8 million

people have been forced to flee their homes and communities due to humanitarian crises of persecution, violence and human rights violations.4

Nearly 95% of displaced people live in LMICs. And over half have been displaced for more than four years.5 Furthermore, NCDs disproportionately affect people in low to middle-income countries (LMICs).6 An estimated 25 to 35% of adults in LMICs live with NCDs such as hypertension, or diabetes.7

NCDs tend to be of long duration. They are often the result of combined genetic, physiological, environmental and behavioural factors.3 These chronic conditions have characteristics in common.  And the people they affect are, therefore, more vulnerable during an emergency.

Anbar province, IRAQ

Markazi camp for internally displaced persons

60-year-old Abda sits outside her tent. Abda has diabetes and has developed gangrene in her left foot. She was displaced from Ramadi a few months ago and has no access to healthcare.

© Magnum Photos for ICRC/SAMAN, Moises

of all deaths globally are due to NCDS 3

NAJAF, IRAQ

ICRC PHYSICAL REHABILITATION CENTRE

This patient lost his leg due to diabetes-related complications.

© Getty Images/CICR/ DI LAURO, Marco

 

Globally, NCDs are the
LEADING CAUSE OF
DISABILITY8

Emergencies appear to increase the risk of NCD-related complications; events such as heart attacks and strokes may be up to 2–3 times more common than in normal pre-emergency circumstances.7,9 A lapse in care for NCDs, even for a short period of time, can result in high levels of disability and premature death.7,9

The chronic nature of these diseases requires continuity of care, which can be even more challenging in a humanitarian crisis, where there are often disruptions in health services or a complete collapse of healthcare systems.2 Furthermore, they are overwhelmingly hosted by communities and countries that are already overburdened by acute health threats such as injuries and infectious diseases as malaria and HIV/AIDS.5,10

Globally, NCDs are the
LEADING CAUSE OF
DISABILITY8

Emergencies appear to increase the risk of NCD-related complications; events such as heart attacks and strokes may be up to 2–3 times more common than in normal pre-emergency circumstances.7,9 A lapse in care for NCDs, even for a short period of time, can result in high levels of disability and premature death. 7,9

The chronic nature of these diseases requires continuity of care, which can be even more challenging in a humanitarian crisis, where there are often disruptions in health services or a complete collapse of healthcare systems.2 Furthermore, they are overwhelmingly hosted by communities and countries that are already overburdened by acute health threats such as injuries and infectious diseases as malaria and HIV/AIDS.5,10

NAJAF, IRAQ

ICRC PHYSICAL REHABILITATION CENTRE

This patient lost his leg due to diabetes-related complications.

© Getty Images/CICR/ DI LAURO, Marco

 

References

*View the sources for this page here

  1. World Bank. Data: Fragile and conflict affected situations. https://data.worldbank.org/region/fragile-and-conflict-affected-situations. Published 2017. Accessed February, 2019.
  2. Rabkin M, Fouad FM, El-Sadr WM. Addressing chronic diseases in protracted emergencies: lessons from HIV for a new health imperative. Global public health. 2018;13(2):227-233.
  3. World Health Organization. Noncommunicable Diseases. Fact sheet. www.who.int/mediacentre/factsheets/fs355/en/. Published 2018. Accessed June, 2019.
  4. United Nations High Commissioner for Refugees (UNHCR). Global Trends: Forced displacement in 2018. UNHCR: The UN Refugee Agency. https://www.unhcr.org/5d08d7ee7.pdf. Published 2019. Accessed September, 2019.
  5. World Bank. Forcibly Displaced: Toward a Development Approach Supporting Refugees, the Internally Displaced, and Their Hosts. License: Creative Commons Attribution CC BY 3.0 IGO. Washington, DC: World bank;2017.
  6. World Health Organization. Time to Deliver: Report of the WHO Independent High-Level Commission on Noncommunicable Diseases. 2018. 9241514167.
  7. World Health Organization. Noncommunicable diseases in emergencies. http://apps.who.int/iris/bitstream/handle/10665/204627/WHO_NMH_NVI_16.2_eng.pdf?sequence=1.%20Access. Published 2016. Accessed 14 January, 2019.
  8. Vos T, Abajobir AA, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2013;2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390(10100):1211-1259.
  9. Hayman KG, Sharma D, Wardlow RD, Singh S. Burden of cardiovascular morbidity and mortality following humanitarian emergencies: a systematic literature review. Prehospital and disaster medicine. 2015;30(1):80-88.
  10. Doocy S, Lyles E, Roberton T, Akhu-Zaheya L, Oweis A, Burnham G. Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan. BMC Public Health. 2015;15:1097.
  11. World Health Organization. Global Report on Diabetes. 2016.