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5 – Food insecurity
A fundamental part of diabetes management is also the management of diet and therefore of blood sugar. However, when food may be scarce or events such as conflicts have caused the cost of everyday staples to rise, for example in Yemen, maintaining regular meal times and reliable portions can become incredibly difficult.
6 – Needles, syringes and waste
Along with access to the insulin itself, the problem of finding and providing the necessary package of tools, such as needles, syringes, and monitoring devices, can be difficult. Even with a reliable supply, keeping these vital items clean and disposing of them safely is also difficult, especially for patients who have been forced to leave their homes or are now living in refugee or displaced persons camps.
7 – The myth of the refrigerator
In many places, daily temperatures can far exceed the recommended storage range for insulin. Normally, insulin is stored in the refrigerator, but this is a problem when a person does not have one, due to poverty, limited power or because they have been forced to leave their home. Instead, patients often make multiple trips a day to get to a health clinic, costing them time, money and potentially their safety. However, from experience, we know that simple alternative storage solutions (such as basic clay pots) can provide a way to keep temperatures cool and stable to store insulin for some time.
8 – The cycle of complications
When a person experiencing a humanitarian crisis is unable to manage diabetes, the long-term risk of serious complications, including kidney failure, heart disease, and vision loss, increases significantly. And, when these conditions reach the point of requiring urgent medical attention, the availability of specialist and emergency care may not be easily accessible. Leaving diabetes untreated becomes a vicious cycle, resulting in more complicated conditions that require more advanced treatments, but are also less likely to be available in the midst of a humanitarian crisis.
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