Immediately following a disaster such as a hurricane, an earthquake, or a man-made conflict, medical personnel are dispatched to help with broken bones and other immediate health needs. But what happens when a diabetic can’t access insulin, a person with kidney disease can’t get dialysis, or a person with high blood pressure can’t access their medication?
As the global burden of chronic disease grows, the medical needs of people in disaster areas are increasingly related to pre-existing chronic medical issues such as diabetes, hypertension and heart disease and the pre-existing capacity of health systems to address these conditions.
Dr. Marcello Tonelli recently travelled to Geneva, Switzerland, to work with the World Health Organization (WHO) on a number of projects related to chronic disease. During his time at the WHO, he was surprised to learn that providing care for chronic medical conditions like diabetes and hypertension is a significant problem for humanitarian relief organizations in disaster zones and other emergencies.
Chronic conditions post an extra challenge during disasters
“Care providers that arrive on the scene have to deal with multiple issues including the urgent provision of health care as well as the other necessities of life,” says Tonelli, professor at the University of Calgary’s Cumming School of Medicine.
“Increasingly, care providers on the front line are realizing that they aren’t equipped to deal with the large numbers of people who can’t get care for chronic conditions like diabetes, heart disease or high blood pressure — and often the stress of these disasters can make these conditions much worse”.
Tonelli worked with colleagues from the WHO, the Office of the United Nations High Commissioner for Refugees (UNHCR) and Doctors Without Borders (MSF) to see how they could improve immediate care to those affected by disasters and who are also living with pre-existing chronic conditions.
Add practical medical supplies to humanitarian relief kits
One of the practical solutions they came up with concerns critical medications such as asthma inhalers and blood pressure medications, as well as equipment to measure blood sugar level and deliver oxygen. The plan is to include appropriate quantities of these materials to the kits that humanitarian relief providers already dispatch to disaster areas. Currently the project is in its pilot stage. Upon completion of the pilot, its effectiveness will be evaluated.
“Similar to the current emergency health kit, this new noncommunicable diseases (NCDs) kit is meant to provide the essential medications and supplies for a population of 10,000 over a three-month period when health infrastructure and supply chains are disrupted. It will complement existing kits by covering the needs for common NCDs such as diabetes, hypertension or asthma. This should help to avoid interruption of care for people affected by emergencies, and prevent life-threatening complications of these chronic conditions,” says Dr. Slim Slama, medical officer at WHO Regional Office for the Eastern Mediterranean, who has been co-ordinating the development of this new emergency kit.
Prevent life-threatening complications for chronic patients
Slama, Tonelli and colleagues summarized their findings in an article that published in The Lancet in September. A separate article on the NCD kit will be published shortly in another medical journal.
Marcello Tonelli is the associate vice-president (health research), University of Calgary, and senior associate dean (clinical research), Cumming School of Medicine. He is also a professor in the Department of Medicine, and a member of the university’s Libin Cardiovascular Institute of Alberta and O’Brien Institute for Public Health. Tonelli also holds the David Freeze Chair in Health Research, funded by the Calgary Foundation.