11. May 2017

Dead Sea Declaration calls for urgent action on diabetes in refugees

Gwendolyn Carleton
Experts in health delivery pledge to address the growing crisis, and urge global stakeholders to join them.
Abu Jamal (left) describes living with diabetes in refugee camps – CLICK ABOVE TO SEE A SHORT FILM.
 
For refugees and those who host them, securing safety, food, shelter and acute medical care comes first. Yet as millions of displaced people move into camps or cramped urban settings, often with limited access to healthy food and exercise, increasing numbers of them are facing a new threat – diabetes. 
 
To address this, 75 experts in health care delivery from multi-lateral agencies, ministries of health, civil society and academia gathered from April 10-12 for the ‘International Conference on Refugees and Diabetes’ in Jordan. The meeting explored current practices and experiences, research, and the way forward to better diabetes care for refugees worldwide. 
 
Calling the conference ‘very important,’ Jordan’s Minister of Health, Dr Ayyob As_Sayaideh, said:  “One of our greatest challenges is the impact of diabetes on refugees. The spread of diabetes and hypertension, a result of these difficult and stressful circumstances and living conditions, is increasing day by day.” 
 
Jordan is currently host to more than 2 million refugees, many of them Palestinian and Syrian. Two of them – a mother of a child with type 1 diabetes, and a man who has lived with diabetes since 2007 – shared their stories with conference delegates.
 
“No one in my situation can avoid NCDs,” said Abu Jamal, a Palestinian who has lived in refugee camps across the region since 1967. He explained that life in a refugee camp is difficult, and stress can make chronic diseases worse. His own uncontrolled blood sugar led to complications including ulcers in his feet.  But staff in the UNRWA health centre prevented an amputation, taught him to manage his disease and followed him closely.
 
“I would like to thank the UNRWA staff for their efforts - because of them, I didn’t fear,” he said.
 
An international problem
 
The United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) has provided health services to Mr. Jamal and other Palestinian refugees since 1948. In 2003, they began working with the World Diabetes Foundation (WDF) to improve diabetes prevention and care in refugee camps. 
 
UNRWA  provides care to more than 250,000 refugees with diabetes and hypertension under extremely challenging conditions and has amassed considerable expertise in the area. UNRWA and WDF organised the conference together, to share these learnings and encourage greater attention. 
 
As Dr Akihiro Seita, the Director the the UNRWA Health Programme, noted: “Diabetes is an international problem. It can’t be managed by one single organisation, system or institution alone.” 
 
“The tragic circumstances that are forcing large scale migration and human displacement make it difficult for people with diabetes to manage their disease, and are also hugely challenging to those trying to provide care,”  said Dr Anil Kapur, Chairman of the World Diabetes Foundation. “This is precipitating acute life- and limb-threatening complications, and also accelerating the development of the disease, its co-morbidities and the development of long-term complications.”      
 
With this in mind, on the final day of the conference delegates endorsed the ‘Dead Sea Declaration and Call to Action on Refugees and Diabetes’ - an urgent call for action to address the problem.
 
The Declaration expresses grave concern about the growing crisis of diabetes in refugees and commits delegates to addressing the prevention and care of diabetes in refugee populations through a series of actions. 
 
It also calls upon other partners and stakeholders to include diabetes care in all humanitarian responses; establish supporting mechanisms for diabetes and other common NCDs; and strengthen health systems to provide care for common NCDs at the primary care level. 
 
“I look forward to being a cog in the wheel moving this Declaration from a call to action to real action on the ground,” Dr Kapur said. “There is an urgent need for a coordinated, multi-sectoral response to this crisis within a crisis with a high transgenerational social, economic and health impact.” 
 
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