Healthcare needs of older people in humanitarian settings

On 3-4 May in Nairobi, Kenya, MSF gathered staff from our projects with experts from academia, clinical practice and the non-governmental sector to consider key issues in humanitarian paediatrics. These included: Vaccination and vaccine-preventable diseases: Amid post-Covid-19 global setbacks in child vaccination coverage, sessions spotlighted recent increases in vaccine-preventable disease outbreaks, potential new vaccination strategies and emergency responses, and MSF’s role in vaccine advocacy and catch-up campaigns. Nutrition: Talks covered the nexus of nutrition with other key conference topics, the latest malnutrition guidance and tools, and MSF’s priorities in nutritional care. Paediatric HIV: With half of all HIV-positive children globally not receiving antiretroviral therapy, presenters reviewed the latest paediatric testing/treatment recommendations and discussed barriers and potential solutions to implementation, nutritional challenges in children with HIV, and systems strengthening for preventing and monitoring paediatric HIV. Click below to read the abstracts. And stay tuned for more conference content, coming soon.

Unsafe abortion is a leading cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 28,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion. So in 2016 we launched a program to systematically implement safe abortion care (SAC), starting with ten pilot sites and then applying the lessons learned to scale up at projects across the globe. This Collection presents highlights of these efforts. Since our first publication on the need to provide SAC as a way of reducing maternal death and injury, several studies assessed the role of unsafe abortion in driving this suffering in specific contexts. Others described internal obstacles to providing SAC, operational solutions developed, and outcomes achieved. And we advocated for shifting towards community-led and self-managed SAC, particularly given new obstacles that emerged during the Covid-19 pandemic.

Diabetes affect hundreds of millions of people worldwide, a large majority of them living in low- and middle-income countries. Yet finding effective strategies, tools and policies for effectively managing this chronic illness—especially amid war, displacement or exclusion from care—is a neglected area of humanitarian medicine. Here we present a cross-section of work on this front by MSF and collaborators. Several studies assess the shift towards community-based, nurse-led models of care in rural settings. Others explore obstacles to diabetes care for war refugees living in camps in Jordan or Lebanon, highlighting how health programs can adapt to their needs. The demonstration that insulin retains potency for 30 days if cooled without refrigeration is opening doors to more patient self-management, as a case study in remote South Sudan shows. At the same time, MSF and others call for regulatory and financing policies that make diabetes medications and supplies cheaper, better adapted to humanitarian settings, and far more available to patients whose lives depend on them.