Floods, conflict disrupt healthcare for chronic disease patients

As conflict, climate disasters, and displacement intensify across Kenya and the African continent, patients living with chronic diseases are increasingly being left unattended.

Humanitarian crises—including flooding, war, and drought—are disrupting access to quality healthcare. Health experts warn that millions of people living with hypertension, diabetes, and heart disease are among the most affected.

A new report by the African Population and Health Research Center and Elrha warns that humanitarian emergencies are disrupting access to life-saving medicines, diagnostics, and follow-up care for patients with cardiometabolic diseases (CMDs), a cluster of chronic illnesses that includes hypertension, diabetes, and cardiovascular disease.

For patients dependent on daily medication and regular monitoring, even short interruptions can quickly become fatal.

According to the report released last week, conditions that would ordinarily be manageable can spiral into medical emergencies during humanitarian crises, including stroke, heart failure, kidney failure, and diabetic ketoacidosis.

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The findings expose weaknesses in humanitarian response systems, which remain largely designed to handle acute emergencies such as war injuries, cholera outbreaks, and hunger crises, while overlooking the growing burden of chronic diseases.

“Current humanitarian responses are not designed to manage chronic disease,” the report notes.

This is particularly concerning in Africa, where rapid urbanisation, changing diets, and sedentary lifestyles have accelerated the rise of hypertension, diabetes, and cardiovascular diseases, even as many countries continue grappling with infectious diseases.

In Kenya, for example, cardiovascular diseases are a leading cause of death, accounting for 14 per cent of all deaths.

The crisis is driven by rising rates of hypertension, diabetes, and smoking, with over 37,000 annual cardiovascular disease deaths, increasingly affecting younger people.

Additionally, the prevalence of hypertension is estimated at 24 per cent, with 78 per cent of those diagnosed not receiving treatment.

The report emphasises that in fragile settings, these illnesses become even harder to manage.

For instance, conflict destroys health facilities, displaces health workers, disrupts medicine supply chains, and pushes patients away from routine care.

Displaced populations often lose medical records, cross borders without prescriptions, and struggle to access medicines in unfamiliar health systems.

In Sudan, for instance, conflict has disrupted insulin supply chains, displaced clinicians, and reduced access to paediatric diabetes care, placing children at heightened risk of life-threatening complications.

To respond, health actors developed a flexible model that rapidly establishes diabetes clinics in conflict-hit areas, repurposes hospital spaces, redeploys displaced doctors, and uses solar-powered insulin storage in electricity-poor settings.

The intervention has reportedly established 26 clinics and supported about 11,000 children.

In the Democratic Republic of the Congo, where conflict, poverty, and weak health systems limit diabetes care, patients have formed decentralised peer-support micro-associations to coordinate medicine access, education, and insulin storage.

These patient-led groups help sustain care in areas where formal systems are unreliable or absent.

Researchers argue that these innovations reveal effective humanitarian health solutions are often not high-tech, but practical and locally driven.

Successful models identified in the report rely on decentralised service delivery, peer-support systems, simplified treatment protocols, resilient medicine supply chains, community health workers, and low-tech digital communication platforms.

Rather than building parallel systems, programmes integrate services into existing government and humanitarian structures to improve sustainability.

However, according to the report, many countries have limited innovations to mitigate crises while pursuing quality healthcare.

Scientists attribute this to weak financing, limited workforce capacity, fragmented coordination, poor documentation, and lack of policy integration.

Despite some successful scientific interventions, many innovations remain underfunded pilot projects.

This comes at a time when global humanitarian financing is increasingly constrained, raising concerns that chronic disease care may remain under-prioritised.

The report calls on governments, donors, and humanitarian agencies to urgently integrate chronic disease prevention and treatment into emergency preparedness and response plans.

In Kenya, humanitarian crises are an everyday occurrence, says research scientist and epidemiologist at APHRC, Fredrick Murunga Wekesa.

For example, flooding continues to displace people in informal settlements and various parts of the country.

Wekesa explains that people in such settings—especially those living with diabetes and hypertension—are often forced to start treatment afresh due to lack of access to medication refills.

“Kenya has everyday crises. Uncertainty about where you live and loss of jobs is an ongoing conflict,” observed Wekesa.

Community conflict associated with banditry in counties such as Elgeyo Marakwet, Turkana, and West Pokot also contributes to limited access to healthcare.

According to the researcher, some conflicts in Kenya are unpredictable, making it difficult to plan and implement effective solutions.

With erratic weather patterns, for example, it is challenging to prepare adequate responses to crises in the country.

Kenya is also one of the largest hosts of displaced communities from neighbouring countries such as Sudan, the DRC, Burundi, and Somalia, many of whom reside in refugee camps.

Scientists noted that the majority of refugees lack medical records needed to continue treatment.

They are therefore forced to undergo fresh screening and diagnosis before being put back on medication.

Among the innovations recommended in the study is the establishment of community-led teams to develop local solutions.

This could include better ways to supply medicines to people living with chronic diseases during floods, or sending text messages to guide patients on where to seek care.

At the policy level, it is recommended that both county and national governments establish non-communicable disease (NCD) programmes and allocate adequate budgets.

Experts warn that failure to implement solutions will continue to cost lives silently and unnecessarily.

Across humanitarian crises, they argue, the biggest health threat may no longer be only bullets, hunger, or disease outbreaks, but the quiet collapse of routine care.

“For a patient with diabetes, missing insulin for days can be as deadly as conflict itself,” emphasised Dr Wekesa.

The report was released over the weekend in Nairobi, bringing together scientists, experts working in NCDs, Africa Centres for Disease Control and Prevention, and officials from the Ministry of Health.

According to Wekesa, the findings are intended to provoke discussion among stakeholders and highlight existing innovations that can ensure continuity of care.

“We were looking at community-led innovations to address our challenges and avoid disrupted care. For example, children with type 1 diabetes struggle to access insulin when flooding destroys roads and bridges,” he said.

Wekesa noted that while significant progress has been made in areas such as HIV, maternal, and newborn health—where maternal mortality has declined—non-communicable diseases continue to lag behind.