Surviving the war to fight diabetes as a refugee
Hammad Faleh, 32, fled Syrian Arab Republic with his wife and 3 children in 2012 to escape the horrors of war. Many Syrian refugees have been forced to leave their homes and seek sanctuary in Jordan. He survived the war but now battles a chronic disease, diabetes, in a new country. Without access to medication, Hammad could die.
“Diabetes has been something I’ve managed almost half my life,” the former English teacher says, taking a seat in the waiting room and instructing Sham, his daughter to draw while he speaks with WHO staff. “But since the war in Syria began, my condition has been difficult to control. This has made things very hard for me and my family,” he says as he patiently waits to receive insulin for his diabetes. Hammad has had type-1 diabetes for more than 14 years.
Jordan currently hosts over 630 000 registered refugees from Syrian Arab Republic, with about 85% of these people living outside camps in some of the poorest areas of the country. A significant proportion of them are classified as extremely vulnerable. Approximately 6% of adult refugees in Jordan suffer from diabetes.
Managing a chronic disease in crises
Hammad relies on health services provided by nongovernmental organizations for the management of his chronic disease. “Before the war, we lived comfortably in Daraa and my diabetes was manageable,” he says. “I had regular access to doctors, the right food to manage my blood sugar, and my consultations and medicines were free. But medicines became very expensive in Syria – sometimes double or triple the regular price. It became impossible for me to control my diabetes. We now come to clinics like this one for treatment,” he says.
From November 2014, registered Syrian refugees living in camps were entitled to free health care services through government facilities in Jordan. Refugees living in communities pay the same price as non-medically insured Jordanians. Although rates are subsidized for vulnerable individuals, the costs are high for refugees such as Hammad.
“On average, I pay 30 dinar (US$ 42) per month for my treatment,” Hammad says. “This is not easy because I do not have a regular income. I help in a vegetable store from time to time, but I am often too weak to work, because of my diabetes. Al-hamdullilah (thank God) no one else in the family is sick,” he says.
In addition to the financial burden, keeping to a low glycemic index diet (including foods such as beans and lentils) is a major challenge for Hammad. “Rice and bread is cheap," he says “and we are not able to afford too much else.”
WHO supports the Ministry of Health and nongovernmental organizations in Jordan by providing medication, updating national guidelines and providing training on noncommunicable disease management.