In humanitarian crisis settings, chronic diseases such as diabetes often turn into life-threatening conditions. In Nigeria’s Borno State, where at least 3 million people suffer from diabetes, we intervene with counseling and treatment for displaced people living in remote areas.
November 14 marks World Diabetes Day. In our missions, we often find ourselves having to assist people who for a long time have not received adequate care or availability of medication, exacerbating their condition as chronic patients. Borno State, Nigeria-where it is estimated there are at least 3 million people with diabetes-presents an important example of the need to ensure care in such fragile and unstable settings.
For more than a decade, Borno State has been at the center of one of Africa’s most complex humanitarian crises. Prolonged internal armed conflict, large-scale displacement, and repeated climatic disasters such as floods and inundation have compromised access to essential services, leaving millions of people dependent on humanitarian aid. Entire communities have been uprooted, with families forced to abandon their homes, farmland and livelihoods. Health systems have been severely weakened, health facilities suffer from shortages of qualified personnel, medical supplies and infrastructure.
In these areas, the burden of chronic diseases such as diabetes may be insignificant compared to the urgent survival needs that people face in their daily lives, yet for thousands of people, these diseases are life-threatening.
In 2023, residents of Konduga, one of the local areas most affected by the ongoing crisis in Borno State, were living in extreme survival conditions. For those suffering from diabetes, epilepsy, anxiety, hypertension, or post-traumatic stress disorder, treatment was often an unattainable privilege. Families displaced by conflict and affected by repeated flooding did not have regular access to medical examinations, medication or psychosocial care. “Every day I feared that my illness would get worse because I no longer knew where to turn,” says a diabetic woman we assisted.
Two years later, that same community tells a different story. Some 83,880 people received counseling, treatment and specialist visits at two primary health care centers. Local health workers now manage chronic disease and mental health services with greater confidence, and vulnerable families have livelihoods and health insurance that will accompany them into the future.
This happens thanks to the Non-Communicable Disease and Mental Health (NCD-MH) project, implemented by INTERSOS with support from Stichting Vluchteling (SV), a programme that has not only addressed urgent health needs but also built a sustainable model of care in one of Nigeria’s most complex and insecure settings.
Among the diseases that the health project focuses on, diabetes remains one of the most challenging because of its prevalence in remote settings and thus the difficulty of reaching many of the people who have it. In crisis-affected communities, where access to insulin, regular testing, and adequate nutrition is limited, the disease can quickly become life-threatening.
Our field team tries as much as possible to expand its care response through diabetes treatment and counseling, reaching 1,149 diabetes visits in the Dalori clinic and 1,000 primary health centers in Konduga LGA. 79% of assisted patients achieved glucose levels within target values. Through regular checkups,patient illness awareness and mental health support,the project has helped people regain control of their health.
Amina, a 52-year-old displaced woman who survived a violent attack by the armed group Boko Haram on her village, visited the Dalori health center for the first time during a community outreach initiative organized by INTERSOS. It was during this occasion that she was diagnosed with diabetes and enrolled in the chronic disease program: “Before this program, I thought my disease was incurable. Today I feel like myself again.” Amina tells.
Through constant monitoring, access to medication and counseling, Amina’s glucose levels have stabilized. Today she supports other women in her community, encouraging them to seek help early and commit to their treatment plans.