Safe noncommunicable disease care in humanitarian settings

Summary

Médecins Sans Frontières / Doctors Without Borders (MSF) provides humanitarian healthcare, which includes caring for people with noncommunicable diseases (NCDs) living though humanitarian crises. In this blog, MSF staff from around the world share how they keep patients safe.

This blog is part of a series on noncommunicable diseases, in support of World Patient Safety Day 2026 (WPSD26).

Content

Médecins Sans Frontières / Doctors Without Borders (MSF) provides humanitarian healthcare to people affected by conflict, outbreaks, disasters and exclusion from care. Often, the image that this conjures is doctors and nurses caring for patients with war-related wounds or an infectious disease. While this is indeed part of our work in many places, MSF staff also care for people living with NCDs. This year, on World Patient Safety Day, we honour those efforts and the challenges that come with caring for NCDs during crises.

The burden of NCDs is increasing in humanitarian settings

The majority of deaths due to NCDs occur in low- and middle-income countries (WHO, 2025).

At MSF, we see more patients each year with conditions like diabetes, hypertension and mental health disorders. In humanitarian environments, access to care can be disrupted, making it difficult to ensure continuity of care to manage NCDs.

Belal Hussein Mohamed, a nursing supervisor with MSF in Sudan says it well: “Patient safety is especially important for people with non-communicable diseases because these conditions require long-term, regular and accurate care. Small interruptions can lead to serious complications.”

In humanitarian environments, as well as in stable settings, multiple conditions may affect people at once. “Mental health struggles, chronic illnesses and infectious diseases are deeply connected. Keeping patients safe means looking at the whole person, so nothing slips through the cracks, preventing dangerous medication mistakes, and making sure their minds and bodies are cared for together,” describes Ajaz Ahmad, an MSF Mental Health Activity Manager in South Sudan.

Providing safe care for NCDs in humanitarian settings has unique challenges

In humanitarian settings, refugees or internally displaced people living with NCDs may face additional barriers to receiving care for their conditions. Doctors and nurses must strive to understand these barriers. Md. Foysal Ahmed, Patient Support Supervisor, shares an example from Bangladesh. Healthcare workers, he says, “must always look beyond the clinical condition and understand the context. In [refugee] camp settings, patients face many barriers—social stigma, family and financial challenges, transport and security issues, limited health knowledge, and poor access to care. When they come to us, they need more than medical treatment; they need safe and person-centred care.”

MSF also works to treat less common NCDs, requiring adapted approaches to case management.  One example of this is Noma disease. Noma is a rapidly progressive and often fatal gangrenous infection of the face; it is an infectious disease but is not subject to transmission between people. It is an NCD but is also a considered a neglected tropical disease, which means that it lacks the global attention and investment needed to adequately prevent and treat this condition.

 In Nigeria, where MSF healthcare teams work with the Ministry of Health to treat patients with Noma disease, the specificities of this unusual NCD must be considered. “Patient safety is important in Noma care because patients are highly vulnerable to complications and rapid deterioration,” says Haruna Yohanna of Nigeria. “Safe care requires early identification, appropriate treatment, infection prevention, pain management, nutritional support, and timely referral. This prevents harm.” Taking a patient-safety approach to Noma is crucial, as is providing holistic and patient- and community-centred care for this disease.

In some humanitarian settings, there are few other options for healthcare. This creates an extra responsibility for health workers to shoulder. Fikre Bedlue, an MSF nursing activity manager, recognises this responsibility at his project in Ethiopia. “Patients come to our facility with great trust in our services, seeking relief from their suffering and restoration of their health. Any compromise in patient safety can endanger patients' lives—the very people whom we are committed to protecting and caring.”

Keeping patient safety at the heart of our humanitarian interventions

Working in humanitarian crises can be hugely rewarding but hugely challenging. Sarah Cross, a quality-of-care specialist who travels to different MSF project sites for hands-on implementation support, knows that resource limitations cannot allow us to look away from patient safety. “We may not always have the resources we would like, but we can always strive to make the care we provide safer,” she says.  

Eshetie Gobie, an MSF nursing team supervisor in Ethiopia, agrees: “Limited resources should not stop us from focusing on safety; we can still do our best with the resources available. Working together and supporting one another helps us reduce mistakes and prevent avoidable harm.”

Haruna Yohanna of Nigeria reminds us that “in humanitarian healthcare, every patient deserves care that is not only timely, but safe. Patient safety is not an extra responsibility. It is the foundation of quality care.”

South Sudanese Counselor-Educator Nyapini Jany Ruot Yaw, agrees: “Patients put their trust in us, as they depend entirely on us. Reminding ourselves of the profound impact we have can inspire us to maintain high standards of care, even when working in challenging or resource-limited environments.”

Medical Team Leader Philippe Manengo Etumbula works in the Democratic Republic of the Congo. He recognises that involving each patient in their care is an important part of patient safety, by ensuring “patients adhere closely to their treatment; otherwise, they may abandon their treatment and become susceptible to complications that could even lead to death.”

At MSF, we believe in safe care for life!  

You can learn more about how MSF encourages the development of diabetes and hypertension drugs fit for use in low-resource settings, advocates for price reductions of essential NCD drugs and brings cervical cancer care to women without other access to these life-saving services.

About the author

Belal Hussein Mohamed, Ajaz Ahmad, Md. Foysal Ahmed, Haruna Yohanna, Fikre Bedlue, Sarah Cross, Eshetie Gobie, Nyapini Jany Ruot Yaw, Philippe Manengo Etumbula and Anna Freeman all contributed to this blog.