Health care when you are displaced: getting what you need, wherever you are

What health problems are most common among displaced people?

Displaced populations face a distinct combination of health challenges. Lost medical records, interrupted treatment chains, unfamiliar water and food sources, and crowded living conditions compound over time in ways that are not always immediately visible.

A 2015 study published in BMC Public Health, which surveyed more than 1,500 Syrian refugees in Jordan, found that over 29% had at least one chronic condition, and a large proportion had no regular access to care. Hypertension, diabetes and chronic respiratory disease were the most commonly documented illnesses in that population.

The most frequently encountered health problems include acute respiratory infections from poor ventilation in shelters, skin and eye infections, diarrhoeal illness from unsafe water, and the worsening of pre-existing chronic conditions that were already being managed before displacement occurred.

A follow-up review published in the Journal of Migration and Health in 2022, looking at Jordan and Lebanon, confirmed that this pattern persists over years of displacement. Access to care improved when host countries formally integrated refugee health services into national primary care networks, but large gaps remain for specialised conditions, mental health and dental care. Understanding which services exist in your specific area is the single most useful first step.

How to find health services in your current location

The first step is knowing who provides services in your area. UNHCR operates or funds clinics in most major host countries including Jordan, Lebanon, Turkey, Iraq and Egypt. IOM provides health assessments on arrival and vaccination. Medecins Sans Frontieres works in conflict zones and border areas and provides emergency care at no cost.

If you are living in a city rather than a camp, look for community health clinics working with non-governmental organisations. Many provide care without requiring identity documents in emergencies. Ask at any pharmacy or local school about the nearest subsidised clinic. Pharmacists are often well informed about available community resources.

If you are in a country with a functioning public health system, many countries offer emergency hospital access to all persons regardless of visa or insurance status. Find out what your legal rights are in your current country. Jordan, for example, formally commits to providing refugee care to registered individuals, while Turkey offers services through its Migrant Health Centres.

In larger cities, pharmacies are often the most accessible first point of contact. A pharmacist can advise on basic treatments, point you to the nearest free clinic, and sometimes provide medications for acute conditions without a prescription at lower cost than a private clinic. Do not underestimate the pharmacy as a starting point, particularly for common infections, wound care and pain management while you are arranging longer-term care.

Managing a chronic condition without your usual doctor

The biggest challenge for displaced people with chronic illness is treatment interruption. A chronic condition does not stop because you have moved. Stopping medicines such as insulin or blood pressure medication for even a few days can trigger serious crises. The first step on arriving anywhere new is to tell any available health provider about your chronic conditions and the names of your medicines.

A review published in Conflict and Health in 2019, which covered several host countries for Syrian refugees, found that treatment interruption for chronic diseases was the leading cause of preventable emergency presentations at health centres. Patients who stopped blood pressure medication because it was unavailable faced higher rates of stroke and hypertensive emergency.

Always ask for prescriptions written in the generic, or International Non-Proprietary Name, of a drug rather than the brand name. The same molecule may be sold under a completely different brand in your new country. Show the generic name at any pharmacy and ask whether a local equivalent is available. In a genuine emergency, most pharmacies can help identify an equivalent if you carry the generic name.

If you cannot find a specialist for a chronic condition, ask for interim prescriptions from a general practitioner or the clinic on site. Most general doctors can maintain existing treatments for stable chronic conditions even if they cannot initiate new specialist-level management. This bridge approach keeps you from going without treatment while you wait for specialist access, which can take weeks in a new system.

Building a personal health record that travels with you

A personal health record is the most important medical document you can carry in displacement. Any new doctor or nurse needs your medical history to provide safe care. Open a simple paper folder or a health app on your phone and record: your list of chronic conditions, the names and doses of all your medicines, the timing of your last key test, and any known drug allergies.

Add to your record the results of your most recent blood tests if you have them, your blood group, and the dates of your last vaccinations. This information saves time at any health facility and protects you from medical errors such as receiving a treatment you are allergic to.

If you have children, keep a separate record for each child. Include weight, a simplified growth record, and the vaccinations each child has received with dates. In refugee settings, children with documented vaccination histories are often prioritised in catch-up immunisation programmes, which is the fastest way to close any gaps.

Reserve space in your record for noting every health facility you have visited, the date, the diagnosis given and any treatment received. These records build over time and can become critically important if you ever need to demonstrate a medical condition to a government authority, an insurance provider or a medical support programme.

Missed vaccinations: how to catch up

Displacement frequently breaks vaccination schedules, for children and adults alike. The good news is that missed vaccinations can be given at any age, and in most displacement health programmes they are provided free of charge.

The vaccines of highest priority in displacement settings are measles, mumps and rubella (MMR), which spread rapidly in crowded conditions; oral polio vaccine in areas where polio remains a risk; hepatitis A where water and food safety are uncertain; and tetanus, which becomes especially important after any wound or injury in unsanitary conditions.

For adults who do not know their vaccination history, MMR and tetanus vaccines can generally be given safely without prior blood testing. Ask at any health centre about the catch-up schedule appropriate to your age. Most international health programmes in displacement settings use the same WHO-recommended schedules.

In crowded displacement settings, measles is the most transmissible of all vaccine-preventable diseases. A single dose of measles vaccine provides over 90% protection, and two doses bring protection close to complete. If you are unsure whether you or your children received measles vaccination, do not delay asking. Outbreaks in camps spread rapidly and the consequences for young children can be severe.

Mental health after displacement: when to ask for help

Displacement is a traumatic experience that leaves a lasting mark on mental health. A systematic review published in 2022 that examined dozens of studies on Syrian refugees found rates of post-traumatic stress disorder (PTSD) exceeding 30%, with depression and anxiety similarly prevalent. These are not personal weaknesses. They are predictable medical responses to extreme circumstances.

Signs that warrant seeking mental health support include: difficulty sleeping or repeated nightmares linked to what you experienced; avoiding places or situations that remind you of what happened; emotional numbness or a sense of disconnection from daily life; episodes of crying or anger that have no clear external cause; and repeated negative thoughts about the future or your own worth as a person.

Mental health support is not a luxury in displacement. It affects your ability to care for yourself and your family. Look for psychosocial support services run by organisations in your area. Many offer group or individual sessions in Arabic at no cost. The barrier to asking is the hardest part. The services themselves are usually accessible once you take the first step.

Community support groups, where people with shared experiences meet regularly, have been shown to reduce isolation and improve coping even when formal therapy is unavailable. Ask at any NGO office whether such groups exist. For children especially, re-establishing structured routines through school, play activities or community programmes is one of the most effective interventions available.

Women's and children's health in displacement

Pregnant and breastfeeding women need special attention in displacement settings. Giving birth without trained attendants in an unsafe environment carries serious risk. As soon as possible after arriving anywhere, inform any health provider of your pregnancy so you are prioritised within available care programmes. Most international health organisations prioritise pregnant women in their services.

Children are more vulnerable to illness in displacement environments because of weakened immunity and inadequate nutrition. Monitor your child's weight regularly and watch for signs of malnutrition such as extreme thinness, swollen abdomen, or thin and brittle hair. Enrol the child in any supplementary feeding programme available in your area.

Vaccination against hepatitis A, measles and rotavirus is particularly important for young children in crowded refugee settings where transmission is easiest. Ask about available vaccination schedules as soon as you arrive at any settlement.

How the Sihtak app can help you

The Sihtak app provides a private, secure space to record your personal and family health history. You can save test results, medication lists, vaccination dates and notes about your conditions in one place that you can access from your phone at any time and from any location.

When you move to a new doctor or health centre, you can share your record directly rather than relying on memory or waiting for files to be transferred between locations. In displacement, the ability to carry your medical record with you digitally can make a real and immediate difference to the quality of care you receive.

Sources

• Doocy et al., Prevalence and care-seeking for chronic diseases among Syrian refugees in Jordan, BMC Public Health, 2015
• Akik et al., Host country responses to non-communicable diseases amongst Syrian refugees: a review, Conflict and Health, 2019
• Akik et al., Healthcare system responses to NCDs among Syrian refugees: Jordan and Lebanon, Journal of Migration and Health, 2022
• World Health Organization: Refugee and migrant health
• UNHCR: Accessing healthcare in displacement situations
• Mental health outcomes in Syrian refugees: a systematic review, PubMed, 2022