When airspace above the Middle East began to close earlier this year in response to the ongoing conflict, my first thought was for patients with diabetes.
As Director of Global Programs at the NGO Direct Relief, I’ve seen conflicts shut down access to insulin and other cold-chain medications time and again, as supply chains collapse and logistics become unpredictable. While virtually all medical conditions make patients more vulnerable to instability, patients with noncommunicable diseases — and especially those who need consistent access to specialty medicines — are at deadly risk.
Almost immediately a Lebanese partner, the Chronic Care Centre in Baabda, near Beirut, reached out. An International Diabetes Federation associate member and longstanding Direct Relief partner, they were hoping we could supply enough rapid-acting analogue insulin to support the 1,200 children and youth who rely on the centre for their diabetes care.
Michele Abi Saad, the centre’s managing director, described staff members coming to work even as they could hear and feel aerial strikes nearby. They cared for displaced families, providing smaller quantities of insulin and more frequent refills to patients living in shelters without reliable refrigeration.
Michele’s long experience of emergency response has taught her to stockpile quickly and plan for long-term disruption.
“This is why I was really keen at the beginning, really at the first day, to contact our suppliers to make sure that I had everything and to contact our partners,” she told Direct Relief.
Michele was able to provide firm data on allocation and consumption. We calculated that 5,700 packs of rapid-acting analogue insulin would support those 1,200 young patients for six months. Getting such a large shipment safely to the Chronic Care Centre meant coordinating a failsafe supply chain that wouldn’t allow precious medication to be wasted, and finding donors to fund its transport on a rare commercial flight into Lebanon.
The conflict had strained shipping channels across the region, drastically cutting down commercial cargo flights and raising transport prices sky high. We were confident we could coordinate the cold chain logistics and find a pathway through the air, but we needed to find additional support to make it happen.
And we were fortunate. A longtime donor not only provided the insulin we were shipping, but generously offered to fund its transport into Lebanon. We were able to deliver this medicine despite the difficulties, and to do it quickly.
To me, this story illustrates two non-negotiable truths about humanitarian work: First, being worthy of trust means fulfilling commitments. It’s a straightforward ideal, but it’s complicated in practice, especially at a moment when disasters and conflicts are on the rise, needs are tremendous, and global resources are strained.
Second, this work is about listening to and supporting others. When Michele described endocrinologists, social workers, and dieticians coming to work as explosions shook their neighbourhoods, their dedication to their patients and their mission was clear. They were already responding, already a trusted partner, already embedded in the local community. They just needed the medicine that made their work possible.
Direct Relief’s role was to make sure they had it.
