Diabetes ranks among the top 10 causes of death globally and affects over half a billion people worldwide. Over 80% of those affected live in low- and middle-income countries.
Insulin pens and newer diabetes medicines can simplify treatment and reduce complications for people with diabetes. While these tools are widely available in high-income countries, access in low- and middle-income countries and humanitarian settings is extremely limited, due primarily to their higher prices.
“It caused me great pain to inject my child, especially since he was so young and sometimes cried. Many times, I cried before he did."
Sitting in her sunlit, mint-green kitchen in Athens, Amina* shares the difficulties she faced in managing her son’s type I diabetes on her own in Iraq, and how in spite of what she knew would be an extremely challenging migration journey from Iraq to Greece with three young children in tow, she fled her abusive husband.
“Do not think that the decision to travel was easy with children and a sick child. The only reason I travelled was my husband.
My son, Ehsen*, was seven years old when I first noticed changes in him. He started wetting the bed, which he had never done before, and his appetite increased. I immediately took him to a doctor, and he was diagnosed with type I diabetes and provided with insulin injections to manage his diabetes.
In the beginning, insulin pens – which are much easier to use – were not widely available in Iraq, so Ehsen had to use injections (with an insulin syringe and vial), and I had to inject him myself. The syringes were difficult because I was not experienced in administering them. It caused me great pain to inject my child, especially since he was so young and sometimes cried. Many times, I cried before he did.
After his diagnosis, I brought Ehsen’s medical records to his school to inform them of his diabetes and ensure he would be properly cared for. However, with 47 students in a class, the principal told me they would not be able to care for Ehsen and so he was forced to drop out of school.
I felt deep sadness and anguish for my child, because although Eshen’s diagnosis was quick, his health was not stable. His hospital visits were frequent and numerous.
Later, Ehsen began experiencing unstable blood sugar levels, which would rise and fall repeatedly. When his sugar level dropped, he would faint. If high, he required long hospital stays to improve his condition.
For me, coping with this was very difficult. I had no support. I was an orphan before I got married, and my husband’s membership in a local militia and violent acts in our community made people avoid me. At home, my husband’s treatment was worse. He was violent, he beat me, and I had to have several surgeries; but I did not fear for myself. I feared for my children and their future.
The decision to travel with three children, one of whom was sick was not easy. First, I consulted my children despite their young age. I sat with them and told them I wanted to take this step for their safety, to protect them from the violence of their father. I asked them if they were okay with it and they told me, “We will be with you on your chosen path.”
Then, when my husband was on a month-long training course, I went to a travel office and told them I wanted to travel to Turkey. I took some money and only two insulin pens for my son and we left (the average number of pens used in a month is 5).
At the airport, I had to plead with an officer to let me and my young children on the plane. Eventually, he took $300 and let me through but our plane was delayed, and I was terrified my husband had returned and was looking for me.
In Turkey, I was a stranger and did not know the language or where to go, but although things got easier, Ehsen soon had no more medication. His condition worsened and he was hospitalised. He spent a month and thirteen days in hospital. During this time, I learned my husband was looking for me and knew we had to leave.
Knowing my situation and living conditions, the hospital discharged us with enough medication and insulin pens for six months, a blood sugar monitoring device, and even a container with fruit and milk.
When we reached the coast to travel by boat to Greece, the smuggler saw me and said, "What are all these bags? How will you cross with them?" I told him these were my bags. He said I had to leave them and only carry a small shoulder bag. We were four people, and except for my sick son, we all a carried small shoulder bag, each containing only his medical supplies.
Unfortunately, our first attempt failed, and we returned halfway before reaching Greece. Living through this was not easy, but we tried again. During the journeys, my son was taking his medication, but it was not regular. When we arrived in Greece, he was again hospitalised.
Once we reached Greece, I applied for asylum. This allowed my family, and especially my son, health insurance so he could go to the hospital and get treatment. However, we were rejected twice, our insurance was stopped, and I couldn’t buy medication for Ehsen. That is how I reached MSF about a year ago, as through them I can access free medication, including insulin pens, for my son.
Thank God my son can now take care of himself and manage his treatment. This is especially because using pens is much easier, whereas the syringe requires someone to help.
It has been six years since we arrived in Greece, and only now my fear and anxiety for my son have increased. This is because I never expected the second rejection of my asylum application. Their excuse was that Iraq was a safe country, and I could return. My lawyer and I explained my situation and family condition. I am currently waiting for a response to a new file: I hope to have official papers because that will bring back medical insurance.
You might think from my talk that these are ordinary events, but living through it is not easy. Exile is difficult and takes away from a person's life. Anyone with diabetes who takes a journey like this should think through every step and consider securing treatment.
In the end, all I want is to ensure my children's future in a country that will embrace and care for them.
