When imagining a refugee camp you may think of long dusty roads, thousands of tents, and families suffering from malnutrition. However, in Iraqi camps where scores of people are displaced by fighting, one of the most dangerous effects of nutrition are chronic diseases such as diabetes and hypertension. Most recent statistics for Iraq estimate that around 10.2% of the population suffer from diabetes, significantly higher than countries such as England (6%), or the US (9%).
There are more than three million people displaced from their homes in Iraq, in addition to several hundred thousand refugees from the war in neighbouring Syria. For elderly Iraqis suffering from diabetes, who are forced to leave their home to travel to a distant camp, it can be difficult to manage their disease with insulin or other medications. When medications are unavailable or people cannot afford to purchase them, it becomes essential for them to manage their condition through lifestyle changes such as proper diet.
Baharka and Harshm camps near Erbil, Iraq have thousands of residents who fled from their homes as ISIL invaded. In order to help people manage their conditions, International Medical Corps carried out diabetes screening for camp residents over 40 years old. Every person who has diabetes was then invited to get together for an educational event in one of the tents.
Dr Hamsa Mohammed, Senior Community Health Officer for International Medical Corps in Erbil, Iraq, manages a team of Community Health Workers who bring education to displaced people in camps and communities around Iraq, teaching them about managing diseases such as diabetes through simple lifestyle changes.
She said: "At our event we taught the community members that in order to manage their diabetes they should avoid sugar and carbohydrates, and should instead ensure they are eating foods that are high in fibre and protein. Even amongst those who were aware of the fact that they had diabetes, many had not heard of a low-glycaemic diet before, and were eating the wrong foods for their condition."
At the event, the team lead a cooking demonstration just like a television cooking show, in order to teach the community members how to make healthful foods, and to show them that preparing foods for the diabetic diet can be both easy and tasty.
"There are many traditional Iraqi foods that are healthy for diabetic people such as fasulye (Iraqi beans) or bulgur wheat cooked with vegetables", Dr Hamsa says. After the cooking demonstration all of the people who came to the event were served a healthy lunch. They were also provided with a food basket containing bulgur, lentils, nuts, and other foods that they could take home and cook for themselves, to start abiding by the diabetic diet.
"One woman who attended the event had been living with diabetes for over 20 years", Dr Hamsa recalls. "She had sores on her hands and feet that were not healing - a common complication from diabetes. After learning that she could eat cheap foods such as beans and bulgur wheat as well as cutting sugar and carbohydrates to lower her blood sugar she has been able to begin managing her disease, and the sores that had been on her feet for months are now disappearing."
In camps and communities around Iraq, International Medical Corps is providing medical services to people displaced from the local conflict. In order to help people live in a way that is healthy and dignified, health education is provided to people so that they can live with their chronic conditions.
"Teaching the community members simple changes like drinking tea without sugar, or eating bulgur instead of rice can allow for them to get their diabetes under control even when medications are difficult to find", Dr Hamsa added. "Through our health education programme we ensure that all people from pregnant women to child labourers to diabetic patients receive the information that they need to live in a way that promotes health and happiness even for people who are hundreds of kilometres away from their homes."
Below is a healthy recipe for people suffering from diabetes. "It's a famous traditional Iraqi recipe", Dr Hamsa explains. "It is very simple - it is a favourite for many Iraqi families."
Iraqi White bean stew (marqa fasoulia bayda)
1 cup dry white beans, soaked over-night
400g lamb (optional)
4 cloves garlic
3 tablespoons tomato paste
1 crushed tomato
1 teaspoon curry powder
Salt and pepper
1. Put the lamb meat & the soaked beans in a pot, cover with water.
2. Bring to the boil, let it boil for about 30 minutes, lower heat and let it simmer for about 1 hour or until both are done.
3. In another pot, fry the garlic in vegetable oil on medium heat.
4. Add the tomato paste, stir for about 1 minute until the mixture is well-blended.
5. Add the crushed tomato and the spices and the remaining water of boiled beans & meat (or 2 cups water).
6. Bring the mixture to a boil, lower the heat and let it simmer for 60-90 minutes.
7. Serve with bulgur and green salad.