14 November 2019
Lebanon Diabetes Type 1
12-years old Houssam during a consultation at MSF clinic in Aarsal. He is enrolled in the continuous glucose monitoring programme that MSF offers in its clinics in the Bekaa and North Lebanon for diabetes type I patients who are under the age of 15. Photo: 
Jinane Saad/MSF

“The news really scared us. We didn’t know that this disease could affect children. We had wrong perceptions about diabetes and how its treatment goes”, says Mohammed, Houssam's father, when asked about their reaction upon learning that their youngest son suffers from diabetes type I.

Around a year ago, following some health complications that let to hospitalization, 12-year-old Houssam was diagnosed with diabetes type I.

Ever since Houssam has been receiving comprehensive medical care at the Doctors Without Borders (MSF) clinic in Aarsal, North Bekaa, which includes medical consultations, treatment, and health education.

He was also provided with all the necessary tools to measure blood sugar levels and receive insulin injections. But now, and for four months, his treatment evolved.

Diabetes type I affects people at a young age, who often find difficulties adapting to this lifelong chronic disease. One of the challenges faced is getting children and parents to accept that the treatment of this disease depends greatly on insulin injections, not on oral medications.

Patients with diabetes type I suffer from pancreatic insufficiency, meaning that the pancreas does not produce enough insulin, thus preventing blood sugar (glucose) from entering cells and producing energy.

The disease also requires periodic monitoring of the blood sugar levels, especially knowing that children affected by diabetes type I are more prone to sudden imbalances which could have serious complications and long term side effects.

As such, MSF gives special attention to this category of patients and is further developing its programs to better cater to their needs.

However, these risks do not negate that patients can have a normal life too. Good disease management implemented by the child and the parents, as well as regular medical follow-up, can guarantee a normal life and the prospect of a bright future.

Lebanon Type 1 Diabetes
12-years old Houssam during a consultation at MSF clinic in Aarsal. Photo: 
Jinane Saad/MSF

“I dream of travelling to Sweden to study and become a doctor”, says Houssam. “I got used to living with the disease, and I am now able to keep it under control with the help of my parents and the support of the medical team”, he added with a smile.

“The most difficult thing about it is not being able to have French fries whenever I want and having to take insulin with needles”. However, Houssam no longer uses the traditional measuring device which requires pricking with needles to measure blood sugar levels.

He was put on the Continuous Glucose Monitoring (CGM) program. This program is provided by MSF to 80 children in Lebanon, within the framework of the chronic disease treatment program specific to diabetes type I patients below the age of 15.

In view of enhancing the quality of life of diabetes type I patients, empowering them, and increasing the level of adherence to treatment, MSF has been adopting the CGM program in its clinics in the Bekaa Valley and Northern Lebanon since mid-2019.

Patients wear a sensor on their arm which measures their blood sugar levels.

The device should be scanned at specific times during the day and night in order to save and display data in the form of graphs, allowing patients and parents to take immediate action and address sudden drops or spikes in sugar levels.

This also allows the medical team to adjust the treatment program during the medical examination based on accurate data.

12-Year-old Sidra shares Houssam’s struggle with diabetes and the challenges of committing to a healthy diet, as she often wishes she could have sweets with her siblings and friends.

However, she uses a different treatment technique: Sidra gets the necessary insulin doses using the insulin pen. MSF provides the insulin pen to over 100 children in its clinics in the Shatila camp in South Beirut.

Lebanon Type 1 Diabetes
Sidra is a 12-year-old affected by diabetes type I. She was admitted to Doctors Without Borders’ clinic (MSF) in Shatila Camp, South Beirut, almost a year ago, where she is provided with insulin pens. Photo: Jinane Saad/MSF

“We use the insulin pen with children and adolescents suffering from diabetes type I because it is more practical for them.

Children or parents can adjust the insulin dosage with more precision, not to mention it is fast-acting”, says Laura Rinchey, Project Medical Referent of the MSF South Beirut project in Lebanon.

“The objective behind this technique is to allow children to control their disease and manage their health on their own. This is the first step towards adapting to living with diabetes.

Our health education and counselling teams work towards providing optimal support to children and communicating the necessary information to parents, thus allowing them to cooperate and provide a healthy lifestyle to their children”, she added.

Houssam will soon get the insulin pen which will spare him the use of needles, as MSF plans to implement this technique in its clinics in the Bekaa Valley. However, if MSF services were not available, Houssam and Cedra might not receive this quality medical care.

Sidra's mother affirms that the family is suffering from difficult financial conditions due to their refugee status and that she is unable to afford the treatment and tools that Sidra needs.

Lebanon Type 1 Diabetes
She was admitted to Doctors Without Borders’ clinic (MSF) in Shatila Camp, South Beirut, almost a year ago, where she is provided with insulin pens. Photo: Jinane Saad/MSF

The insulin, monitoring device, strips and insulin pens could cost up to 100 every month, an amount she can simply not afford. “I am sometimes unable to provide the healthy food recommended for my daughter, let alone the medication”, she says. “This worries me.”

Although being diagnosed with diabetes type I might shock the children and their parents and present an obstacle in terms of treatment costs, our medical teams attest to the courage of these children and the increased awareness of parents. 

They are doing a great job adapting to this disease and protecting their children from its psychological repercussions and physical complications.

The children that come to our clinic embrace life with a smile, their hearts filled with innocence and determination.


Read more about MSF's activities in Lebanon