Armed conflict often draws attention to immediate casualties and overwhelmed hospitals, but the broader health consequences for civilians are less visible. In the Middle East, the recent escalation in Lebanon, Iran, and the Gulf countries is another phase of a prolonged conflict, where dense urban areas face repeated bombardment. While direct injuries are evident, the cumulative impact on people living with non-communicable diseases (NCDs) and population mental health remains insufficiently recognized and addressed.
NCDs, which require continuous care, reliable medication, and regular follow-up, are particularly vulnerable during conflict. Clinic closures, disrupted supply chains, and displacement of patients and healthcare workers lead to preventable complications such as strokes, diabetic crises, hypertensive emergencies, and amputations. These interruptions often cause higher morbidity and mortality than direct war injuries, yet emergency response rarely prioritizes NCDs, despite their life-threatening implications for conditions like type 1 diabetes.
In Lebanon, Médecins Sans Frontières (MSF) is responding to the growing needs of displaced populations while maintaining routine care. Drawing lessons from the 2024 Israel-Hezbollah conflict, MSF has adapted care delivery through online consultations, phone support, and alternative drug distribution. Mobile clinics provide medical consultations and psychological first aid, integrating NCD management with mental health services to address both physical and psychosocial risks. Anxiety, depression, and trauma are significant contributors to the worsening of chronic conditions, making integrated care essential.
MSF prioritizes access to insulin for people with type 1 diabetes, providing guidance on medication management, food insecurity, and emergency storage of insulin without reliable electricity. Peer support networks and digital platforms like WhatsApp have become critical for sharing lifesaving advice and maintaining treatment continuity. Health workers themselves face repeated displacement, personal loss, and extreme stress, highlighting the psychological burden on caregivers, which is vital for sustaining healthcare delivery under conflict conditions.
Prolonged exposure to violence, trauma, and insecurity erodes individual and community coping mechanisms, forcing populations into survival strategies such as self-medication and social withdrawal. This cumulative psychological harm is worsened by violations of international humanitarian law, attacks on healthcare, and obstruction of aid, which undermine trust in protection systems and exacerbate long-term mental health risks.
For the global medical community, these realities emphasize that emergency trauma care is necessary but insufficient. Sustaining care for long-term conditions, integrating mental health services, and adopting adaptive community-based and remote healthcare models are critical. Above all, protecting healthcare services and upholding international humanitarian law are foundational determinants of health. The conflict in Lebanon exemplifies these challenges, which are present in many contemporary conflicts, though often less visible and less prioritized by donors, yet profoundly impactful for affected populations.
