Asthma in Disaster Zones

The Global Asthma Network (GAN) report issued in 2022 and the Global Initiative for Asthma (GINA) report of 2023 emphasize challenges and difficulties faced by health workers in managing asthma in Low- and Middle-income countries (LMICs). Among the many reasons for these difficulties are insufficient knowledge of health workers of management guidelines, and lack of medical resources especially inhaler medications^1,2,3. When available in limited amounts, these resources are prohibitively expensive^4,5,6. These reports did not address the impact of disaster on asthma care. In this article, we aim to highlight this issue, hoping that future international asthma reports will take this aspect into consideration.

When disasters such as war and earthquakes occur in LMIC, several aspects of asthma care are negatively impacted. First, challenges in asthma management are compounded by difficulties related to displacement, overcrowding in shelters, immigration of health care workers (HCW), damage to health facilities, limited referral capacity to specialists, and limited availability of expensive inhalers^4,5,6. Second, governments face logistical challenges. While the immediate need may be to provide emergency needs,^6,7 health facilities should secure medications to provide care according to World Health Organization (WHO) guidelines⁷. Third, asthma research and data collection are hampered.⁸ Digital health could be a solution^9,10.

It is therefore imperative that we develop suitable asthma management programs applicable to zones in turmoil^4,11,12.

We conducted a literature search on challenges in asthma management in zones of turmoil. We used the following search keywords and phrases: asthma and war, asthma and turmoil, asthma and earthquakes, and asthma and disasters. We reviewed all publications that relate to this topic that appeared in the literature between 2014 and 2023. Based on this review and analysis, we list several lessons learned, conclusions and recommendations.