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Healthcare needs of older people in humanitarian settings | Collections | MSF Science Portal
Healthcare needs of older people in humanitarian settings

Healthcare needs of older people in humanitarian settings

Globally, the number of older people is rapidly increasing, with those aged 60+ expected to more than double by 2050—yet in humanitarian crises, they remain one of the most neglected groups. Older adults often face higher risks due to chronic illnesses, mobility issues, and limited access to appropriate care, especially in low-resource or emergency settings. Despite these needs, humanitarian responses rarely prioritize them, and data on their health and mortality are often lacking.


This collection reflects MSF’s ongoing examination of its own data and practices to identify pathways toward more age-inclusive services in humanitarian crises. It includes analysis of data from MSF-supported mental health services, inpatient departments, and sexual violence services, and further offers several calls to action and reflections on why older people remain overlooked in humanitarian crises. However, MSF also acknowledges major challenges remain, including inadequate age-inclusive services, data gaps, and the need for more geriatric expertise.


Watch this space for more publications from a Lancet Healthy Longevity series on healthcare rights and needs of older people.


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See more collections

Expanding access to lifesaving new TB tools

Expanding access to lifesaving new TB tools
Many settings with a high burden of drug-resistant tuberculosis (DR-TB) lack access to advanced diagnostics and to groundbreaking new treatments. The Collection linked below spotlights work by MSF and collaborators to analyze barriers, identify gaps, and accelerate the roll-out of these tools to people whose lives hang in the balance. Several reports examine price, regulatory, and patent obstacles that persist despite considerable public investment into developing many of these tools. Other authors examine critical remaining weaknesses in care pathways—especially in screening and diagnosis, and particularly in children. Several studies describe new strategies that could be part of the solution, from a pilot program in Tajikisttan that trains family caregivers to treat children with DR-TB at home, to a person-centered care model adapted to a conflict zone in Afghanistan. Lastly, initial findings demonstrate that pregnant women—another vulnerable population—can be effectively treated for DR- and multidrug-resistant TB, improving maternal outcomes without harming neonates.
Safe abortion care at MSF

Safe abortion care at MSF
Medical and humanitarian harms of restrictive European migration policies

Medical and humanitarian harms of restrictive European migrat...
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Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

Conflict, persecution, poverty, food insecurity and natural disasters—increasingly fueled by climate change—continue to drive migration globally. Yet many wealthy countries are doubling down on hostile policies to prevent people from seeking safety within their borders, thereby subjecting them to a wide range of harms. In a newly-published report MSF focuses on European Union and member state policies that intensify exposure to violence, exploitation, risk of drowning at sea, disease, and lack of access to basic health care and shelter, both within European Union borders and beyond. The Collection linked below presents this report alongside selected publications illustrating the broader context, based on quantitative studies and accounts from MSF patients and medical teams over nearly a decade of operational experience along the European migration route. From violent, squalid detention centers in Libya— where people intercepted by the EU-supported Libyan coast guard are forcibly returned —to perilous Mediterranean crossings in flimsy rubber boats and often abysmal reception centers and camps within the EU, it documents how these policies and practices further harm highly vulnerable people seeking safety and protection.
Journal Article
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Research

Health conditions of older adults in complex humanitarian settings in low- and middle-income countries: a retrospective analysis of 2019–2025 data from Médecins Sans Frontières-supported inpatient departments

van Boetzelaer E, Keating P, Caleo G, Oluyide B, Masum RR,  et al.
2025-11-01 • BMJ Global Health
2025-11-01 • BMJ Global Health

BACKGROUND

Inpatient admissions of older adults in humanitarian settings in low-income and middle-income countries remain poorly documented, likely leading to g...

Journal Blog
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Perspective

Symposium on ageing in crisis: Advancing the overlooked healthcare rights and needs of older people in humanitarian crises

van Boetzelaer E
2025-10-29
2025-10-29
Journal Article
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Research

Differences in sexual violence against younger and older adults in complex humanitarian settings: a retrospective analysis from Médecins Sans Frontières in 2019–24

Van Boetzelaer E, Biru T, Idris A, Keating P, Staunton M,  et al.
2025-10-16 • Lancet Global Health
2025-10-16 • Lancet Global Health

BACKGROUND

Sexual violence against older adults in humanitarian settings is poorly documented, leading to gaps in prevention and delivery of support services. T...

Journal Article
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Research

Differences in mental health between younger and older adults in complex humanitarian settings in low-income and middle-income countries: retrospective analysis from Médecins Sans Frontières-supported mental health services, 2019–2024

van Boetzelaer E, Sleit R, Rodriguez E, Kagomba Barathi G, Escobio F,  et al.
2025-09-26 • BMJ Global Health
2025-09-26 • BMJ Global Health

BACKGROUND

Humanitarian emergencies increase the risk of development or exacerbation of mental health conditions. This study documents how mental health differs...

Journal Article
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Research

Mental health of older adults in humanitarian settings in low- and middle-income countries: a retrospective analysis from Médecins sans Frontières-supported mental health services, 2019–2024

van Boetzelaer E, Keating P, Wasara N, Rodriguez E, Escobio F,  et al.
2025-07-05 • BMJ Global Health
2025-07-05 • BMJ Global Health

BACKGROUND

More complex humanitarian emergencies have a profound impact on a rapidly growing ageing population. There are few data available on the mental healt...

Journal Article
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Review

Health needs of older people and age-inclusive health care in humanitarian emergencies in low-income and middle-income countries: a systematic review

van Boetzelaer E, Rathod L, Keating P, Pellecchia U, Sharma S,  et al.
2024-12-30 • The Lancet Healthy Longevity
2024-12-30 • The Lancet Healthy Longevity
Journal Article
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Commentary

Involving older people in the preparedness, response, and recovery phases in humanitarian emergencies: a theoretical framework on ageism, epistemic injustice, and participation

van Boetzelaer E, van de Kamp J, Keating P, Sharma SK, Pellecchia U,  et al.
2024-01-01 • The Lancet Healthy Longevity
2024-01-01 • The Lancet Healthy Longevity
Journal Article
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Letter

The disproportionate vulnerability of older people in humanitarian emergencies

van Boetzelaer E, Franco OH, Moussally K, Khammash U, Escobio F
2023-10-20 • Lancet
2023-10-20 • Lancet
Journal Article
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Commentary

Elderly people in humanitarian crises, a forgotten population: A call for action

van Boetzelaer E, Browne JL, Vaid S, Pellecchia U, van de Kamp J,  et al.
2023-07-17 • PLOS Global Public Health
2023-07-17 • PLOS Global Public Health
Journal Blog
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Perspective

Conflict in eastern Ukraine is a reminder that older people are especially vulnerable in emergencies

Simonyan G
2019-06-04 • BMJ Opinion (blog)
2019-06-04 • BMJ Opinion (blog)
Journal Article
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Research

Risk factors for mortality during antiretroviral therapy in older populations in resource-limited settings

O'Brien DP, Spelman T, Greig J, McMahon J, Ssonko C,  et al.
2016-01-01 • Journal of the International AIDS Society
2016-01-01 • Journal of the International AIDS Society
INTRODUCTION
An increasing proportion of adult patients initiating antiretroviral therapy (ART) in resource-limited settings are aged >50 years. Older populations on ART appear to ha...
Journal Article
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Commentary

Should mortality data for the elderly be collected routinely in emergencies? The practical challenges of age-disaggregated surveillance systems

du Cros PAK, Venis S, Karunakara U
2013-10-10 • Transactions of the Royal Society of Tropical Medicine and Hygiene
2013-10-10 • Transactions of the Royal Society of Tropical Medicine and Hygiene
Data on the elderly are rarely collected in humanitarian emergencies. During a refugee crisis in South Sudan, Médecins Sans Frontières developed a prospective mortality surveillance syst...
Journal Article
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Commentary

Ending neglect of older people in the response to humanitarian emergencies

Karunakara U, Stevenson F
2012-12-18 • PLOS Medicine
2012-12-18 • PLOS Medicine