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

By guest contributor Elburg van Boetzelaer

“When an older person dies, it is a library that burns down.”

With these words by Hampaté Bâ, Aissami Abdou, operations coordinator for Médecins sans Frontières (MSF), reminds us that older people play vital social and economic roles as caregivers, mediators, and community connectors in their communities, often providing stability and continuity in times of humanitarian crises. Older people can provide solidarity and support to each other, and to others across a range of ages, and often function as first responders in humanitarian crises. At the same time, evidence shows that older individuals are disproportionately affected by humanitarian crises due to a combination of pre-existing chronic conditions, mobility limitations, sensory impairments, and neurological or cognitive constraints. Yet, as emphasized in an earlier call to action, older people remain frequently overlooked in humanitarian responses. They are less visible in data collection, less prioritized in programme design, and less likely to be reached by standard delivery models. By 2050, one in five people will be over the age of 60, and 80% of them will be living in low- and middle-income countries (LMICs), contexts where humanitarian crises most frequently occur and where health systems are often least equipped to address the complex needs of older adults. This demographic shift creates an urgent need to re-examine how humanitarian preparedness and responses account for the healthcare rights and needs of older people. 

To mark the International Day of the Older Person on 1 October 2025, Médecins sans Frontières (MSF), HelpAge International, University Medical Center Utrecht and Knowledge Center Global Health organized an international symposium on healthcare rights and needs of older people in humanitarian crises, accompanied by an exhibition of pictures by HelpAge International, displaying older people across humanitarian crises and their testimonials. This symposium brought together humanitarian workers, public health experts, gerontologists and policymakers and highlighted the unique health challenges of older populations in emergencies and evidence-based interventions and best practices.  

The devastating effects of ageism: whose needs are counted and whose lives are protected?

To better understand the challenges to age-inclusive humanitarian health services, MSF’s operational research director Amrish Baidjoe asked symposium participants what they perceived bottlenecks to age-inclusive humanitarian responses. In line with previously identified challenges to age-inclusive healthcare services, symposium participants identified the lack of earmarked funding, prioritization, knowledge/awareness of humanitarian actors. The symposium’s keynote speaker, Claudia Mahler, UN independent expert on the enjoyment of all human rights by older persons, delivered her report on older persons in armed conflict and peacebuilding earlier this summer to the UN General Assembly at its 80th session. In her keynote speech, she stressed: “The right to health does not disappear in times of crises, or even in situations of severe resource constraints….Ageism leads to a form of structural discrimination resulting in unequal treatment with devastating effects – whose needs are counted in assessments and whose lives are protected.”

Rhea Tariq, Global Impact Director of HelpAge International, explained that ageism takes place at the individual, community and institutional level, and contributes to the exclusion of older people from humanitarian preparedness, response and recovery. More specifically, Basem Shaher, medical manager for SEMA (Syrian Expatriates Medical Organization), shared from his experience in Türkiye and Syria, that donor (de)prioritization is a major obstacle to providing appropriate services, explaining that donors often prioritize other vulnerable groups, leaving older people overlooked.

Observed healthcare needs of older people across humanitarian crises

To illustrate the plight of older people in humanitarian crises, MSF made a video, narrated by an 87-year-old woman, highlighting key findings of studies assessing health conditions and mental health symptoms and characteristics of sexual violence against older people in humanitarian crises. Rhea Tariq shared how she met older people in Ukraine who were unable to flee from violence, staying behind in collapsed appartements without heating or access to services. While Aissami Abdou, operations coordinator responsible for MSF programs in the Sahel region, shared that in the Sahel region, health services are often difficult to access, and do not meet the healthcare needs of older people, for example ophthalmological needs and cancer screening. Ruth Kauffman, emergency manager for MSF, shared her experience from Ukraine, where MSF adapted their sexual and reproductive health services to meet the needs of an ageing population, including urinary incontinence and pelvic organ prolapse, as stress, trauma, and potential physical injury from conflict are known contributing factors to urinary incontinence, and women in conflict zones face heightened risks for these issues. Favila Escobio, palliative care advisor for MSF, stressed that while Ukraine is called “oldest humanitarian crisis in the world”, this is not the only crisis that affects older people. He highlighted the critical need for integrating palliative care into humanitarian response, not only for those at the end of life but also for those experiencing prolonged suffering playing a crucial role in preserving dignity and alleviating suffering yet remains largely overlooked in humanitarian settings. Acknowledging that not all old people have disabilities, and not all people with disabilities are old, Maria Kett, professor at University College London and one of the co-founders of the Global Disability Innovation Hub, presented her work on access to assistive devices in humanitarian crises. Maria emphasized the underreported need of assistive devices in humanitarian crises, such as wheelchairs, walking canes, hearing aids and glasses, and how this unmet need impacts people’s independence, dignity and quality of life. Moreover she stressed again the crucial roles of older people in their communities as caregivers and source of support for older people and other community members, and how humanitarian actors should reflect on how to best support these roles.

Next steps towards better inclusion

Yuka Sumi, on behalf of WHO’s Department of Sexual, Reproductive, Maternal, Child, Adolescent Health and Ageing, introduced the integrated care for older people approach (ICOPE). ICOPE is WHO’s approach to provide a continuum of integrated care that helps to reorient health and social services towards more person-centred and coordinated care. The approach supports optimizing intrinsic capacity and functional ability for older people and bringing services in the community, close to older people lives. It is currently being piloted for application in humanitarian crises. Basem Shaher underlined the importance of community-based approaches to address social isolation, and age-inclusive health services, including adaptations for people with disabilities. Hans van Delden, Professor of medical ethics at the UMCU, raised controversial questions around making decisions in times of scarcity such as humanitarian crises. He concluded that to proceed ethically in situations of scarcity, resources would have to be used more efficiently, prioritize interventions and that minimum standards for older age in humanitarian crises, and a UN convention for the rights of older people is needed. 

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