Chronic Disease in a War-Torn State

Background: Abkhazia, a small former Soviet Union state under international embargo with previously very well-functioning health and social system and infrastructure, suffers from health system collapse due to a civil war in a post-Soviet era. Medications and medical supplies are provided by international organizations. Chronic diseases such as coronary artery diseases, hypertension, and osteoarthritis were common before the soviet collapse and civil war.

Methods: During an ongoing and systematic evaluation to identify common pathologies in office visits, all 75 generalists and pediatricians in all countries' 24 clinics and hospitals documented diagnoses and treatments over a six-month period. Regular visits to offices ensured proper data collection.

Result: 86% of all diagnosis was: infectious diseases (40.5%) mostly upper and lower respiratory infections. Chronic cardiovascular diseases (18%) including hypertension and ischemic heart diseases as well as musculoskeletal diseases (5.6%) including osteoarthritis were documented. Other diagnoses included gastro-intestinal (4.7%) including gastritis and peptic ulcers, neuro-psychiatric (4.6%) including migraine, sleep disorders and epilepsy, skin disorders (4.6%), and chronic respiratory diseases (3.6%). Helminthes was 2.8%. Tuberculosis was epidemic. The provision of medications and supplies were adjusted accordingly to ensure proper management of common illnesses. Data was communicated to local authorities and other international organizations.

Conclusion: This data provides insight into the unique health challenges faced by a society with a previously well functioning system as compared to other common post-conflict states. The relatively high rate of chronic disease demonstrates that the epidemiology of disease after a conflict mirrors the original social and health characteristics of the society.