Hey I'm Sudanese and have crohn's as well. I'm on azathioprine and about to start humira too. Humira's temperature needs to be kept at 2-8C and I think it spoils easily. If you don't have access to refrigeration then I would imagine it would not be possible for you to effectively take humira for an extended period while you're out there. Besides access to refrigeration another aspect that would concern me is exposure to UV rays. I don't know if you're on azathioprine as well but I know that that can give you an increased risk of skin cancer, and I'm pretty sure Humira does as well. If you did decide to go I would recommend taking stocks of sunscreen and covering up to avoid direct exposure. With regards to medical infrastructure and accessing treatment out there, I have no direct experience myself, but just judging from visiting numerous times, and as I'm sure you're aware, Sudan is very underdeveloped and I would not rely on health facilities/expertise even in the capital (where I have spent most of my time), let alone somewhere provincial like Darfur (although i stress again I have no knowledge of what the facilities are like in Darfur or anywhere else in Sudan for that matter). If they have prescribed Humira I would imagine its because you've exhausted other treatment avenues and the disease is still active. I would definitely consult closely with your doctor before making the decision to go to Darfur. I would check what the risks were for you with not taking Humira, as that might be effectively what you are doing, if you can't access refrigeration out there. I've been reluctant to start Humira myself and my doctors advice to me was that delaying going on the medication increases the risk that my gi tract will become permanently scarred by the untreated active disease and this in turn will increase the likelihood that I will need surgery in the near future. I would echo what shamrock said, you need to research whether taking Humira whilst you are in Darfur is feasible, and if not you need to research with your doctor what the potential impact on your health and the progress of the disease would be if you were to delay taking Humira, possibly for five years. This way you can weigh it up and be confident you are making an informed decision, whatever it is you decide to do. Good luck and I wish you the best with it!
