A health system under attack: Ukraine one year on

On 24 February, 2022, Russian military vehicles crossed the border into Donetsk, sparking a series of events which defined the year. What followed dominated global news reports and marked one of IHP’s most significant disaster responses to date.

The ensuing conflict in Ukraine has uprooted lives. Within the country, there are now nearly 18 million people are in need of urgent protection and assistance. Over 5.3 million people are estimated to be internally displaced, and over 8 million refugees have been forced to flee the conflict to neighbouring countries such as Poland and Moldova.

Much of the population remaining in Ukraine cannot satisfy their most basic needs. Water, food and medicines are in short supply. Numerous challenges make it difficult to deliver vital medicines and aid, given the lack of safe humanitarian passage in areas of active fighting.

Millions of Ukrainians have been displaced from their homes. Over 8 million refugees have been recorded across Europe. PHOTO: Jana Cavojska

 

The bombardment on healthcare

One of the most devastating results of the ongoing conflict has been the vast destruction of the healthcare infrastructure, creating an urgent need for medicine and health supplies. Hospitals, clinics and health workers have been attacked and caught in the crossfire throughout the conflict and continue to be to this day.

WHO’s European Regional Director Dr Hans Kluge called the Russian airstrikes on Ukraine’s energy and medical infrastructure “the largest attack on healthcare on European soil since the Second World War.”  Since the start of the conflict, according to the WHO surveillance system, there have been over 800 confirmed attacks against healthcare in Ukraine – which makes up around 70% of the global total, which spans 16 countries.

Of the over 800 confirmed attacks against healthcare in Ukraine, 713 have directly impacted health facilities. PHOTO: Getty Images

According to Statista, not a month went by when healthcare in Ukraine was not under threat. March 2022 saw the peak of this threat, with 375 attacks over the course of the month. The WHO have verified 101 deaths of health workers and patients as a result of these attacks since the start of the conflict.

 

Data as of 24 February, 2023

Thanks to the organisations such as International Health Partners and their donation, only the doctors knew how close the hospital was to a complete lack of medicine at some points, but the patients did not feel it.

– Dr Shvaiher, Thoracic Surgeon at a hospital in central Ukraine–

The impact of conflict

These assaults on healthcare have adversely affected medical facilities, warehousing and transport; injuring and killing healthcare workers and patients. The hospitals which haven’t been destroyed are now overwhelmed by those seeking treatments for ailments, either caused or worsened by the current crisis. Thousands of Ukrainians have been without access to primary care, psychological treatment, gynaecological services, critical drugs, and medical supplies since March 2022.

Dr Iryna Bondarets, Chief Endocrinologist at a hospital in central Ukraine, experienced these challenges first-hand. “The big problem was that many essential medicines disappeared from the pharmacies due to broken pathways and constant attacks on infrastructure," she told us.

Dr Iryna Bondarets in her office. PHOTO: Project HOPE

Medicine and medical supply chains were crippled due to a lack of safe humanitarian passage in areas of active fighting. Many families have had to go months without access to even basic treatments.

Yevhen receives medicine for the first time since the conflict began through our in-country partner, Project HOPE. PHOTO: Project HOPE

“I worked in the construction of large facilities, but with the beginning of the war, my apartment was bombed, we lost our home, and I had to go to Kyiv with my wife and two daughters.” Yevhen, a civilian from the Donetsk Oblast region told our in-country partner Project HOPE, which IHP has supplied with medicine and health supplies. “Humanitarian aid is essential for everyone at the moment. Today is the first time we have received medicine. It is crucial for my family, and I hope we will keep getting aid until the war is over. We want to find a new home…and continue living a normal life.”

Ensuring trained medical staff and humanitarian workers were equipped with the medicine and supplies they need was a vital aspect of our response. During a crisis, it is critical that health workers are supported in responding to the drastically increased needs of the populations they care for. Many hospitals and clinics were forced to adapt the care they provide to meet the increasing need of patients.

Doctor Shvaiher has been a thoracic surgeon at a hospital in central Ukraine since 2012. Usually, thoracic surgery includes a variety of operations in the chest (thorax). From heart and lung surgeries to the throat. Since 24 February, 2022, the department has been forced to expand its care, helping people whose traumas are not limited to the chest, due to the drastic increase of patients with life-threatening injuries like explosive injuries, penetrating wounds, and polytraumas of the limbs.

Dr Shvaiher examines a recovering patient's leg wound. PHOTO: Project HOPE

In the first six months of 2022, Dr Shvaiher’s department had already served more people than throughout the whole of 2021. This meant that the amount of medicine the department had requested from governmental programmes at the start of the year, was a fraction of what was needed just months later. Dr Shvaiher told us of the relief IHP donated medicines brought to the hospital: “Thanks to the organisations such as International Health Partners and their donation, only the doctors knew how close the hospital was to a complete lack of medicine at some points, but the patients did not feel it.”

Providing targeted support

IHP addressed a broad range of primary health needs during this disaster, supporting child health, maternal health and crisis-specific health needs for displaced people in Moldova, and people with restricted access to local health services. IHP has shipped over 450,000 treatments since the conflict began, ensuring over 150,000 patients had access to potentially life-saving medicines when they were needed.

 

As the winter months drew in, temperatures plummeted below 0°C, putting the populations’ health at huge risk. “A lot of people die from the cold, mainly from stroke, from heart attack and from respiratory infections." Dr Hans Kluge, the WHO's Regional Director for Europe, told reporters at a press conference in Kyiv in November 2022.

Temperatures in Ukraine plummeted as low as -11°C in December. PHOTO: Jana Cavojska

“Until February 24, I lived a calm and balanced life with my beloved wife.” Maxim, a 64-year-old from a city in south-eastern Ukraine, reflected on his life in Ukraine before the conflict. “We spent every weekend with our grandchildren. On weekdays, we walked in the park near the house, and in the evenings, we watched our favourite TV shows every day at 8pm. February 2022 made my life black and white. My beloved wife, my beloved Lena, died. My life was ruined. They took her from me. The children persuaded me to go from there to [stay with them].

In the summer of 2022, I suffered a heart attack. I went to my family doctor where I was prescribed medicine from Project HOPE,” IHP supplied over 300,000 treatments and supplies to Project HOPE in Ukraine throughout 2022. “I take medication because I must survive for the sake of our kids. After the war, I want to see my children and grandchildren live a calm and balanced life, as I once did with my Lena.”

 

Ukraine is a crisis that has devastated lives and left the population scattered across the country and Europe. Meanwhile, there doesn’t appear to be an end to the conflict in sight. Reports suggest Russia is beginning a fresh offensive, intensifying its bombardment of Ukrainian towns and cities, and ramping up military activity along frontlines in the east of the country.

 

IHP will continue to work closely with our partners working in Ukraine to monitor the needs as the crisis continues and provide targeted support.

 

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