It was February 24 when Russian troops invaded the country. Hospitals and health centers have been working ever since, with “very damaged” health care, in unfavorable conditions to heal and save all possible lives due to the war in Ukraine. Representatives of several of the most important NGOs operating on the ground told EFESalut: Doctors of the World and Doctors Without Borders.
“The war is taking a brutal toll on the people of Ukraine, especially in the east and south,” he says the Emergency Coordinator of Doctors Without Borders (MSF) in this country, Paulo Milanesio. In the areas to which the NGO has been able to access, it treats patients with war wounds in emergency departments, ambulances and the organization’s reference train.
The nature of the injuries that MSF professionals see near the front lines – people injured due to shelling and fighting – as well as the stories that patients tell them, “clearly show that civilians, including the elderly and children, they are not saved from the war in Ukraine”.
Immense needs of the sick
In eastern and southern Ukraine, the needs of the elderly, the chronically ill and the disabled are immense in a healthcare system badly battered by the war.
In fact, 40% of the Ukrainian population is a subsidiary of humanitarian aid for different reasons, he explains the president of Doctors of the World, Pepe Fernández.
Fernández relates what is happening with patients with chronic diseases such as diabetes but also with those with cancer who need oncological treatments, those with hypertension or cardiovascular pathologies, among others.
As a result of the war, the country has suffered a breakdown in the stockpiling of medicines and care processes, so that these pathologies are getting worse.
Elderly people, with disabilities…
Elderly people or people with various disabilities are also having additional difficulties traveling to Ukraine for health care because of the war.
And to all this we must add the power cuts in the most affected areas, which affect millions of homes, as well as medical care facilities. Thus, there are serious interruptions in the healthcare activity. All this in the middle of “a harsh winter”, remembers the MSF emergency coordinator.
Another important need is the rehabilitation of those who have passed the acute phase, in particular physiotherapy for traumatized patients with war wounds.
“This is an area of medicine that is not very well developed in the Ukrainian health system and the brutality of the war is resulting in people with serious injuries that will have lifelong consequences if timely and good quality rehabilitation is not provided,” adds Milanesio.
Health undermined by the war
The consequences of the war are being felt “very much in the health system and more so the further east we move, but also in the central area and partly in the west”, adds Fernández, who remembers that there are more than 5.5 million internally displaced people who go to other territories of the country, who need attention and a response capacity “that the health system does not have”.
“Health care is very damaged in the east of the country because we have recorded more than a hundred health infrastructures with direct and significant damage and there has also been a break in all the supply chains for the replacement of materials, equipment, goods, of supplies, and above all of medicines”, points out the president of Medges del Món.
In the same vein, explains Milanesio, who abounds that far from the front line, missile attacks against the energy infrastructure throughout Ukraine have been carried out since October and are causing significant damage, even in areas civilians
On this point, the president of Doctors of the World does not think that health infrastructures are being targeted by Russia, but he does emphasize that “international humanitarian law is not respected in relation to preserving health institutions from war attacks” something that, in his opinion, today with current technology “we know very well that it can be avoided”.
Invisible wounds: mental health
Fernández, in addition to providing figures such as the thousands of civilian deaths among which there are more than a hundred health workers, emphasizes the invisible wounds of the population related to mental health.
They are post-traumatic stress, adaptive disorders such as neurosis, anxiety, sleep disorders, alterations of this nature as a result of the stress that war also causes. Then there are those who have suffered an aggravation of the processes that dragged them before such as depressive syndromes, bipolar disorders or schizophrenia”, he adds.
The MSF representative also highlights these wounds which may seem invisible at first, but which are not at all.
“Mental health remains a serious concern as the needs are enormous. We treat patients with serious mental health problems. We see that people are devastated by what has happened and continues to happen and the uncertainty and fear that this war has created”, laments Milanesio.
Panic attacks, dueling, are common symptoms that MSF teams see in many parts of Ukraine, “whether the person has fled the fighting or stayed in the areas under attack.”
Bringing reality closer
To continue bringing the reality that the country is experiencing, the president of Doctors of the World recalls what we have experienced in Spain with the pandemic, which has caused a very high level of demand for direct assistance to people with covid which has influenced care for chronic and other diseases, and even affected surgical waiting lists.
“In Ukraine it’s this but much more serious,” says the president of Doctors of the World about healthcare during the war.
In this sense, it invites us to think, for example, of chronic renal failure that requires dialysis and requires a continuous supply of consumable materials when there are power cuts, or in patients with oncological treatments, either radiotherapy or chemotherapy.
For this reason, Fernández assures that indirect mortality has also increased as a result of the war.
What would Ukraine be without humanitarian aid?
Without humanitarian aid, the damage suffered by the country and the population would be much more serious. Only Medges del Món has ten locations within the country and others in neighboring countries.
“Humanitarian aid is vital,” emphasizes Fernández.
And MSF’s emergency coordinator explains how his teams provide primary health care and mental health services through, among others, mobile clinics. “We support local health workers to restart some medical services and help provide ‘catch-up’ treatment for people who have missed their medical care.