More than 2 years since Russia began its illegal invasion of Ukraine the tragic human suffering and loss of life are clear. Each day brings more death, injuries, and stories of people fighting for their lives. The implications of the war extend beyond the military and civilian casualties. There are geopolitical, financial, infrastructural, and health impacts. And the effects of this war, particularly on health and health care within and outside Ukraine, will continue long after violent conflict ends.
There is measurable declines in functioning across virtually all domains of health services, with the notable exception of emergency services, which increased consistently across most hospitals.
The impact of conflict on routine preventive health services, such as routine immunizations, oral health, cancer screenings, and routine pharmacy services. Many of these services were among the most affected with declines in services of more than 20% since the invasion.
WHO has documented 1552 attacks on health, impacting health providers, supplies, facilities, warehouses and transport, including ambulances. They have claimed at least 112 lives, including health-care workers and patients, and injured many more. It is difficult, if not impossible, to deliver health services at or near the front lines.
Since last February, the war has caused approximately US$2.5 billion (€2.29bn) in damage to health sector infrastructure in Ukraine, while the total reconstruction and recovery needs in the country are estimated at US$16.4bn (€15bn) over the next 10 years.
Challenges
Currently, two-thirds of those seeking care encounter barriers that are primarily related to cost, time and transportation. In areas close to the front lines, 22 percent of households delay seeking medical care, with 7 percent struggling to acquire essential medications. Family doctor access is also significantly reduced in these regions where financial constraints are more acute, and almost 25 percent cannot afford medicines, while 51 percent are unable to pay for medical services. The biggest challenges are listed below as:
Prosthetics – so far 90,000 amputations has been made.
Ukraine suffers from lowest immunization rates across several infectious diseases.
Insecurity and instability engendered by the invasion have impeded access to treatment programs for chronic and infectious diseases. Active conflict, disrupted supply lines, and unreliable communications restrict movement between care centres and access to medicines. Continuity of care is essential to treat noncommunicable diseases, which are a leading cause of premature death in Ukraine. Disruptions in treatment for chronic cardiovascular and respiratory diseases are likely to increase immediate term mortality. Many Ukrainians, including 120,000 living with Type 1 diabetes, rely on regular doses of life-saving medicines to survive.
Multidrug-resistant tuberculosis (MDR-TB) is a serious concer as well—Ukraine has the fifth-highest number of confirmed cases of extensively drug-resistant tuberculosis in the world. The Covid-19 pandemic halved tuberculosis case detection in Ukraine in 2020, and as the invasion further degrades tuberculosis surveillance capacity, interruption to treatment regimens will likely result in increased spread of drug-resistant variants.
Nine million people are expected to suffer from common mental health disorders and two million from severe mental health disorders as a result of Russia’s invasion. The Ukrainian Ministry of Health four million people need psychotropic medication and up to 15 million need other psychological support.
Needs
In terms of material needs, urgent priorities include surgical supplies, anesthetics, transfusion kits, intensive care unit equipment, and essential medicines. These supplies are difficult to deliver to territories under siege or heavy fighting.
– 26 required essential medicine types identified
– 4 medicines in critical demand
– Various medical equipment required
