Medical needs remain urgent for both residents and people displaced by conflict on both sides of the front line in Ukraine. Many Ukrainian health workers have left rebel-held areas, leaving thousands of people in remote villages without access to adequate health care. Many medical facilities have been damaged or destroyed, and there are critical shortages of both basic and specialized medicines and supplies.
Doctors Without Borders/Médecins Sans Frontières (MSF) continues to expand its medical activities to meet the needs of people living in the hardest-hit areas, and to those who fled the conflict. Since the beginning of the conflict, MSF has supplied more than 110 facilities, hospitals, ambulatory treatment centers, and social facilities with medicines and medical materials and equipment.
In January, MSF began running mobile clinics in the Donetsk and Luhansk regions, on both sides of the front line, to provide basic health care to residents and displaced people living in temporary accommodations in towns and villages. MSF teams now run mobile clinics in more than 30 locations in the cities of Donetsk, Luhansk, Debaltseve, and Artemivsk, and in villages in the surrounding region, trying to reach people in rural areas where the needs are acute.
People living in villages closest to the front line are suffering the most. In these areas there are far fewer medical staff—or none at all—and no drugs. Most of the people who have remained in rebel-controlled areas are elderly or disabled, or did not have the means to leave. MSF doctors mostly see patients with chronic diseases. Respiratory infections are also common, as many homes have had windows blown out and people are living in poorly heated shelters.
Mental Health and TB Care
MSF is also expanding its mental health program to reach more people affected by the conflict, including patients in social facilities, displaced people, and medical workers. More than 1,100 individual consultations were conducted from May 2014 to February 2015. Many patients are traumatized by the events they experienced and can experience insomnia or anxiety. Some witnessed bombings and lost loved ones, while others were separated from their families when they fled. MSF provides counseling to alleviate the most acute symptoms they experience.
MSF has been running a multi-drug resistant tuberculosis (TB) program in Ukraine since 2011, and currently has 170 patients under treatment in five pre-detention centers and prisons in Mariupol, Artemovsk, Dnepropetrovsk, Dzhanivka, and Donetsk. The team provides all necessary drugs to treat the disease and to help patients deal with the side effects of the treatment.
When the conflict started in eastern Ukraine, MSF had to suspend its work in the detention centers, as heavy shelling made it too dangerous for the teams to reach them. However, even though the team could not get there, MSF managed to make sure that the drugs were still available—and they have remained so, without rupture, throughout the conflict.
MSF has now resumed its regular presence in the facilities and is helping to fill some of the gaps in health staff. Many of the patients who stopped their treatment have now restarted, and data from the past two months show good results in terms of their adherence to treatment. MSF is also trying to help control the spread of TB within the penitentiary system by providing support with early diagnosis and improved infection control mechanisms.