UPDATE: March 19, 2015
Fighting in eastern Ukraine has reduced since the February 15 ceasefire, halting more than a month of escalating violence. Despite the ceasefire, however, some areas still experience shelling. Meanwhile, intense fighting continues over the front line town of Debaltseve.
The conditions for civilians caught in the conflict zone are dire and the humanitarian situation continues to deteriorate. “We don’t have plans for the future,” says Alyona, a 24-year-old woman who fled Debaltseve with her husband and two-year-old son. Concerned about the impact the conflict was having on her son, Alyona sought assistance from an MSF psychologist. “It is difficult to have hope,” she says. “Everybody has been affected, mentally or physically. People had everything, [and] now my child is homeless.”
For people on both sides of the front line, living conditions are precarious. Residents face a severe shortage of basic needs, such as food and medication. Many medical facilities have been damaged or destroyed by the fighting, while doctors struggle to treat their patients with dwindling supplies.
“Medical workers have been under intense strain for months on end dealing with thousands of wounded and displaced people,” says Loïc Jaeger, deputy head of mission for MSF in Ukraine.
MSF is responding by expanding its operations in the region. Aside from supporting doctors and medical facilities close to the fighting, MSF medical teams are providing basic healthcare and medicines to people close to the fighting, mainly through mobile clinics.
Mobile clinics are now operating in 25 locations in and around the front line, including rural areas outside Donetsk and Luhansk cities, in heavily affected towns such as Uglegorsk and Debaltseve, and to displaced people staying in Svyatogorsk.
“We haven’t had a doctor in Uspenka for many months,” says Lydia, a 65 year-old living in the Donetsk region. “The previous doctor died before the conflict. So people had to go to Amvrosievka [approximately 14 miles away] if they needed to see a doctor. Now Dr Wael from MSF comes here and there are long queues to see him. I’m very grateful to MSF, they help people here a lot.”
MSF has also expanded its psychological support program, providing counseling to both individuals and groups affected by the violence in 30 locations.
As of March, more than one million people have been displaced by fighting in Ukraine, with over 600,000 seeking refuge in other countries. Many more have been trapped in front line towns, unable to escape due to heavy fighting. In Gorlovka, one of the hardest-hit cities on the front line, thousands of civilians were unable to flee the violence, with only one narrow and dangerous road leading out of the city.
Since January 13, when the most recent surge in violence began, directors of hospitals in Dontesk, Stakhanov, Pervomaisk, and Novoaidar—all supported by MSF—have reported a drastic increase in wounded patients admitted for care, putting increased pressure on overburdened and under-supplied hospitals.
“The intensification in fighting has only exacerbated the already acute shortage of essential medicines such as antibiotics, pain killers, and suture materials,” says Jaeger.
MSF has been relieving pressure on these and seven other hospitals on both sides of the front line by providing much-needed supplies. Since the beginning of the conflict, MSF has providing supplies and medicine to treat almost 18,000 wounded patients, 14,400 chronic diseases, and 2,000 childbirths.
|MSF-provided Supplies||Since Start of Conflict|
|Wounded (supplies for treating X wounded patients)||17900|
|Chronic diseases (medicines for treating X patients)||14400|
|Primary health care (medicines for treating X patients)||13300|
|Maternity (supplies for X deliveries)||2000|
|Hygiene kits (no. of recipients)||5634|
|Mobile clinic locations||25|
|Primary health consultations (mobile clinics)||1790|
|Individual counselling sessions||1144|
|Group counselling sessions||1874|
|Psychological training sessions||432|
|Drug resistant-TB facilities supported||5|
|Drug resistant-TB patients under treatment||170|
Ukraine: Latest MSF Updates
- Ukraine: Reaching the Vulnerable
- Ukraine: Voices from the Front Line
- Ukraine: Fighting Declines, but Medical Situation Remains Dire
- Ukraine: Debaltseve, a Town Devastated by Fighting
Why are we there?
- Armed Conflict
- Health care exclusion
This is an extract MSF's 2013 International Activity Report:
The dual drug-resistant tuberculosis (DR-TB) and HIV epidemics in the Ukrainian penitentiary system are an urgent public health issue.
Overcrowded prison environments and the inadequate healthcare provided to inmates exacerbate the spread of DR-TB. The diagnosis and treatment of the disease in Ukrainian prisons is limited.
Since 2012, MSF has provided DR-TB treatment to prisoners and ex-prisoners in eastern Ukraine’s Donetsk region. DOTS (directly observed treatment, short course), the treatment recommended by the World Health Organization, is provided in a special prison TB hospital and in three pre-trial detention centers. Antiretroviral (ARV) therapy is given to DR-TB patients co-infected with HIV. After the prisoners are released, MSF works to ensure that they complete their DR-TB treatment.
The course of treatment for DR-TB takes up to two years and can result in a number of side effects, some of them severe, including vomiting, nausea, depression, and loss of hearing. Counseling is an important part of the patient-centered program, to help people cope with their diagnosis and adhere to treatment. Inmates often come from deprived environments, with difficult family histories and experiences of social marginalization. Some have psychological disorders, and many suffer from drug and alcohol addictions.
MSF provides laboratory services for rapid, accurate TB diagnosis, adverse effects diagnosis, and management, and guarantees an uninterrupted quality-assured drugs supply is available. MSF also lobbies the State Penitentiary Service of Ukraine and the Ministry of Health, at regional and national levels, for the integration of TB and HIV services and multidisciplinary, patient-oriented TB case management in penal facilities.
At the end of 2013, MSF had 62 staff in Ukraine. MSF has been working in the country since 1999.
Andriy*, 31 years old
“I grew up in Artyomovsk, a small town outside Donetsk, in eastern Ukraine. Unfortunately, I am infected with drug-resistant tuberculosis. I was studying to become a builder, but I got into a drunken fight one night and ended up in jail.
Inside prison, MSF started to provide me with DR-TB treatment.
When I got out of prison, my mother had died and my sister had sold my flat. I had nowhere to go. MSF will provide me with treatment until I am cured, and has also arranged for me to stay at the Artyomovsk TB dispensary until I can find a place to live.”
* The patient’s name has been changed.