Why are we there?
- Armed Conflict
- Health care exclusion
Ukraine: Latest MSF Updates
- Ukraine: MSF Strongly Refutes False Allegations by Donetsk Authorities
- MSF Forced to End Activities in Donetsk, Leaving Thousands Without Health Care
- MSF Refused Permission to Work in Lugansk
- Ukraine: Reaching the Vulnerable
- Ukraine: Voices from the Front Line
- Ukraine: Fighting Declines, but Medical Situation Remains Dire
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 health care 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|
This is an excerpt from MSF's 2015 International Activity Report:
In January and February, fighting between the Ukrainian army and the self-proclaimed Donetsk and Luhansk People’s Republics escalated to a level not seen since August 2014, and had a devastating effect on civilians caught in the conflict zone.
MSF teams urgently expanded their support to hospitals on both sides of the frontline. However, heavy fighting trapped civilians in frontline towns and made it difficult for MSF to reach the hardest hit areas. Medical facilities were regularly shelled, forcing staff to flee and depriving thousands of people of healthcare. A ceasefire came into effect following the fall of the strategic city of Debaltseve on 18 February, three days after the signature of the Minsk II agreement.
In 2015, MSF donated medicines and medical equipment to more than 350 health facilities on both sides of the frontline, enabling the treatment of over 9,900 patients with conflict-related injuries and more than 61,000 with chronic diseases; additionally, 5,100 births were assisted. Teams also carried out around 159,900 basic healthcare consultations and 12,000 mental health consultations in cooperation with the Ministry of Health.
Supplying Essential Medicines
Although there was less fighting after the Minsk II agreement, shelling continued in many areas and medical needs remained on both sides of the demarcation line. Drug supplies had been disrupted or cut off for more than a year by this point and prices had increased significantly. People struggled to obtain antibiotics, painkillers and psychiatric drugs, as well as medications for chronic illnesses such as high blood pressure, diabetes and heart and kidney disease. The supply of essential drugs for tuberculosis (TB) and HIV, as well as vaccinations for measles and polio, was also disrupted.
MSF became one of the major suppliers of medicines for chronic diseases to hospitals, health centers and homes for elderly and disabled people in the east of the country. Teams provided insulin to more than 5,000 diabetic patients in 16 hospitals in Gorlovka, Donetsk, Yenakevo, Starobesheve, Telmanovo and Novoazovsk, and also provided haemodialysis supplies for patients with advanced kidney failure in Gorlovka and Donetsk.
In addition, teams ran mobile clinics in 80 towns and villages around Donetsk, Luhansk, Artemovsk, Mariupol and Debaltseve and throughout Luhansk region, offering basic healthcare and mental health support to residents and displaced people.
Providing Psychological Support
MSF psychologists provided individual and group counselling sessions for people affected by the conflict, including those displaced or wounded, and the elderly and children. They also trained health workers, teachers and social workers.
Continuing multidrug-resistant TB (MDR-TB) treatment
Throughout the conflict, the MDR-TB program that MSF has been managing in the penitentiary system in Donetsk region since 2011 continued until October. The team expanded its support to patients in penitentiary facilities in Mariupol, Artemovsk, Dnepropetrovsk and Zhdanivka.
First Aid at Checkpoints
MSF teams opened first aid and water points to assist people waiting in long queues in the freezing cold or intense heat who wanted to cross the frontline at the Artemovsk–Gorlovka, Volnavakha–Donetsk, and Mayorsk checkpoints.
MSF Forced to Cease Activities in Luhansk and Donetsk People’s Republics
Although MSF succeeded in working on both sides of the frontline for most of the year, in September MSF’s permission to work was refused in the self-proclaimed Luhansk People’s Republic, and at the end of October, its accreditation in the self-proclaimed Donetsk People’s Republic was also withdrawn. The projects were closed, leaving thousands of people vulnerable and without access to essential medical care.
Ukraine: War-Torn Minds
At the end of 2015, MSF had 254 staff in Ukraine. MSF has been working in the country since 1999.
Nina Dedukh – 64-year old patient receiving counselling from an MSF psychologist in Popasnaya
“I was in the yard with my husband when the shelling came. We had heard shelling before, but never this close. An artillery shell hit very close by. My husband was very badly wounded. Some shrapnel went into my legs and my chest. I still have a piece of metal lodged between my ribs. I called for an ambulance, but they said it was too dangerous . . . My husband died in the yard. I’ve been staying at this hospital in Svitlodarsk for two months with my five-year-old daughter because we have nowhere else to go. I’m too afraid to go back to Debaltsevo . . . Now I hear explosions when there aren’t any. When my daughter hears an explosion, she asks ‘Is that a grad or a shell?’ Is that normal for a five-year-old?”