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|
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 2014 International Activity Report:
Over 600,000 people were displaced and 10,000 wounded during the intense conflict in eastern Ukraine in 2014.
The political protests that started in late 2013 gained momentum in 2014, leading to violent clashes between police and protestors and the removal of the Ukrainian president from power in February. Doctors Without Borders/Médecins Sans Frontières (MSF) provided medicines and supplies to health facilities receiving the injured in the capital Kiev. Following protests in the east of the country, fighting broke out in May between armed separatist groups and Ukrainian government forces.
Medical supply lines were severely disrupted or cut completely, and health facilities’ budgets for the year were quickly exhausted. While local doctors were able to cope with treating the wounded, they faced an acute shortage of medical supplies, so MSF donated medicines and materials for treating war-wounded patients to hospitals in Donetsk and Luhansk regions.
As the conflict spread and intensified, MSF dramatically increased this support, and by the end of the year had provided enough supplies to treat more than 13,000 wounded patients in hospitals on both sides of the front line.
Throughout the conflict, hospitals were damaged by shelling, depriving people of medical care just when they needed it the most. This demonstrated a lack of respect for the health staff who continued to offer care at great risk to themselves, even though many of them had not been paid for months on end.
Despite a ceasefire in September, the fighting dragged on and medicines became increasingly difficult to obtain. Following a Ukrainian government decision to withdraw all support for state services from rebel-controlled areas, pension payments were cut, leaving disabled and elderly people particularly vulnerable, and all banking services were blocked. People began to delay going to see a doctor simply because they could not afford transport or medication. In response to the difficulties people were facing to access basic health care, MSF started to expand its medical support to include those patients with chronic diseases such as diabetes.
MSF teams also distributed more than 2,600 hygiene kits, including soap, dental supplies, and towels, to people in Donetsk region who had fled their homes. In preparation for the harsh winter, MSF donated 15,000 blankets to hospitals and displaced people around Donetsk and Luhansk.
Treating the Psychological Effects of War
In March, MSF began to work with Ukrainian psychologists in Kiev, conducting training sessions and workshops on psychological problems such as depression and posttraumatic stress, and treating patients on both sides of the conflict. From August, MSF psychologists started to run individual, group, and family mental health sessions in several cities on both sides of the front line in the east, educating people about emotional reactions following traumatic events, and teaching them practical tools to help cope with fear, anxiety, and nightmares. In addition, MSF psychologists trained local medical and mental health staff to improve their skills and avoid burnout.
Tuberculosis (TB) Program
MSF has been running a program for people with drug-resistant TB within the regional penitentiary system in Donetsk since 2011. Throughout the conflict, MSF has made every effort to keep this project running and support patients to avoid treatment interruption. When heavy shelling made it too dangerous for the teams to reach the penitentiaries, they ensured the drugs were still available by delivering them to a safer location to be picked up by prison staff.
At the end of 2013, MSF had 71 staff in Ukraine. MSF has been working in the country since 1999.
Svetlana—a patient receiving counseling from an MSF psychologist
“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?”