What’s left after the flames: Four years of full-scale war in Ukraine

“We use wipes now because it’s very cold,” says Damir’s mother, Kateryna Murashkina. “The room doesn’t warm up in time to bathe him. I’m afraid of giving my child a cold.”

Kateryna and Damir live in a former scientific institute in Dnipro, Ukraine, which was repurposed as a shelter in 2022 and is where Doctors Without Borders/Médecins Sans Frontières (MSF) teams now provide medical consultations for residents. Around 270 people displaced from occupied areas or destroyed cities now live there. Repeated strikes by Russian forces on energy infrastructure mean residents endure days without heating, water, or electricity — in temperatures that fall to minus 4°F.

Needs are growing as the conflict grinds on

MSF’s increased presence in shelters through mobile medical clinics reflects the growing needs for displaced people as fighting continues to empty towns and villages. Consultations provided through mobile medical clinics more than doubled in 2025 compared to 2024 — increasing from 4,327 to 9,500.

For many people living near the front line, the decision to leave home takes a long time, and is extremely difficult — despite the extreme danger posed by the encroaching front line. With limited financial means and few alternatives, elderly people and those with chronic illnesses often remain in their homes until sustained bombardment and the collapse of infrastructure and essential services, including medical services, leave them no choice but to flee.

The scale of destruction in Ukraine is enormous and has only grown since Russian forces invaded in 2022. The nature of frontline warfare encompassing artillery, drones and missiles, means that nothing and no one is spared as it shifts. MSF teams have also been forced to adapt — leaving seven hospitals and over 40 locations where they were running mobile clinics — when the situation has become too dangerous. 

Lyman, in the Donetsk region, is one district where MSF was running mobile medical clinics before insecurity made operations impossible. In June 2024, activities were suspended entirely. Today, approximately 2,000 residents remain in the frontline town, which faces daily shelling.

Lyman was also home to Zinaida Babisheva, who now lives in the Dnipro displacement shelter. She recalls life before the full-scale invasion, when she used to pull tables into the street on public holidays to eat with neighbors. She remembers her garden.

“We had apples, plums, cherries, pears, peaches. So many roses and lilies,” she says. “Now my daughter grows flowers, but I no longer feel like doing anything.”

Liubov Kuzmenko from Siverskodonetsk also lives in the shelter with Zinaida, Kateryna and Damir. She says her apartment was looted after Russian forces took control. But what weighs most heavily on her is separation from her family.

"My parents remained under occupation," she says. "My father died in 2024, and I couldn't even bury him. Now my sister comes to visit our mother, and I record videos for her and send her greetings. It depresses me so much that I'm not there, near my mother."

How MSF is supporting health care in Ukraine amid war

As the war grinds on, hospitals, pharmacies, schools and shops have been destroyed or closed. Entire communities have become uninhabitable. As fighting continues, displacement has risen — and the humanitarian needs grow more complex and prolonged.

MSF continues to provide medical and psychological care across Ukraine: supporting hospitals near the front line, running ambulances for war-wounded patients, and operating mobile clinics in shelters and communities hosting displaced people and in locations where people are trying to remain despite collapsing services and encroaching front lines.