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Ukraine - First train referral

Ukraine 2022 © MSF

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Ukraine

As the war in Ukraine escalates, our teams are responding to a deepening humanitarian crisis.

Our work in Ukraine

On February 24, 2022, Russia launched a large-scale military operation in Ukraine that rapidly escalated into a war across most of the country. We are expanding our medical and humanitarian response to the evolving needs.

Mariupol, Ukraine AP 13 March

What's happening in Ukraine?

Access to health care has been difficult for people living along the contact line of the conflict in eastern Ukraine since fighting intensified in the region in 2014. Prior to the escalation of war across Ukraine in February 2022, MSF ran a range of activities, including programs for tuberculosis (TB) and HIV care. We started new projects in Donetsk and Luhansk, while continuing to support the national COVID-19 response. Now we have had to halt normal activities and are carrying out an emergency response.

MSF staff members transport a patient from our medical train after its arrival in Lviv from Kramatorsk on April 7, 2022. The train evacuates patients in need of higher levels of care from hospitals close to the front lines.

How we're helping in Ukraine

Before the war escalated in February 2022, MSF teams in the Donetsk region were working with local volunteers, organizations, health care professionals, and authorities to help people travel to health care facilities, access prescribed medications, and to raise awareness about common health challenges.

As of July 1, 2022, there are approximately 147 international Doctors Without Borders/Médecins Sans Frontières (MSF) staff and 494 Ukrainian staff working across Ukraine, with more joining the team every day. They work as medical staff (surgeons, doctors, nurses); psychologists; logistics and administration; and management. We currently have teams based in Apostolove, Dnipro, Ivano-Frankivsk, Kharkiv, Kropyvnytskyi, Kryvyi Rih, Kyiv, Lviv, Odesa, Poltava, Pokrovsk, Uzhhorod, Vinnytsia, Zaporizhzhia, and Zhytomyr.

Since February 24, MSF has brought more than 800 metric tons of medical and relief supplies into Ukraine to support hospitals, health centers, and displaced people.

Medical evacuation trains

On April 1, 2022, MSF completed its first medical train referral, taking nine patients who had been wounded in or near the besieged city of Mariupol from hospitals in Zaporizhzhia to hospitals in Lviv. They were transported on a two-carriage train equipped as a basic hospital ward, accompanied by a team of nine MSF medical staff.

We are now using a larger and more highly medicalized train. So far, we have completed 30 referral trips, mostly taking patients from hospitals close to front lines of the war in the Donetsk and Luhansk regions. We have also evacuated seriously wounded patients from Kharkiv and babies and children from an orphanage in Zaporizhzhia. A total of 801 hospital patients have been medically evacuated to date, along with their family members, in addition to 78 orphans. Further medical referrals are planned as urgent requests from hospitals in the east continue.

Kyiv

In Kyiv we are running a telephone hotline for survivors of sexual violence and domestic violence, offering confidential consultations and delivery of medications to prevent HIV, sexually transmitted infections, and unwanted pregnancy in Kyiv and Chernihiv oblasts.

In Hostomel, on the outskirts of Kyiv, an MSF team continues to support basic health care alongside Ukrainian doctors, following intense fighting in the area in March and April. We are increasing our support for mental health care to address the psychological consequences of the war.

We support shelters for survivors of sexual violence around Kyiv with training for staff and mental health consultations for residents. We are working with a women’s clinic in Borodyanka and Pylypovychi, offering mental health support and conducting community engagement. We are also meeting with other local groups to collaborate and provide training for treatment of sexual and gender-based violence.

In Fastiv, Makariv and Borodianka, MSF is focusing on elderly and internally displaced people who suffer from chronic diseases, through mobile clinics and home-based care.

We also provide training to local health facilities and donate medical supplies to health facilities in the Kyiv oblast.

Sumy

We are running mobile clinics in villages in the Sumy region, offering general outpatient care, including family planning and treatment for chronic diseases or sexual and gender-based violence, as well as mental health services.

Chernihiv

We are shifting from running mobile clinics in several villages in Chernihiv oblast to a more specific focus on mental health needs, women's health, and caring for survivors of sexual and gender-based violence. We are working to reach patients through our hotline and are continuing to donate medical supplies to health facilities.

Kropyvnytskyi

Our teams are donating medical supplies, carrying out trainings for health workers and first responders, distributing relief items to displaced people and providing mental health consultations. We are supporting a maternity hospital to make health services more accessible for survivors of sexual and gender-based violence by providing transportation and paying for medications.

Kryvyi Rih and Apostolove

An MSF team is helping a hospital in Apostolove develop its emergency room and increase its capacity for responding to mass casualties. In the broader Kryvyi Rih area, MSF has started running mobile clinics providing basic health care, including sexual and reproductive health care. 

Mykolaiv and Odesa

To help Ukrainian health facilities cope with a potential influx of injured people, MSF teams have trained hundreds of medical doctors and nurses to triage patients according to the severity of their injuries.

In Mykolaiv MSF is also funding the work of local volunteers who bring medical and logistical equipment in and out of the besieged city.

In Bashtanka, north of Mykolaiv, we made a large donation of medications and emergency supplies to the local hospital after an airstrike caused many casualties on June 6. 

Kharkiv

In Kharkiv we have phased out our mobile clinics in metro stations now that many people are no longer sheltering there. We have moved our activities above ground, focusing on people who have no homes to return to or still need medical support. We are currently supporting displaced people staying at the University Hostel and Polyclinic N. 23. Daily shelling makes it challenging to work in the city, but our mobile clinic was able to visit 10 locations in and around the city in mid-June. 

Outside the city, we have started regular visits to two shelters in Donets and two shelters in Slobozhanske, providing medical consultations and mental health support. We are also continuing to visit remote villages in Kharkiv oblast, focusing initially on areas toward Derhachi, Chuhuiv and Ruska Lozova, to run mobile clinics, make connections and provide donations to health facilities.

We operate a phone hotline for Kharkiv city and oblast to respond to ongoing needs for medications and online medical and psychological consultations. We will collaborate with a volunteer network to distribute medications from our warehouse to people’s homes.

MSF Mobile Clinics in Kharkiv Metro

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Zhytomyr

In Zhytomyr, MSF teams are supporting care for tuberculosis patients to help them continue taking their medication correctly and complete treatment. We are providing patients with food, hygiene supplies and psychological support and transporting samples to the tuberculosis hospital for testing so patients' progress can be monitored. At the same time, we continue to support the regional tuberculosis hospital by providing medications as well as laboratory supplies.

Eastern Ukraine

In and around Dnipro we are providing support to people who have fled parts of Donetsk and Luhansk oblasts where the conflict has intensified and who are now staying temporarily or longer-term in more than 40 shelters. Many of the people living in the shelters are highly vulnerable, including the elderly, people with disabilities, unaccompanied children, and people who cannot afford to make the journey farther west in Ukraine or abroad. Our teams run mobile clinics in shelters, distribute relief items, ensure continuity of care for people with chronic illnesses, administer psychological first aid, and refer patients to hospitals when needed.

We are working with hospitals and primary health care centers close to the front line in Donetsk oblast to make sure they have enough of the right supplies and training to be able to keep treating patients even if they get cut off from supply lines by intense fighting. This includes support for primary health care, treatment for chronic diseases, maternal health care and trauma care. We are also providing logistical support to some of these facilities so they can have their own supply of electricity through generators and solar power, and clean water to continue functioning for up to a week.

MSF has a surgical team based in the region to provide guidance, coaching, and ongoing training for hospitals to improve and expand their surgical capacity, and also to help in case of an overwhelming influx of patients.

MSF runs an ambulance referral service based in the towns of Dnipro and Pokrovsk, transferring patients from hospitals near the front lines to health facilities farther away, such as in Dnipro. Some patients are also transferred onto an MSF medical train. In recent weeks, the ambulance service has seen been very active as fighting in the region has intensified.

In Zaporizhzhia, we are providing support to people who are arriving from Mariupol and other areas where fighting is intense. Our teams run mobile clinics in the main reception center and in shelters throughout Zaporizhzhia. We provide medical consultations, continuity of care, and medications for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease, and epilepsy, and referrals to hospital for severely unwell patients. Our teams also give psychological first aid and mental health consultations and basic relief items. We have donated medical supplies and carried out mass casualty training for staff at the main referral hospital in Zaporizhzhia.

Vinnytsia

In Vinnytsia we are running mobile clinics in shelters for displaced people, providing medical consultations and medications for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease and epilepsy, as well as psychological first aid and mental health consultations. Our team refers patients to hospitals when needed.

We donate essential household and relief items to displaced people, including items such as toilet paper, toothbrushes, toothpaste, soap, shampoo, diapers and towels.

We have rehabilitated a part of a medical facility to accommodate older adults who were evacuated from eastern Ukraine and require medical attention for chronic diseases.

Uzhhorod and Ivano-Frankivsk

We have carried out trainings with local health professionals, including on mental health for psychologists and first responders, and our teams have started group therapy sessions and mental health consultations with displaced people. We are supporting a clinic in Ivano-Frankivsk for displaced people, which is run by doctors who are also displaced from their homes, and we have started a mobile clinic for displaced people in Uzhhorod. We continue to donate supplies to health facilities and distribute relief items for displaced people in nearby rural areas.

According to the UN Refugee Agency, more than 7.2 million people have fled Ukraine since the war began, 2.3 million of whom have since crossed back into Ukraine. MSF is responding to the needs of Ukrainian refugees in neighboring countries.

Slovakia

More than 540,000 people have crossed to Slovakia from Ukraine, and more than 270,000 have cross back into Ukraine, as of June 28. We have signed a memorandum of understanding with the Ministry of Health to import medical supplies, and we have trained health staff on providing care for people with tuberculosis, including multidrug-resistant tuberculosis, and people who have suffered sexual and gender-based violence. For the moment, critical humanitarian and medical needs are being covered by local authorities and civil society. 

Poland

More than 4.3 million people have crossed from Ukraine into Poland as of June 28. We are supporting the Ministry of Health to provide treatment for patients with drug-resistant tuberculosis, including patients previously treated by our teams in Ukraine. 

Russia

More than 1.4 million people have crossed to Russia from Ukraine as of June 28. Our teams have worked in Russia for 30 years. Currently, our teams work with health authorities in the Arkhangelsk and Vladimir regions to support crucial, life-saving treatment for patients with drug-resistant tuberculosis. In the last few months, we scaled up our assistance to partner organizations in St. Petersburg and Moscow to ensure the continuation of HIV treatment for people from Ukraine and other people in need. We have seen an increase in the number of people from Ukraine living with HIV and hepatitis C who need refills of their medications. 

We have also recently started to support displaced people in Rostov and Voronezh, in coordination with local authorities. In May 2022, a dedicated MSF hotline was launched with an aim to provide referral services to medical and social support for refugees and displaced people from Ukraine. As of late June, with the support of local specialists, we responded to the needs of more than 100 people. In collaboration with local organizations, we delivered essential relief items including food, glucometers and supplies to diabetic patients from Ukraine in Voronezh. We are continuing this support with food and hygiene items.

Through local organizations, social workers and health providers, we aim to link people in need to existing medical and humanitarian services and improve their ability to receive medical and humanitarian support. Our work is focused on providing medical care where we can, based on medical need alone.

Belarus

According to the Belarus State Border Committee, more than 32,000 Ukrainians have arrived since February 24, including about 16,000 via the Ukrainian-Belarusian border. An MSF assessment team has moved to the border to assess potential medical and humanitarian needs.

In Belarus, our teams now see an increasing number of people forcibly displaced from Ukraine in need of medical assistance and social support. We are responding to the needs of patients from Ukraine, as well as other countries, in the Minsk, Brest, Gomel and Vitebsk regions. Among our patients are many children and people with chronic diseases, many of whom also urgently need psychological support. 

We continue to run our regular programs in Belarus, supporting the national tuberculosis program in prisons and elsewhere. Since 2021, we have also assisted people on the move stranded between Belarus and the European Union.

SEE MORE
MSF response to the war in Ukraine

How we're helping in 2022

703

International (133) and Ukrainian (570) staff working in response to the war

1,053

Patients transferred on evac trains

78

Orphans evacuated from an orphanage in Zaporizhzhia to an orphanage in Lviv

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Not everyone can treat patients in the field. But everyone can do something.

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