“Access to quality care and medications is limited. Women, children, adolescents – representing over 60% of the affected people – and the elderly are disproportionately affected by a severe reduction in health services, care and support.”
This is the health picture of the humanitarian crisis in eastern Ukraine, painted by WHO and other organizations at a high-level conference organized jointly by the European Commission and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), held on 28 February 2018 in Brussels, Belgium. The conflict in Ukraine has affected 4.4 million people and has led to the displacement of 1.6 million. In the eastern part of Ukraine, 3.4 million people need humanitarian support. Around 200 000 residents in the area near the contact line continue to face limited freedom of movement and shortages of food, fuel and medicines.
Despite ongoing humanitarian efforts, health needs continue to rise
Dr Nedret Emiroglu, Director of Programme Management and the Division of Health Emergencies and Communicable Diseases at WHO/Europe, briefed conference participants on the impact that 4 years of violence has had on the health-care system, and the most urgent health needs of the population. She outlined the support that WHO and health partners have provided in recent years, including delivering essential medicines and medical equipment for 2.5 million people living in conflict-affected areas, using mobile health clinics to provide psychosocial support services for 313 000, and upgrading blood banks to enable safe blood transfusions for roughly 50 000 people.
Despite these efforts, health needs continue to rise and the overstretched and fragmented health system can hardly respond. Prevention, treatment and care for chronic diseases are limited. This concerns people affected by noncommunicable diseases, such as cancer, diabetes, hypertension and heart diseases, in addition to those suffering from tuberculosis (TB), including its drug-resistant form, and HIV.
Dr Emiroglu stressed that Ukraine is 1 of the 18 high-priority countries in the WHO European Region for TB and is among the 30 countries in the world with the highest burden of multidrug-resistant TB. Mortality from TB in Ukraine is among the highest in the Region.
Ukraine has the second highest number of new HIV infections in the European Region and ranks fourth in the world among countries with the lowest levels of immunization, including against polio. Routine immunization coverage has declined as a result of the conflict. Dr Emiroglu warned, “We have already witnessed a polio outbreak and are now facing massive measles and diphtheria outbreaks”.
Health-care facility attacks
Over 150 health-care facilities have been damaged or destroyed during the conflict. Up to 66% of health facilities within 5 kilometres of the contact line in Ukraine were damaged in 2017. WHO condemns these attacks, which have an impact on families and the community at large, undermining health systems and long-term recovery efforts.
Investing in the future of Ukraine
Different voices at the conference echoed WHO’s concerns, highlighting that insufficient humanitarian support – including for health care, food and education – will destroy an entire generation. Funding for the ongoing humanitarian response in 2018 will determine how the health needs of those affected by the conflict will be covered.
The European Union (EU) has committed to providing further humanitarian aid to the sum of €24 million to help the victims of the conflict in eastern Ukraine, Christos Stylianides, European Commissioner for Humanitarian Aid and Crisis Management, confirmed at the opening of the conference.
According to Stylianides, the new emergency aid will help address basic needs – food, health care and education for children – of the most vulnerable populations along the contact line, including in non-government controlled areas. It will also help those who have fled the conflict areas to neighbouring countries.
With this new funding, the EU will have provided over €677 million for the people of eastern Ukraine since the beginning of the conflict in 2014.