28 days of war, 64 verified attacks on health care, and 18 million people affected

One month of war has had a devastating impact on Ukraine’s health system, severely restricted access to services, and triggered an urgent need to treat trauma injuries and chronic conditions. Destroyed health infrastructure and disrupted chains of medical supplies now pose a grave threat to millions of people.

Impact on health

Close to 7 million people are internally displaced, and the number of people that have fled to neighbouring countries is fast approaching 4 million.

That means that 1 in 4 Ukrainians are now forcibly displaced, aggravating the condition of those suffering from noncommunicable diseases. According to the International Organization for Migration (IOM), 1 in 3 of the internally displaced suffers from a chronic condition.

A number of hospitals have been repurposed to care for the wounded: a shift due to necessity – which comes at the cost of essential services and primary health care. Approximately half of Ukraine’s pharmacies are thought to be closed. Many health workers are displaced themselves or unable to work.

Close to 1000 health facilities are close to conflict lines or are in changed areas of control. The consequence of that – limited or no access to medicines, facilities and health professionals – mean that treatments of chronic conditions have almost stopped.

COVID-19 vaccination and routine immunization has also come to a halt. Prior to the invasion, at least 50 000 people were getting vaccinated against COVID-19 per day. Between 24 February and 15 March, however, only 175 000 people were vaccinated against COVID-19.

Attacks on health care

As of 22 March, WHO had verified 64 incidents of attacks on health care in 25 days (between 24 February and 21 March) causing 15 deaths and 37 injuries. That is 2–3 attacks per day. WHO condemns these attacks in the strongest possible terms.

“Attacks on health care are a violation of international humanitarian law, but a disturbingly common tactic of war – they destroy critical infrastructure, but worse, they destroy hope,” said Dr Jarno Habicht, WHO representative in Ukraine. “They deprive already vulnerable people of care that is often the difference between life and death. Health care is not – and should never be – a target.”

WHO’s response

On the day the war started, WHO activated its contingency plans, repurposed staff and projects, and shifted focus to emergency needs – to support Ukraine’s health system and workers.

WHO works closely with Ukraine’s Ministry of Health and authorities to identify gaps and needs in the country’s health system – and swiftly respond. WHO has opened an operations hub in Rzeszów in Poland, developed a pipeline of trauma supplies to most Ukrainian cities, and sent more than 100 metric tonnes of medical equipment over the border, to health facilities across the country.

Some 36 metric tonnes of supplies are currently on their way to Lviv, with an additional 108 metric tonnes in the pipeline, consisting of trauma supplies, medication for chronic diseases, paediatric drugs and blood transfusion supplies.

“What we are delivering – and where – meets the very needs of people on the ground, where Ukrainian health workers are working around the clock in unimaginable circumstances. A team of trained health-care professionals can, with one WHO trauma kit that contains surgical equipment, consumables and antiseptics – save the lives of 150 wounded people. In other words, delivering 10 such kits, means 1500 lives saved,” said Dr Habicht.

As part of a United Nations convoy on 18 March, a WHO truck also reached Sumy in the north-east of Ukraine, carrying critical medical supplies sufficient to treat 150 trauma patients and provide primary health care to 15 000 patients for 3 months. Among other deliveries to health facilities in past days are artificial lung ventilation machines, chemical protection suits, a haematology analyser, liquid oxygen bulk tanks and cryogenic cylinders.

More than 20 emergency medical teams have also been deployed to Ukraine, Poland and the Republic of Moldova, to provide training and specialized medical care to supplement existing services.

In an [assessment of the public health situation in refugee-hosting countries, WHO identifies and lists key health risks and makes related recommendations – on vaccine-preventable diseases, maternal and child health, and chronic infectious and noncommunicable diseases.

“I have seen with my own eyes the exceptional humanitarian response in neighbouring countries, but this emergency is far from over. We expect more people – mainly women, children and older persons – with even greater health needs to be displaced in the coming weeks. They may face challenges in accessing the services and medicines that they need – and this can have life-threatening consequences,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.