Although fighting in eastern Ukraine has reduced since a ceasefire came into effect on 15 February, shelling continues in some areas and medical needs remain urgent on both sides of the frontline. Residents and displaced people are living in extremely precarious conditions, many medical facilities have been damaged or destroyed and there are critical shortages of basic and specialised medicines and medical supplies.
In response to the surge in violence since January and the increasingly dire humanitarian situation after ten months of conflict, Médecins Sans Frontières (MSF) has rapidly expanded its medical activities on both sides of the frontline in the hardest-hit areas.
MSF reaches shattered Debaltseve
On 21 February an MSF team was able to reach the heavily affected city of Debaltseve, after weeks of intense fighting made it impossible to provide humanitarian assistance there. MSF had been supporting the hospital in Debaltseve with supplies since September 2014, including sending medicines in January.
“The city has been destroyed,” says Olivier Antonin, MSF’s Emergency Coordinator. “The windows of the houses have been blown to pieces, tree branches are strewn on the ground, and power lines are severed hanging in the wind. The people who remain are living in shelters or in basements of buildings as it’s freezing inside the houses. There is no electricity, no heating and no running water in town. When we arrived they were in shock, asking where they could find medications or other assistance. Many need drugs for chronic diseases.”
The city’s two hospitals have been damaged, with one unusable. Only three doctors remained for the entire city – the head doctor of the Central hospital and two others working in a clinic located in the ground floor of a building on the main square. Although many residents have fled or been evacuated, out of a population of 25,000 people before the fighting, at least 5000 people remained and many are in urgent need of medical care. The MSF team provided medical supplies for treating war-wounded, medicines and supplies for basic healthcare, as well as materials such as syringes, catheters, and gloves. An MSF doctor also began providing consultations on 24 February in the city.
Teams are currently assessing the situation around the city of Gorlovka, where an MSF surgeon provided support to Hospital #2 during the most intense period of shelling in January. A team visited Uglegorsk, east of Gorlovka, on 25 February, where the hospital has been shelled. Two days later, they began mobile clinics and mental health activities, and this week will distribute essential relief items to 1000 families in the city and surrounding villages.
Huge need for basic healthcare
MSF has started running mobile clinics in 19 locations in Donetsk and Luhansk regions to provide basic healthcare to people living in rural areas or displaced by the conflict. In just the first three weeks, MSF doctors carried out more than 1500 consultations, illustrating the huge need for healthcare and medicines in these areas.
"We see mostly respiratory infections, because many people have been living in damp, overcrowded and unheated basements," says Zahir Muhammad Khan, MSF’s doctor in Svyatogorsk, a town one hundred kilometres north of the frontline. MSF is running a mobile clinic in four sanatoriums in Svyatogorsk where more than 3000 people fleeing the conflict zone have taken refuge, many since the escalation in fighting in January.
With medical supply lines in the east of the country severely disrupted or cut entirely since last summer, and health facilities located in rebel-held areas not included in the 2015 Ukrainian government health budget, people now face a critical shortage of medicines. Banks have been closed and pensions have not been paid for many months, so people have been delaying going to see a doctor simply because they cannot afford the cost of transport or medication. The price of medicines has increased significantly and even basic medications such as painkillers are out of reach for people. Patients with chronic diseases are particularly affected, with the majority of MSF’s patients in the mobile clinics needing treatment for heart disease, hypertension, diabetes or asthma.
The humanitarian situation is particularly alarming in Luhansk region as the shortage of medicines and essential supplies, including food, is even more acute. Most people who have remained in Luhansk are the most vulnerable members of the community – the elderly, disabled, and sick – who did not have the means to flee the conflict. As well as running mobile clinics in health centres in rural areas, the MSF team is also supporting social facilities, including hospices for the elderly, disabled, orphaned, and people with psychiatric disorders, by providing consultations, medicines and hygiene materials.