Across Ukraine, war-related insecurity, combined with extremely stressful living conditions, is triggering a worrying trend of people seeking medical care late. These late consultations often leave patients developing complications that could have been prevented with timely care.

For months, many patients, particularly elderly people, seeking routine consultations with Médecins Sans Frontières (MSF) teams have ended up requiring hospitalisation. Manageable chronic conditions have worsened in silence until they become emergencies.

Vira, 64, from Mykolaiv, is one of them. Having fled the city following Russian shelling, she now lives in Ostrivka, in Mykolaiv oblast (region).

“My apartment was destroyed, just like those of my daughter and son,” says Vira. “That’s why we came here. But insecurity persists. A farm has recently been hit. Many cows were killed.” 

“I was scared. I started to feel weak and experienced double vision,” she continues. “Luckily, as I couldn't find any family doctor, I went straight to the hospital.”

After examination by an MSF doctor, Vira, who lives with diabetes, was rapidly referred to one of the hospital’s inpatient wards.

Like her, more than 3,200 patients MSF teams have seen since the beginning of the year in supported hospitals near the frontline, have been directly referred to specialist hospital departments for stabilisation of their chronic disease. This represents over 75 per cent of all patients MSF has seen at triage stage. The most common diagnoses are hypertension, diabetes, and ischaemic heart disease (coronary artery disease).

Mobile clinic teams working in shelters for displaced people and remote communities near the frontline report the same trend. In some cases, patients arrive in such severe condition that ambulances must be called for urgent care.

“People are living under constant stress, exposed to daily attacks, power cuts, and prolonged uncertainty,” says Robin Meldrum, MSF country director in Ukraine. “This makes it difficult for them to recognise when a condition is serious. What should be manageable, chronic conditions, are becoming life-threatening.”

Among patients seen by MSF, many are elderly people with complications for medical conditions such as hypertension, diabetes, and asthma, following the interruption of their outpatient care. In Kherson, for instance, the average age of patients admitted to the intensive care unit we support is 63.

“By the time they reach a doctor, they are often already in a critical condition — and sometimes [it’s] too late,” says Meldrum.

Bringing care closer

Access to healthcare remains a major challenge in some parts of Ukraine. Since Russian forces launched the full-scale invasion in February 2022, many local clinics have been damaged or destroyed, medical staff have left, and pharmacies are often closed. Reaching a doctor can require travelling long distances — sometimes 20, 30, or even up to 100 kilometres — along damaged roads and under the constant threat of drone strikes. Public transport has mostly collapsed.

Disruptions to healthcare are also affecting patients with tuberculosis and other infectious diseases. Many must travel long distances to continue treatment, while reduced access to diagnostics means cases may go undetected — masking the true scale of needs.

To address these gaps, MSF supports hospitals near the frontline and runs mobile clinics in Donetsk, Dnipropetrovsk, Kherson, Mykolaiv and Zaporizhzhia oblasts.

“We try to reach settlements where access to medical care is most limited,” says Katsa Brenneman, MSF health promotion manager in Ukraine. “However, due to insecurity — including attacks on civilian infrastructure, railway stations, and passenger buses — people are afraid to leave their homes.” 

“Humanitarian workers are also operating under constant threat; we have had to suspend activities in dozens of locations near the frontline because of missile and drone attacks,” says Brenneman.

MSF teams are trying their best to maintain some level of general healthcare in areas that are too dangerous for people to physically access by conducting remote consultations. In these cases, an MSF-trained community volunteer takes vital signs and assists with patient interaction, while consultations are carried out via video call with an MSF doctor. 

As the war continues, ensuring access to basic healthcare is not only about treating emergencies but preventing them. Without timely care, manageable chronic diseases will continue to escalate into life-threatening conditions, silently worsening the health of those already living through extreme hardship.