Attacks on medical facilities are a violation of international law

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Dr. Jarno Habicht, Head of the WHO Country Office in Ukraine, WHO Representative, in an interview with Interfax-Ukraine spoke about the impact of the war and the actions of the aggressor on medical infrastructure and access of Ukrainians to medical services

Text: Anna Levchenko

What are the main problems currently identified by the WHO in the field of health care and medicine in Ukraine? Which of these problems are related to the war?

After eight months of Russia’s invasion of Ukraine, the country’s critical infrastructure has been impacted, but the resilient health system continues to deliver lifesaving care with the support of WHO and partners as it prepares to a difficult winter ahead.

Access to health care has been hampered due to the war amid ongoing attacks on health care which render some health facilities non-functional and significantly impact the way people access health care .

The ongoing war has also had a significant impact on supply lines to enable the provision of life-saving medical supplies to reach those most in need by humanitarian actors, including the WHO. Ensuring access to vital medical supplies in newly accessible areas in Ukraine remains a top priority for WHO in Ukraine and we continue to deliver much needed supplies to these areas.

The WHO has verified more than 660 attacks on healthcare in Ukraine since February 24, 2022. National authorities have also recorded attacks on healthcare in the country. These attacks violate international law and have injured or killed healthcare workers, patients, and disrupted supply lines and damaged hospitals and health facilities.

Other health-related issues include the increase in chronic diseases, including hypertension, high blood pressure and other non-communicable diseases. The massive displacement of populations within Ukraine has also caused additional strains on local health facilities, particularly in smaller towns and rural areas, as health systems learn to adapt.

A recent health needs assessment conducted by WHO in Ukraine showed that soaring costs, logistical obstacles and damaged infrastructure are making access to essential services all the more difficult for a growing number of civilians. Read more.


Does the WHO have answers to solve these problems based on the accumulated experience of other countries, or is Ukraine’s experience unique to some extent?

WHO is working closely with the Ministry of Health, national and local health authorities and its more than 150 partners on the ground to work towards the recovery of the health system in Ukraine.

WHO is one of the largest suppliers of medicines to Ukraine and has delivered over 1,300 metric tons of medical supplies to the country since the Russian invasion on February 24, 2022. These supplies include oxygen generators for ensuring the continued operation of intensive care units, power generators to ensure hospitals can continue to operate and provide vital care in emergencies, surgical kits, essential drugs to treat chronic diseases, ambulances And much more. These supplies can often mean the difference between life and death and keep the health system running even in some of the most difficult circumstances.

We are also continuing to deliver much-needed supplies to newly liberated areas, including the Kharkiv and Donetsk regions. Areas such as Izium, Lyman, Kharkiv and Sviatohirsk have been reached in recent weeks with vital humanitarian supplies and more areas will be reached in the days and weeks to come.

WHO is also working programmatically in various areas to ensure that it responds to health needs in Ukraine. In collaboration with the Office of the First Lady, WHO supports the provision of mental health and psychosocial support to the civilian population and health workers. Tens of thousands of psychosocial support consultations have taken place since the war.

WHO has trained thousands of health workers across a range of needs, including gender-based violence, trauma surgery, mass casualties, chemical exposure, epidemiology and laboratory diagnostics. WHO is also supporting continued vaccination against COVID-19 with vaccine donations through the COVAX facility and other immunization programs, all the more critical as winter approaches with an expected surge. respiratory infections.

Support the coordination of emergency medical teams across Ukraine by providing medical consultations, trauma and emergency surgeries, rehabilitation supplies, and supporting medical evacuations.

We continue to support the mobile health unit team project for 7 regions to ensure continued access to health care. It focuses on treating non-communicable diseases, including cardiovascular disease, hypertension, respiratory disease and diabetes, which remain the leading cause of premature death in Ukraine. WHO is also helping distribute drugs for non-communicable diseases in hard-to-reach areas, with a focus on the most vulnerable.


What assistance is WHO providing to Ukraine? How and by whom is the provision of this assistance coordinated?

WHO coordinates with authorities at the national level with the Ukrainian Ministry of Health and at the local level with authorities and health facilities. WHO support complements efforts by authorities at national and local levels. We also coordinate with other UN agencies and more than 150 humanitarian partners, with WHO as the health cluster lead agency.


Does WHO monitor the distribution/use of aid provided?

We have established an efficient supply chain that allows us to bring tons of medical supplies to Ukraine and distribute them throughout the country in coordination with the Ministry of Health.

Emergency pre-positioning of medical supplies in regional warehouses ensures they are ready for immediate use in areas as acute needs arise. To this end, besides our main office in Kyiv, we have established five regional centers with warehouses in Lviv, Vinnytsia, Odessa, Dnipro and Poltava.

WHO in Ukraine maintains regular dialogue with health authorities at national and local levels and monitors the distribution and use of the aid provided.

How does WHO assess the prospects for post-war health system recovery? How much money do you need for this? How long will it take?

A key question that must guide the recovery is how to ensure that key health services reach the populations that need them most. While rebuilding some facilities may be part of the response, WHO is also committed to supporting the long-term recovery of the health system in Ukraine.

Building a better, smarter healthcare system is as much about improving processes and policies as it is about increasing investment in healthcare. Strengthening the health workforce, ensuring the availability of affordable pharmaceuticals and other essential medical supplies, and driving evidence-based change through the effective use of clinical data and practices and public health remain a priority for WHO in Ukraine.

Investing in health not only guarantees well-being, it also lays the foundation for long-term national recovery and growth. The availability of health services and medicines conveys a sense of safety and normalcy for all and promotes reconciliation and trust in local and national government. In short, health must be at the center of recovery.


What attention should be paid to supporting the mental health of Ukrainians during the war? What resources will be needed to support the mental health of Ukrainians after the war?

It is estimated that one in five people in conflict situations suffers from a mental health problem. Ukraine is no exception. It is estimated that 22% of the population currently living in conflict-affected areas are likely to have some form of mental health problem at any time in the next 10 years – one in 10 people suffering from a moderate or serious as depression with suicidal behavior or psychosis. People with pre-existing mental disorders who previously relied on public mental health and social care face additional challenges in accessing the services they need.

The population is also affected by anxiety or sadness, sleep disturbances, fatigue, anger and unexplained somatic symptoms. Ensuring that Ukrainians and healthcare workers have continued access to mental health and psychosocial support is a priority for WHO in coordination with its partners on the ground.

Everyone should appreciate and know how to protect their mental health and well-being. In this regard, basic self-help strategies and the practice of basic stress management techniques should be prioritized during these difficult times and consult the services of public health institutions and mental health specialists if necessary.

However, we believe that with such a level of commitment and innovation from the government and the First Lady’s office, Ukraine is well positioned to advance its mental health system and services quite quickly, because many preparatory measures have been taken within the framework of the reforms under way in this area. field in recent years.


Does Ukraine have the appropriate infrastructure? How can WHO help in this regard?

WHO provides technical advice to the Ministry of Health and the Office of the First Lady as well as other partners. WHO also chairs a group of up to 300 partners working in the areas of mental and psychosocial health in Ukraine through the promotion of best practices, training of frontline workers in stress management, staff training from PHC to the management of common mental health problems.

Ukraine has taken steps to overhaul its mental health infrastructure. This process was initiated before the war. In the context of war, mental health support structures must be carefully planned, supported and successfully implemented upon completion, as mental health support is essential for Ukraine’s recovery.

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