The World Health Organisation is organising its activities in support of health care in Ukraine from Lviv in the Western part of the country while the attacks against the health care system continue.
WHO has a fully-functional office in Lviv and is setting up an operational base in Dnipro, in East-Central Ukraine, to mobilize resources more quickly and reach some of the most vulnerable people in conflict zones with urgent supplies.
In a statement to the press in Lviv on World Health Day yesterday, WHO Regional Director for Europe, Dr Hans Kluge, reminded that WHO was founded 74 years ago in the aftermath of the Second World War, “to uphold the principle that health is a human right, and all people should enjoy the highest standard of health”.
“As a doctor myself, I am here in Ukraine to stand in solidarity with the health care workers in the country,” he said.
“I thank them for their dedication and professionalism – as they continue to deliver care in the face of unimaginable human suffering and in scenes of total devastation - that no nurse, doctor, midwife, ambulance driver, pharmacist, therapist or social worker should ever have to experience.”
A grim milestone was crossed on Thursday in the war in Ukraine – more than 100 attacks on health care verified by WHO since the start of the war on 24 February. The attacks so far have claimed 73 lives and injured 51. Of the current total of 103 attacks, 89 have impacted health facilities and 13 have impacted transport, including ambulances.
“WHO strongly and unequivocally condemns these attacks,” WHO’s Director-General, Dr Tedros Adhanom Ghebreyesus, said. "This kind of destruction means that already battered communities will further be deprived of vital health services.”
The impact of this violence is not only immediate, in the numbers of deaths and injuries – but also long-term in the consequences for Ukraine’s health care system. It’s a major blow to the country’s efforts to institute health reforms and achieve universal health coverage, a goal it had made significant progress on before the war erupted.
WHO’s three priorities in Ukraine
In the current situation, WHO’s overarching goal is to ensure that people have sustained access to essential health care, and that it can respond to changing health needs due to the war. Given the uncertainties of the current situation, there are no assurances that the war will not get worse, Dr Kluge warned.
WHO’s activities are based around three priorities, he explained.
Firstly, to keep health services operational in Ukraine. Until now, over 185 tonnes of medical supplies have been delivered to the hardest hit areas on the country, reaching half-a-million people with materials to support trauma, surgery and primary health care. Last week, WHO was able to bring in supplies to the encircled city of Sumy.
Bhanu Bhatnagar, WHO Spokesperson in Ukraine, told The Brussels Times that to date, WHO has delivered trauma and emergency medical supplies to the following oblasts (districts): Kyiv, Cherkasy, Dnipro, Zhytomyr, Chernihiv, Sumy, Kharkiv, Poltava, Luhansk, Donetsk, Kherson, Odesa, and Zaporizhzhia.
A further 125 tonnes of essential items are also on their way. Assistive products – wheelchairs, other mobility aids, communication aids for the blind, are in transit, and will be distributed across Ukraine soon.
The second priority is to work with Ukraine’s neighbours, with countries across the entire European Region and beyond, to ensure that the health needs of those fleeing the war are met, treatment and care for refugees with special needs are maintained, and that the health systems of host countries can manage these large influxes of people.
So far, more than 4.2 million people have fled Ukraine since Russia’s invasion of the country. WHO is also coordinating with the EU to triage patients arriving, to make sure that they are received in an EU country that is best placed to treat them.
Thirdly, WHO is supporting the Ukrainian Ministry of Health to rebuild the country’s health system back better. WHO has had a presence on the ground in Ukraine since 1994, supporting the country to strengthen its health system especially the primary healthcare and health financing.
Since 2015, Ukraine had been in the process of reforming the entire health system, moving towards Universal Health Coverage. “The country had been making excellent progress on specific challenges – turning the corner in its fight against TB and HIV. It was a beacon of best practice in Eastern Europe, with TB incidence falling by almost half in the past 15 years.”
“Health requires peace, well-being requires hope, and healing requires time. The life-saving medicine Ukraine needs right now is peace.”
How is the COVID-19 situation inside Ukraine and among the refugees who have fled the war?
“Inside Ukraine, vaccination for COVID-19 has been disrupted. Prior to the conflict at least 50,000 people per day were receiving vaccination,” Bhanu Bhatnagar replied. “This number has dropped significantly, with only 175,000 people being vaccinated between 24 February and 15 March (an average of 8,750 vaccinations per day).”
“The COVID-19 pandemic is still here. It will not stop because of conflict. The virus will just take advantage of the situation. The virus is still spreading at far too intense a level three years into this pandemic.”
Low rates of COVID-19 testing since the start of the conflict mean there is likely to be significant undetected transmission, the spokesperson said.
“Coupled with low vaccination coverage (around 40%), this increases the risk of large numbers of people developing severe disease. Older people will be disproportionately affected as their access to health care is disrupted, and because only a third of the over-60s are fully protected with a complete vaccine series.”
He added that the information WHO has is that all refugees entering EU countries and Moldova will have full access to basic health services including COVID-19 services. “This includes access to free COVID-19 vaccination. At the moment, we haven't had any indication any country hosting refugees that they have a shortage of COVID-19 vaccines.”
He also underlined the need to care for vaccination campaigns among children. WHO estimates that around 50% of the refugees are children under the age of 15.
“Population displacement is a risk factor for disease, especially communicable and infectious diseases, due to closer and more intense social mixing, poor quality shelter and WASH (water, sanitation, and hygiene) conditions, greater exposure to the elements including the cold winter weather, psychological stress and exacerbating factors (e.g. nutritional stress).”
The vaccination coverage for vaccine-preventable diseases in Ukraine has been consistently low over past years. WHO recommends that children from Ukraine receive all vaccines recommended for their age in line with the host country schedule. These include measles, polio, diphtheria and tetanus amongst others.
M. Apelblat
The Brussels Times
