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Perspective The War in Ukraine: Health Care Under Attack
The War in Ukraine: Health Care Under Attack
By Sreenidhi Vanyaa Manian
The unprovoked attacks on Ukraine by the Russian government since February 24, 2022, has had deleterious effects on the country’s health care and general well-being and has set back the country’s development by several years. It is a humanitarian crisis that is adding stress to a world already overwhelmed by the pandemic. Only three days into the brutal invasion, the Volnovakha Central District Hospital was shelled for the first time by Russian armed forces. 42 days since the beginning of war, ironically on World Health Day, a grim milestone of 100 attacks on health care facilities including ambulances was surpassed. However, despite several pleas by the World Health Organization (WHO) to stop brutal attacks on health care facilities, they continue to occur as this article is being written, the current number of attacks as of this writing, surpassing 200. ACEP Liaison Vitaliy Krylyuk, MD, a surgeon and emergency physician at the Ukrainian Scientific and Practical Center of Emergency and Disaster Medicine, says what is going on is not a military operation, but terrorism.
Unfortunately, attacks on health care during a war is not unheard of. Syria and Afghanistan, similar war-torn areas, have also had their hospitals and health care workers attacked. To attack the most vulnerable — women, children, the ill, and health care workers who are laying down their lives for others — is one of the most heinous acts during war. Routine health services for chronic conditions as well as infectious diseases have been disrupted, resulting in increased morbidity, and mortality and decreased life expectancy. Also, this is happening amidst a pandemic that has already strained the health care system in Ukraine where the COVID-19 vaccination rate for the first dose is only 36%. In a setting where 80,000 women are expected to give birth in the next three months, there isn’t an access to reproductive, maternal, and antenatal care due to security concerns, restricted mobility, broken supply chains, and
mass displacement. The organization, Save the Children, has reported that even children moved to safety are experiencing poverty, hunger, and health challenges. Lastly, the trauma of the war and the imposed status of “refugee” on millions of Ukrainians and its impact on mental health are also of paramount concern. Despite the daunting nature of this war, several professionals have come forth to help.
Emergency medical teams (EMTs) are an integral workforce to ensure global health. It consists of doctors, nurses, and other health care professionals from across the world that provide aid during disease outbreaks, natural disasters, and war. The EMTs deployed in Ukraine have integrated into health facilities at refugee centers, in primary health care facilities, and in ministries of health; they are doing invaluable work. Emergency medicine is a specialty which bestows the ability to provide care to people from all walks of life, especially in circumstances of war and natural disasters. At times like these, emergency medical care knowledge is critical and its development must be prioritized by the governing nations of the world.
The international health organizations have lauded Ukraine’s ability to pivot their health care system to meet the needs of the war. For example, a nationwide hotline originally set up for COVID-19 is now for general medical concerns. Hospitals have restructured their staff, paying attention more to trauma care and receiving patients directly from the battlefield. They have transformed their hospitals into fortresses within battlefield, providing shelter to the victims of war.
The emergency physicians in Ukraine are putting up an admirable fight as well: “Our doctors have [forgotten] the meaning of the word ‘sleep.’ They [are] saving lives and dying alongside the soldiers. Because it appears that for Russians, [the] Red Cross is not a sanctuary, it’s a target mark,” said Dr. Anton Volosovets, MD, Dr.Sc., head of the department of emergency medicine at Shupyk National University of Healthcare of Ukraine in Kyiv.
Despite their valiant efforts, the Ukranians need international aid to sustain their health care system and survive this war, even long after it is over. It has been heartening to see many health organizations such as WHO, MSF (Medicines Sans Frontiers), International Medical Corps and other international non-governmental organizations offering help by providing health supplies and workers acquainted to provide care in such dire circumstances. For example, several telehealth projects allow United States physicians to provide remote care that ranges from addressing injuries to assessing the need for a potentially dangerous trip to a hospital. Moreover, attempts have been made to shift patients to the U.S., translate mental health resources and several universities are involved in the provision of material supplies such as drugs, medical equipment, and vaccines.
Donating medical supplies and funds through legitimate organizations, sharing your knowledge as physicians and using your voice to advocate to bring an end to this unfair invasion are impactful stepping stones to combat the damage the war has caused. The pandemic has proven that global integration and combined efforts are pivotal for the well-being of every individual as well as a necessity to transcend tough times. The impact of global aid in this war is a testament to this statement. Like all wars, this one will come to an end, but even in its aftermath the medical community and health care organizations all over the world must provide help to enable the survivors to emerge from the ashes and rebuild their country.
ABOUT THE AUTHOR
Sreenidhi Vanyaa Manian (MBBS) is a final year medical student from PSG Institute of Medical Sciences and Research, India. An aspirant for emergency medicine residency in the US, a career in global health and hopes to be a part of Médecins Sans Frontières someday. @sreenidhivanyaa
