Ukrainian health care facilities
The COVID-19 pandemic greatly impacted Ukrainians and Ukrainian health care facilities and safety issues only escalated with Russia’s invasion of Ukraine on February 24, 2022.

Ukrainian Health Care Facilities Under Fire

Since Russia’s invasion, the World Health Organization (WHO) has confirmed 715 attacks on Ukrainian health care facilities, creating a shortage of proper medical care and supplies for Ukrainians. The Washington Post reported that Russian soldiers destroyed nearly all of the health infrastructure in the recaptured territories. This has left thousands of Ukrainians, mainly in seized villages, without necessary health care access.

Low Vaccination Rates, Disease Outbreaks and Health Concerns

At the beginning of the war, nearly 60% of Ukrainians were unvaccinated against COVID-19, with cases at a record peak. The Russian attacks have limited access to vaccinations, COVID-19 testing and treatment. In addition, crowded bomb shelters and border crossings have created the perfect conditions for extreme COVID-19 outbreaks. This would overextend the already limited capacities of Ukrainian health care facilities. Millions of Ukrainians that rely on regular doses of life-saving medication, such as insulin, are unable to access the medication necessary for survival. Hospital closures also put thousands of pregnant mothers in extreme danger. They end up in extenuating circumstances without access to health teams, checkups or delivery services.

Earlier in 2022, WHO estimated that 15% of these Ukrainian births would result in complications that would need skilled medical care: a feat difficult with limited medicine and oxygen access. Outbreaks of other diseases, such as Polio, HIV/AIDS and tuberculosis, pose great threats to Ukrainian lives during the war. The rampant misinformation regarding vaccines in Ukraine contributed to a low immunization rate, making Ukraine more susceptible to disease outbreaks.

Relief Organizations

Relief organizations have attempted to combat this issue by focusing their efforts on reinstating emergency medical care in seized areas, yet they face a number of challenges. Land mines and leftover military weaponry still threaten many recaptured areas. There is also an extreme shortage of health care workers, with many worried about entering dangerous areas. Finally, targeted attacks on Ukrainian energy sources have created mass blackouts throughout the country, leaving thousands of Ukrainians without heat or running water. This makes seeking health care and remaining healthy increasingly difficult.

Also, hospitals have canceled all nonessential procedures and patient records are unavailable due to internet outages. Blackouts also inhibit proper hygiene, as running water is often inaccessible. Infections run rampant due to poor hygiene, increasing the urgency for health care. Doctors must perform emergency surgeries in freezing temperatures while using headlamps as light sources due to frequent power outages.

Limited Resources

Limited resources make it increasingly difficult for relief organizations to provide aid. The Kyiv City Charity Foundation Food Bank is operating actively to provide food for Ukrainians, yet they have lacked proper food supplies since Ukrainian plants had to shut down production. This food bank, along with others in Ukraine, has received aid and supplies from foreign organizations such as Save the Children and the U.N. World Food Programme (WFP).

WFP recently received a $50 million donation from the United States, which has gone towards providing food for Ukrainians. It plans to assist more than 3 million people through these funds, with three operation locations established throughout Ukraine. WFP purchased most of the food in Ukraine to help their economy, but it has also created hubs in Poland to safely distribute food. It has been difficult for these organizations to anticipate needs throughout Ukraine as food insecurity and supply limitations change daily, but relief organizations have been able to help limit the extreme circumstances in Ukraine through aid.

Rebuilding Ukrainian Health Care Facilities

According to Deputy Minister of Health Oleksiy Yaremenko, damaged health infrastructure alone will cost at least $1 billion to fix, so rebuilding Ukrainian health care facilities is a lofty but necessary ambition. Along with foreign aid, internal organizations have helped Ukraine. Ukrainian civil society organizations have risen to the challenge, meeting the needs of hospitals throughout the country. The Alliance for Public Health (APH) provides limited service in most regions, including occupied areas.

To combat shortages, APH delivered 140 metric tons of medical supplies to Ukrainian hospitals between March 23 and April 6 alone. Its mobile clinics serve as transportation of humanitarian aid into conflict zones and evacuation vans. 100% LIFE, Ukraine’s largest organization for people with HIV, distributed an initial delivery of 18 million doses of antiretroviral medication, enough to cover a six-month supply for all people with HIV on first-line treatment.

The lack of health care provisions for Ukrainians has caused an increase in sickness and casualties. However, the presence of foreign aid and relief organizations has alleviated the damage. As the war continues, the lack of Ukrainian health care facilities and resources will likely become more harmful to the protection of Ukrainians and the rebuilding of society.

– Mariam Abaza
Photo: Flickr

HIV in Ukraine
Over the past several years, Ukraine has been battling the second largest HIV epidemic in Eastern Europe and Central Asia. As of 2018, approximately estimates determined that 240,000 people were living with HIV in Ukraine out of the nearly 45 million citizens.

Causes of Ukraine’s HIV Epidemic

In origin, Ukraine’s HIV epidemic stems from transmission through the injection of drugs, predominantly among the male population. However, as of 2008, the catalytic force driving the outbreak has shifted to the transmission through sexual contact. According to the Joint United Nations Programme on HIV and AIDS (UNAIDS), up to 73.8 percent of the HIV cases in Ukraine during 2018 spread through sexual contact.

Complicating treatment initiatives is the fact that only 71 percent of the people living with HIV in Ukraine are aware of their condition and only 52 percent are receiving treatment. Further, the war in Donbass between the Ukrainian government and pro-Russian separatists has spurred the spread of the virus as national unrest grows. Both war conflict and HIV are predominant in the Ukrainian provinces of Donetsk and Luhansk. Initially, the government made attempts to supply the areas with antiretrovirals for HIV treatment but security reasons and separatist control throughout the region obstructed the efforts.

Efforts to Treat and Prevent HIV

Following the report of 12,000 new HIV cases among citizens in 2018, the Ukrainian government designated $16 million to fund and expand HIV prevention methods and treatment services for the 2019-2020 year. This budget is a part of Ukraine’s plan to shift to a nationally-funded HIV response as opposed to the previously held international donor funding.

Working closely with the government, 100% Life, the largest patient-based and nonprofit organization in Ukraine for people living with HIV provides services for up to 90,000 patients. According to the Ukrainian Philanthropic Forum, the organization served as the nation’s largest philanthropist in both 2016 and 2017.

Moreover, in March 2019, Merck & Co. Inc., a pharmaceutical company, agreed to reduce the price of HIV treatment drug Raltegravir as a direct result of the organization’s advocacy. The cost per pill fell from $5.50 to $2.75, the lowest price for the drug in all of Eastern Europe and Central Asia. This was not the first time that 100% Life urged the company to make treatment more accessible for HIV patients. In 2016, the price reduction of HIV drug Atripla also received confirmation as Merck & Co. Inc. agreed to forgo patent protection of the drug. Estimates allege that non-patented or generic versions of the drug should result in savings that could provide up to an additional 2,800 patients with treatment annually.

Despite the intensity and duration of Ukraine’s HIV epidemic, the nation’s government and activists are continuously working to ensure treatment and prevention initiatives for the whole population. The implementation of a domestic response budget and the availability of more cost-effective treatment commence the reinvigoration of Ukraine’s approach to HIV management and restriction.

Bhavya Girotra
Photo: Unsplash