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UKRAINE

Over 600,000 people were displaced and 10,000 wounded during the intense conflict in eastern Ukraine in 2014.

KEY FIGURES

1,200

individual and group mental health consultations

280

patients under treatment for TB

The political protests that started in late 2013 gained momentum in 2014, leading to violent clashes between police and protestors and the removal of the Ukrainian president from power in February. Médecins Sans Frontières (MSF) provided medicines and supplies to health facilities receiving the injured in the capital Kiev. Following protests in the east of the country, fighting broke out in May between armed separatist groups and Ukrainian government forces.

Medical supply lines were severely disrupted or cut completely, and health facilities’ budgets for the year were quickly exhausted. While local doctors were able to cope with treating the wounded, they faced an acute shortage of medical supplies, so MSF donated medicines and materials for treating war-wounded patients to hospitals in Donetsk and Luhansk regions.

As the conflict spread and intensified, MSF dramatically increased this support, and by the end of the year had provided enough supplies to treat more than 13,000 wounded patients in hospitals on both sides of the frontline.

Throughout the conflict, hospitals were damaged by shelling, depriving people of medical care just when they needed it the most. This demonstrated a lack of respect for the health staff who continued to offer care at great risk to themselves, even though many of them had not been paid for months on end.

Despite a ceasefire in September, the fighting dragged on and medicines became increasingly difficult to obtain. Following a Ukrainian government decision to withdraw all support for state services from rebel-controlled areas, pension payments were cut, leaving disabled and elderly people particularly vulnerable, and all banking services were blocked. People began to delay going to see a doctor simply because they could not afford transport or medication. In response to the difficulties people were facing to access basic healthcare, MSF started to expand its medical support to include those patients with chronic diseases such as diabetes.

MSF teams also distributed more than 2,600 hygiene kits, including soap, dental supplies and towels, to people in Donetsk region who had fled their homes. In preparation for the harsh winter, MSF donated 15,000 blankets to hospitals and displaced people around Donetsk and Luhansk.

Treating the psychological effects of war

In March, MSF began to work with Ukrainian psychologists in Kiev, conducting training sessions and workshops on psychological problems such as depression and post-traumatic stress, and treating patients on both sides of the conflict. From August, MSF psychologists started to run  individual, group and family mental health sessions in several cities on both sides of the frontline in the east, educating people about emotional reactions following traumatic events, and teaching them practical tools to help cope with fear, anxiety and nightmares. In addition, MSF psychologists trained local medical and mental health staff to improve their skills and avoid burnout.

Tuberculosis (TB) programme

MSF has been running a programme for people with drug-resistant TB within the regional penitentiary system in Donetsk since 2011. Throughout the conflict, MSF has made every effort to keep this project running and support patients to avoid treatment interruption. When heavy shelling made it too dangerous for the teams to reach the penitentiaries, they ensured the drugs were still available by delivering them to a safer location to be picked up by prison staff.

No. staff in 2014: 71 | Expenditure: 5.5 million | Year MSF first worked in the country: 1999 | msf.org/ukraine

Patient story


© Julie Rémy / MSF

Svetlana – a patient receiving counselling from an MSF psychologist

I was in the yard with my husband when the shelling came. We had heard shelling before, but never this close. An artillery shell hit very close by. My husband was very badly wounded. Some shrapnel went into my legs and my chest. I still have a piece of metal lodged between my ribs. I called for an ambulance, but they said it was too dangerous … My husband died in the yard.

I’ve been staying at this hospital in Svitlodarsk for two months with my five-year-old daughter because we have nowhere else to go. I’m too afraid to go back to Debaltsevo ... Now I hear explosions when there aren’t any. When my daughter hears an explosion, she asks "Is that a grad or a shell?" Is that normal for a five-year-old?