Kyiv/Lviv – “Do you know where I can get L-thyroxin?” This is one of the most frequently asked questions in Ukraine's war-affected capital Kyiv. A similar situation can be observed in other cities.
On Facebook, posts of people looking for thyroid drugs are common, including in the regions not yet affected by the war. In the first week of Russian military invasion, people spent up to five hours queueing near a handful of pharmacies still operating in Kyiv. Nobody left the queue to shelter even when air raid sirens went off. On the third week, it took about an hour to enter a pharmacy. Now, there are almost no queues, mostly because the supplies have run out, and it is unclear when new batches of medicine will arrive. Stores that might still have the much-needed drugs have remained closed since 24 February, with fading hope of them opening their doors soon.
Due to the lack of public transport, restricted movement and active hostilities, the World Health Organization (WHO) warns about increasingly challenging access to medicine and care for noncommunicable diseases, including but not limited to cardiovascular disease, hypertension, diabetes, chronic kidney disease, chronic respiratory disease, epilepsy and cancer.
Continuous shelling of medical infrastructure poses an enormous burden on medical workers in the most affected areas. In the first three weeks of the war, over 40 facilities were attacked, resulting in 34 injuries and 12 deaths.
A recent survey by the International Organization for Migration (IOM) indicates that there are 6.48 million internally displaced persons (IDPs) in Ukraine. About one third of the displaced households had members with chronic illnesses, and almost 20 per cent included persons with disabilities. Medicine and health services were identified as the second most pressing needs. Despite these challenges, since the start of hostilities until mid-March more than 4,300 children were born in Ukraine and 80,000 more women are about to give birth in Ukraine over the next three months.
The western city of Lviv hosts over 250,000 IDPs with the capacities of medical institutions visibly stretched. The city has witnessed several missile attacks since the start of the war but still remains at the heart of humanitarian efforts to help those fleeing the war into neighboring countries or those who decided to stay in this region.
In Lviv, IOM’s partner clinic, the Andrii Sheptytsky hospital, volunteered to provide medical care, both urgent and planned, for everyone, including newly displaced persons. The hospital’s staff established a regular presence at the Lviv railway station – a major hub that welcomes IDPs. Several psychologists provide consultations directly at the shelters for displaced persons, helping them to overcome acute distress after fleeing from the war zones. Since the war started, the hospital extended capacities of its palliative care unit, accommodating those who need permanent care.
“Due to shortages of specific medicines in eastern Ukraine, many patients with noncommunicable diseases are fleeing to the west, where they can receive treatment and care. It is important for us to anticipate the scale of further displacement and increase our capacities,” explains Andrii Login, the head of the charity fund at the hospital. “Many health workers are still here, they did not move to the EU, so we need to make everything possible to keep this staff and improve medical infrastructure at regional and local levels. Otherwise, the system will get overloaded.”
The medical director of the hospital, Roksolana Velgush, warns that mass displacement can result in a new wave of the COVID-19 pandemic, as people are staying in overcrowded shelters with poor ventilation. Several outbreaks of respiratory infections, including COVID-19, have already been reported in the shelters for IDPs in Lviv, while 35,396 new cases of COVID-19 and 556 new deaths were registered in the country between 10 and 16 March. As COVID-19 designated units are getting reoriented towards treating the wounded and those in critical condition, capacities are scarce to isolate patients with COVID-19. As a positive signal, Roksolana flags that vaccination against COVID-19 continues, although at a much slower pace.
The health impacts of the war are the focus of IOM’s work. IOM has been present in Ukraine for over 25 years, advocating for migrant-inclusive health practices and policies, facilitating migration health assessments together with partner clinics, refurbishing medical institutions affected by the conflict in eastern Ukraine that erupted in 2014 and providing them with medical and personal protective equipment to help counter the spread of COVID-19.
In response to the current crisis, IOM aims to deploy mobile health teams composed of physicians and nurses to support access to life-saving primary health care. The Organization will also support local primary health-care centres through the procurement of personal protective equipment to reduce the spread of communicable diseases, including COVID-19.