Shelling continues in parts of eastern Ukraine and medical needs remain urgent despite a reduction in fighting since the 15th February ceasefire. People are living in extremely precarious conditions, many medical facilities have been damaged or destroyed and there are critical shortages of medicines and medical supplies.
In response to the increasingly dire humanitarian situation after 10 months of conflict, Médecins Sans Frontières/Doctors Without Borders (MSF) has rapidly expanded medical activities in the hardest-hit areas on both sides of the frontline.
Healthcare reaches "destroyed" Ukranian city
On 21st February one of our teams was able to reach the heavily affected city of Debaltseve, after weeks of intense fighting made it impossible to provide humanitarian assistance there.
We have been supplying one Debaltseve hospital since September 2014, including sending medicines in January.
“The city has been destroyed,” says Olivier Antonin, MSF’s Emergency Coordinator.
“The people who remain are living in shelters or in basements of buildings as it’s freezing inside the houses. There is no electricity, no heating and no running water in town. When we arrived they were in shock, asking where they could find medications or other assistance. Many need drugs for chronic diseases.”
People have lost everything
There is no electricity and no running water. People have to get water from wells. The people who have stayed in Debaltseve need everything.
One woman, the mother of a six-year-old girl, fled Donetsk after her house burned done only for the house where she sheltered in Debaltseve to burn as well.
“All that’s left is what we have on our backs,” she says.
Hospitals damaged
The city’s two hospitals have been damaged, with one unusable; the Railway hospital, where 30 doctors used to work, is now a battlefield. An abandoned tank sits at one of the building’s entries.
Only three doctors remained for the entire city – the head doctor of the Central hospital and two others working in a clinic on the main square.
Although many residents have fled or been evacuated, out of a population of 25,000 people before the fighting, at least 5,000 people remained – and many are in urgent need of medical care.
Our team provided medical supplies for treating war-wounded, medicines and supplies for basic healthcare, and materials such as syringes, catheters and gloves.
An MSF doctor also began consultations on 24th February.
Story continues below photo essay
Two weeks after the fighting ended in the bitterly-disputed eastern Ukrainian city of Debaltseve, many people have lost everything. Hundreds are living in shelters and basements. These Debaltseve residents stayed because they are the most fragile and disadvantaged or because they were trapped by the bombing.
In Debaltseve central square, local authorities try to provide some support to the people who have come for help.
Scenes of devastated buildings are common in Debaltseve.
“All the windows in my apartment are broken,” says a 69-year-old woman, who is living in a shelter in the center of the city, in the basement of a government building. “It is too cold there. I’m not moving from here until there is electricity and I can cook food.”
The inhabitants of Debaltseve had not seen bread in more than a week. As well as providing medical care, our team meets with local authorities who are in charge of organising help and reinstating public services in the city.
The local authorities were able to hand out bread in the city’s central square. Debaltseve’s inhabitants can also now get a meal of buckwheat porridge and hot tea.
The Central Hospital in Debaltseve has been severely damaged. Pictured here is the operating theatre. On the ground floor, two rooms where the windows remain intact have been set up with 10 beds.
MSF medics are on the ground and several doctors are also expected to arrive from Donetsk, the largest city in eastern Ukraine. However, their arrival will not begin to meet the needs of a population estimated at more than 5,000.
Most of them have been traumatised by the bombing. Several worried patients ask the same question – “It’s not going to start again, is it?”
Medical care in Ukraine
Teams are currently assessing the situation around the city of Gorlovka, where an MSF surgeon provided support to Hospital #2 during the most intense period of shelling in January.
A team visited Uglegorsk, east of Gorlovka, on 25th February, where the hospital has been shelled.
Two days later, they began mobile clinics and mental health activities, and this week will distribute essential relief items to 1,000 families in the city and surrounding villages.
Huge need for basic healthcare
We have started running mobile clinics in 19 locations in Donetsk and Luhansk regions to provide basic healthcare to people living in rural areas or displaced by the conflict.
In just the first three weeks, our doctors carried out more than 1,500 consultations, illustrating the huge need for healthcare and medicines in these areas.
"We see mostly respiratory infections, because many people have been living in damp, overcrowded and unheated basements," says Zahir Muhammad Khan, MSF’s doctor in Svyatogorsk, a town 100 kilometres north of the frontline.
MSF is running a mobile clinic in four sanatoriums in Svyatogorsk where more than 3,000 people fleeing the conflict zone have taken refuge, many since the escalation in fighting in January.
Healthcare system severely disrupted
With medical supply lines in the east of the country severely disrupted or cut entirely since last summer, and health facilities located in rebel-held areas not included in the 2015 Ukrainian government health budget, people now face a critical shortage of medicines.
Banks have been closed and pensions have not been paid for many months, so people have been delaying going to see a doctor because they cannot afford the cost of transport or medication.
The price of medicines has increased significantly and even basic medications such as painkillers are out of reach for people.
Patients with chronic diseases are particularly affected, with the majority of our patients in the mobile clinics needing treatment for heart disease, hypertension, diabetes or asthma.
Humanitarian situation
The humanitarian situation is particularly alarming in Luhansk region as the shortage of medicines and essential supplies, including food, is even more acute.
Most people who have remained in Luhansk are the most vulnerable members of the community – the elderly, disabled, and sick – who did not have the means to flee the conflict.
As well as running mobile clinics in health centres in rural areas, the MSF team is also supporting social facilities, including hospices for the elderly, disabled, orphaned, and people with psychiatric disorders, by providing consultations, medicines and hygiene materials.