Staff have fled from many hospitals in eastern Ukraine (Image: Antonio Bronic/Reuters/Corbis)

Many of Ukraine’s healthcare workers have died or fled, leaving the country struggling with TB and at risk of polio and measles infections, the World Health Organization (WHO) has warned.

The WHO says that between 30 and 70 per cent of the country’s health workers in the region affected by the sepratist unrest have gone and at least $23 million is needed to provide better healthcare for the 5 million inhabitants of eastern Ukraine. An estimated 1.4 million people are thought to be particularly vulnerable in part because of pre-existing medical conditions or because they have had to move from their homes.

“The humanitarian health crisis in Ukraine is severe,” said Dorit Nitzan, the WHO representative to Ukraine, in a note published on 16 January. “Insecurity, displacement and cold weather, combined with the poor state of the country’s health system, means that basic health care is out of the reach of many people,” she said.


According to the WHO, vaccination coverage in Ukraine is well below 50 per cent, placing the population at risk of preventable infectious diseases like polio and measles. TB is reported to be on the rise in the easternmost Donbas region, which has been gripped by unrest and includes the cities Donetsk and Luhansk. The WHO warns that people with HIV or AIDS in this region are at a high risk of having their care interrupted.

Society unravelled

Almost half of all healthcare costs in Ukraine are paid for by those who need them, says Kateryna Onishchenko, a health economist at Swansea University, UK, who is originally from Donetsk.

“Due to the deteriorated economic situation in the Donbas area, access to healthcare services has worsened, as some people are unable to pay for their medical services,” she says. “Ill patients cannot purchase drugs, for example insulin or antibiotics, due to lack of financial resources and destroyed supply chains in the occupied territories.”

Water and power supplies have broken down in Donetsk and Luhansk, and 50 of the country’s healthcare facilities have been at least partially destroyed by fighting or looting. The Ukrainian Ministry of Health has asked the WHO to be responsible for the distribution of all essential medicines for a temporary period.

A ceasefire was agreed in September between Ukraine and Russia, but action has continued. The Ukrainian government is currently fighting to regain control of Donetsk airport from pro-Russian rebel forces.

The conflict and instability are placing a strain on the country’s under-developed support systems. “Elderly care support has declined to an almost negligible level,” says Onishchenko. She says that older people who cannot access government-controlled areas are unable to rearrange their pension payments to pay for primary care and medication. The war has also increased demand for Ukraine’s scant mental health and psychological services.