The fighting has intensified dramatically since last week and the situation here is deteriorating rapidly. In the past five days, there has been heavy fighting. We hear the constant boom of shelling and crackle of shooting.

More than 70 houses are reported to have been damaged or destroyed in the last week, and several hospitals have been damaged since the fighting began in the summer. In recent days, a building of a psychiatric institution that we’re supporting was destroyed by shelling.

It’s getting more complicated to get into the areas caught in the conflict. Last week the checkpoints to cross into the rebel-controlled areas were closed and no one has been allowed to pass.

Medical supply lines have been cut and little medicine is getting through, as has been the case for months. When Médecins sans Frontières (MSF) started working here in May, we focused on supplying hospitals on the frontline with kits to treat war injuries. Obviously, when you’re in a conflict zone, the frontline is where the people are being seriously injured and killed.

After months of stress on the health system, it is clear that the conflict is having an impact on the whole population of the area. Basic healthcare, maternity care, treatment of chronic diseases; everything is affected.

When you go to the hospitals or primary healthcare centres, many are empty because the doctors don’t have enough medicines. As soon as we get any supplies, we distribute them. But it’s not enough. The biggest problem is that there are no more psychiatric drugs, and no anaesthetic drugs we need for surgery. The doctors are desperate for supplies.

We are still here, we are trying, but we’re treating people with words

It’s not just medicines. I’ve visited orphanages and homes for the elderly and physically and mentally disabled, and I’ve seen people who are weak and are not getting enough food. They’re relying on donations and the goodwill of the people around them, but they’re hanging on by a thread. They’ll receive a bag of potatoes one day, and a cabbage another. When you visit the kitchen, there is always some food on the stove but the fridges are empty.



The director of one of the old people’s homes we visited last week burst into tears in front of us: “We are still here, we are trying,” she said, “but we’re treating people with words.”

There are shortages of everything: cleaning materials, soap, even nappies. If you don’t have nappies, then you have thousands of people in care homes, orphanages and hospices for disabled people, sleeping and living in their excrement all day. But they can’t be found in the market any more. We’ve ordered more than 10,000, but it will never be enough because you need millions. And now that movements into the conflict zone have been stopped, it’s even worse.

Months of protracted fighting have had a huge psychological impact on people living on both sides of the frontline. A town I visited recently, around 500 metres from the frontline, has been shelled repeatedly. Houses have been destroyed, the electricity has been cut off and the people are traumatised.

The head doctor of the hospital asked us to help his staff because they’re so stressed that they can’t treat patients. We’ve just sent our team of psychologists and we’re hoping to expand our mental health work.

In another town located 10km (around six miles) from the frontline, I met the mayor. He was crying as I was speaking to him; the situation is just too hard. Since then, there has been more shelling and we are going back to donate some supplies for treating war-wounded patients, as well as blankets and hygiene materials.

People living here have not received their pensions in six months. People have run out of money, and there is no longer any industry. This war has destroyed so much.

Doctors are still working, and some of them walk more than an hour each day because they don’t have the money to pay for transport. But they’re working for free, they haven’t been paid for more than six months. The only thing keeping the system going is the commitment and dedication of the community and the medical staff. That type of solidarity is impressive to witness, but you can’t ask people to continue like this for months on end. People are just holding on. If it goes on like this, it’s only a matter of time before they just collapse.

There are many terrible things about this conflict, but one of the hardest things is that people feel abandoned. They’re grateful that we’re here, but wherever we go they ask us: “Where is everybody?Where are the journalists? Where is the international community? People are dying here every day.”

• Emilie Rouvroy is MSF’s coordinator in Luhansk, eastern Ukraine