From the Doctors Without Borders/Médecins Sans Frontières (MSF) International Activity Report:



Conflict in Ukraine

As fighting in eastern Ukraine continues to escalate, Médecins Sans Frontières/Doctors Without Borders (MSF) is urging all parties to the conflict to halt shelling of hospitals and ensure civilians can reach safe places. In response to the surge in violence, the organization is urgently expanding its support to hospitals on both sides of the front line as doctors try to deal with influxes of wounded patients and continued heavy fighting traps civilians in front line towns. Medical facilities continue to be shelled, forcing staff to flee and depriving thousands of people of healthcare. Several medical facilities supported by MSF have either been damaged or destroyed by shelling or rockets.

'We have major concerns about Ukraine because we think it will deteriorate' — Dr. Joanne Liu, MSF international president

The operational set up in Ukraine is different to the regular MSF response. We do not have any MSF facilities or fixed project locations, but instead have five teams based on both sides of the frontline, covering Donetsk and Luhansk regions. They are mobile, moving to different towns and cities each day to deliver medicines and relief materials, as well as run the psychological support program.
In a recent interview with Canada's Global News, MSF international president Dr. Joanne Liu said that Ukraine is one of MSF's top concerns looking ahead in 2015. 'We have major concerns about Ukraine because we think it will deteriorate' she said. "I hope I will be mistaken, but we are concerned that it's going to create enclaves with very difficult access."

MSF update from eastern Ukraine, March 3, 2015

Although fighting in eastern Ukraine has reduced since a ceasefire came into effect on February 15, shelling continues in some areas and medical needs remain urgent on both sides of the front line. Residents and displaced people are living in extremely precarious conditions, many medical facilities have been damaged or destroyed, and there are critical shortages of basic and specialized medicines and medical supplies. In response to the surge in violence since January and the increasingly dire humanitarian situation after ten months of conflict, Médecins Sans Frontières/Doctors Without Borders (MSF) has rapidly expanded its medical activities on both sides of the frontline in the hardest-hit areas.  


An MSF team gathers information on location in Debaltseve.


MSF reaches shattered Debaltseve

On February 21, 2015, an MSF team was able to reach the heavily affected city of Debaltseve, following weeks of intense fighting that had made it impossible to provide humanitarian assistance there. MSF had been supporting the hospital in Debaltseve with supplies since September 2014, including sending medicines in January.

“The city has been destroyed,” says Olivier Antonin, MSF’s emergency coordinator. “The windows of the houses have been blown to pieces, tree branches are strewn on the ground, and power lines are severed hanging in the wind. 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.”

The city’s two hospitals have been damaged, with one unusable. Only three doctors remained for the entire city. Although many residents out of a population of 25,000 people before the fighting have fled or been evacuated, at least 5,000 people remain and many are in urgent need of medical care. The MSF team is providing medical supplies for treating war-wounded, medicines and supplies for basic healthcare, as well as materials such as syringes, catheters and gloves. An MSF doctor also began providing consultations in the city.

Teams are currently assessing the situation around the city of Gorlovka, where an MSF surgeon provided support to Hospital No. 2 during the most intense period of shelling in January. A team visited Uglegorsk, east of Gorlovka, 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.

Many people were forced by fighting to live in improvised shelters.


Huge need for basic healthcare

MSF has started running mobile clinics in 19 locations in Donetsk and Luhansk regions in order to provide basic healthcare to people living in rural areas or displaced by the conflict. In just three weeks, MSF 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 front line. MSF is running a mobile clinic in four sanatoriums in Svyatogorsk, where more than 3,000 people fleeing the conflict zone have taken refuge.

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 simply 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 MSF’s patients in the mobile clinics needing treatment for heart disease, hypertension, diabetes or asthma.

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, providing consultations, medicines and hygiene materials.


MSF is providing medical care to people who have taken refuge near a sanatorium in Svetagorsk.


MSF in eastern Ukraine

Since May 2014, MSF teams have provided medical supplies to around 100 medical facilities on both sides of the front line in Donetsk, Luhansk and Dnepropetrovsk regions, enough to treat more than 15,000 wounded patients, 1,600 pregnant women and 4,000 patients with chronic diseases. In January 2015, MSF began providing basic healthcare through mobile clinics in rural and conflict-affected areas and to people displaced by the conflict. MSF psychologists are providing mental health support to those affected by the conflict, including 700 individual and 1,760 group counselling sessions. MSF psychologists are also running a training program for local psychologists, social workers and medical staff working throughout the affected region. MSF is continuing its drug-resistant tuberculosis treatment program within the regional penitentiary system in Donetsk, which has been running since 2011.