The conflict between Russia and Ukraine has now reached its fourth year. Initiated on February 24, 2022, this war has led to the destruction of cities, the displacement of millions, and significant loss of life.
The health infrastructure in Ukraine has faced an unparalleled assault. Nevertheless, it has exhibited extraordinary adaptability. The pressing question remains: can it sustain its resilience in a conflict that shows few signs of resolution?
Unprecedented assault on the healthcare system
The World Health Organization (WHO) has confirmed 2,236 attacks on healthcare facilities in Ukraine since the onset of the war, marking the highest incidence recorded in any armed conflict.
Russia has not only targeted medical infrastructure intentionally but has also compounded the challenges by attacking the energy grid and logistics centers.
Ukraine’s resilience
In spite of the overwhelming pressure, the Ukrainian healthcare system has demonstrated remarkable resilience, largely due to insights gained from the 2014 annexation of Crimea, as noted in an article published in the British Medical Journal on February 24.
A significant reform undertaken by Ukraine has been the enhancement of public funding for primary healthcare, which has provided essential resources for healthcare facilities to maintain operations amid the ongoing conflict.
Moreover, the establishment of a national e-Health system has facilitated improved coordination and data sharing among healthcare facilities. With information on over 35 million patients, this system has empowered Ukraine to make prompt, informed decisions regarding healthcare delivery, enabling the system to remain proactive in the face of wartime disruptions.
Mobile pharmacies and primary healthcare units have been established in conflict zones, ensuring that even the most isolated regions have access to vital services.
Another significant aspect has been the collaboration between military and civilian healthcare systems. This integration has enabled Ukraine to optimize its healthcare resources.
Challenges continue to escalate.
These adaptations, necessitated by the circumstances, have become essential elements of Ukraine’s ongoing health response.
However, this situation has not been without its difficulties. Several major challenges threaten Ukraine’s ability to maintain such resilience.
The ongoing war economy, combined with currency devaluation and widespread displacement, exerts tremendous pressure on the healthcare sector.
The shortage of healthcare workers has intensified, as many professionals have either lost their lives or been compelled to flee the conflict. For those who remain in Ukraine’s healthcare facilities, mental health issues are prevalent, with approximately one in five healthcare workers experiencing the psychological effects of the war.
The unpredictability of international aid introduces an additional layer of vulnerability. The future of foreign assistance, particularly from crucial sources such as the United States Agency for International Development (USAID), remains uncertain.
If this funding were to be reduced or eliminated, the repercussions for Ukraine’s healthcare system could be catastrophic. Programs that provide support for HIV testing, veteran rehabilitation, and mental health services are heavily dependent on this assistance.
Additionally, there is the threat of double-tap strikes carried out by Russia.
A double-tap attack consists of an initial airstrike, followed closely by a second strike on the same site, aimed at killing or injuring first responders, medical personnel, and civilians who rush to aid the victims of the first strike.
The strategy not only raises the number of fatalities but also instills fear within the populace, discouraging individuals from assisting the injured. Gradually, the cumulative impact undermines the already fragile healthcare system.
The economic burden of replacing damaged ambulances, retraining medical personnel, and replenishing vital medical supplies exacerbates an economy that has already been devastated by conflict. Consequently, this leads to an increase in the loss of lives.
