World must respond to urgent health needs of displaced Ukrainians - freetxp

World must respond to urgent health needs of displaced Ukrainians

I am just back from my first international trip in two years to visit Medical Teams International’s work with refugees and the displaced in Uganda and Ethiopia, but there’s no time to write a trip report. Our next response has already begun.

As more than 2 million Ukrainians have escaped into the countries, we are preparing for impact of such a displacement and the impending humanitarian crisis that will follow. While other humanitarian agencies focus on the first and obvious needs of the refugees — water, food and shelter — we are urgently responding to an equally vital pillar of humanitarian response: health.

As a humanitarian health agency, we know it will not be long until the already-weakened Ukrainian hospitals are targeted or start to collapse. We know that health crises are already mounting in the wake of the invasion, and we know how the added burden of thousands of patients will overwhelm the health services in the countries where they are fleeing. We know there will not be adequate capacity to treat the wounded. And we know this setting is a tinderbox for communicable disease.

Ukraine is a highly developed country, and its health needs will mirror our own — diabetes, hypertension, heart disease. Different from some other rapid refugee departures, like the Rohingya who fled Myanmar into Bangladesh, this medical response is likely to be more like our Syrian response in Lebanon where initial mobile medical care transitioned to community health workers who helped the Syrians manage their diseases long after the media had left. In layman’s terms: We are in it for the long-haul.

As we send out our team and formulate our response, this is what we can expect in the coming weeks in Ukraine:

∙ Profound disruption in the continuity of care. This means access to prescriptions, medicines and treatment for chronic and terminal illnesses, as well as medical supplies. There is already an acute shortage of medical oxygen as trucks are unable to deliver supplies — a huge concern with continued high COVID-19 caseloads and other acute respiratory diseases likely to surge in the cold and cramped living conditions.

∙ Migration and forced displacement will cause a steep rise in communicable and noncommunicable diseases. Ukraine has relatively low vaccination rates and was already addressing a polio outbreak and trying to bring it under control through targeting vaccines for kids 6 years and under. Global health experts are gravely concerned that this vaccination campaign will fail or fail.

∙ A lapse in the prevention of COVID and a spike in cases is likely since less than 35% of Ukrainians are fully vaccinated. Public health measures like vaccinations, masks and safe distancing will be difficult to manage and deliver.

∙ Exposure to vaccine-preventable disease from mass movement as well as confinement into small spaces like bomb shelters.

∙ Routine and ongoing health services will be interrupted. Pregnant women will need prenatal care and trained staff to deliver babies. Cancer patients must still receive their medicine, and emergency surgeries will still be needed. There are already reports of hospitals moving patients into bases for care, including children with cancer.

∙ Wartime consequence at levels not seen in decades. Imagine “MASH”-like makeshift clinics and field hospitals. This will test our clinical capacity to provide first-aid and urgent care while managing all the other public health needs from a global COVID pandemic that is not over.

∙ Scant professional care. Trained medical staff are leaving in some regions close to the conflict, leaving huge gaps in care and support.

∙ A mental health crisis. There will be devastating levels of trauma, shock and other mental-health needs.

These are the realities for the projected 5 million refugees this senseless war will create. Humanitarian crises always expose gaps, uproot systems and widen cracks in existing health care systems. We must join the courageous and brave Ukrainians and their valiant neighbours, and respond to the urgent health needs of this crisis. Their lives depend on it.

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