The brutal war in Ukraine has become one of the most destructive conflicts of our time, and people from all walks of life are paying a heavy price.
Soon after the escalation in war last February, I went to Ukraine when my organization, Doctors Without Borders/Médecins Sans Frontières (MSF), started helping people evacuate from the east to the west of the country by medical train as the front lines inched closer. No one is spared from the impact of this war. We prioritized those who needed significant care to make the journey, including very young orphans, older adults with disabilities, war-wounded people, and other hospitalized patients.
Paulina was one of these patients. I met her and her father, Sergiy, on the medical train en route to Lviv. She was 11 years old and in need of medical treatment for rocket shrapnel in her leg, difficulty breathing, and a severe cut to her finger that her father had wrapped to keep from falling off.
She and her father left their home in Mariupol in Donetsk oblast and sought safety at his office before aerial bombardments—"hellfire," her father said—forced them to flee again. They had walked for days from Mariupol before reaching Zaporizhzhia, where we picked them up. She lost her mother to COVID-19 months before the war escalated last year, but she was luckier than some. On this same ride, we had 90 orphans.
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Paulina is just one of the nearly 3,000 people we’ve helped reach safer areas by train, but that number seems small considering the scale of the tragedy that continues to unfold.
This war has been simmering in the eastern part of Ukraine for nine years, wreaking havoc on people’s health and sense of security. Shelling continues daily, as does Russian strikes on residential areas and critical energy and water infrastructure, causing repeated blackouts in the middle of a bitter winter. Approximately five million people are currently displaced in Ukraine and living in sub-par conditions.
What we’re seeing with these civilians on the ground is a complete disregard for their safety. While we provide people the medical care they desperately need, we see firsthand the traumatic impact of the war as people are being killed and wounded in their homes and when they try to flee to safer areas. Under the rules of war, civilians must be protected—both from intentional and indiscriminate attacks—and they must be allowed to flee safely.
We now have more than 800 Ukrainian and international staff working across the country, focusing on increasing medical and humanitarian needs including physical therapy for war-wounded people and basic health services for residents of communities that have been cut off from care since 2014.
Our mobile clinic teams are working in areas across the country to ensure people continue to receive medical care, including older adults with chronic conditions such as hypertension, heart problems, or diabetes, as well as people with tuberculosis who have to take very specific medications daily for months to prevent building a resistance to them. In southern Kherson and Mykolaiv oblasts, in particular, we see people are struggling with their mental health after months of extremely limited access to medical care while the area was under Russian control. While mental health conditions used to be stigmatized here, people are now openly seeking the help of MSF counsellors.
We also support health care facilities in war-torn areas with specific needs such as supplies for surgery. And we work to bring new skills and approaches to the challenges that people in Ukraine are confronting on a daily basis by bolstering psychological care; developing physiotherapy programs for people who have experienced life-altering injuries; running ambulances; providing support to health care workers who are burned out as they live and work in this conflict; ensuring access to sexual and reproductive health care services; and continuing to assess where our resources and personnel are most needed.
Notably, in the town of Hostomel, on the outskirts of Kyiv, we have started a program to treat victims of torture—both mentally and physically by providing physiotherapy rehabilitation. Our teams also provide mental health care in 10 different locations outside of Kyiv and provided almost 1,000 individual mental health consultations and 184 group therapy sessions in 2022. We’re offering a similar rehabilitation project in Vinnytsia oblast and continue to treat people with war wounds.
It has been nine years since war first broke out in eastern Ukraine, and one year since it escalated onto a wider scale. No one knows how long it will last. We only know that people will continue to suffer the physical, psychological, and social consequences of this violence long into the future.
Avril Benoît is the executive director of MSF-USA.
