Overcoming Ukraine’s healthcare crisis: the activities of “UK-Med”

Photo: Jonathan Moore

The beginning of the Russian invasion of Ukraine on February 24th 2022 was a shock that will become part of European collective memory. For the staff of “UK-Med” it meant preparing for a quick intervention in order to provide medical assistance to the country’s population.

UK-Med is a British non-governmental organisation which aims to deliver high-quality emergency medical care to people affected by epidemics, conflicts and natural disasters. “G”, the field manager of the organisation for the Sumy and Poltava Oblasts, in north-eastern Ukraine, explains that “UK-Med’s task is to be ready to deploy an entire field hospital within twenty-four hours after a request from the authorities of a country affected by an emergency.”

The organisation was established in 1988 and, over the years, it has been assisting people affected by natural and man-made disasters around the world.

To mention some in the areas covered by our news site Meridiano 13, UK-Med carried out its first international mission in Armenia in response to the Spitak earthquake (1988). During the Siege of Sarajevo (1992-95), UK-Med organised surgical teams to support local staff in their management of war injuries. UK-Med has once more assisted Armenia during the COVID-19 pandemic. Finally, in recent weeks, a mission has been organised in Turkey in the area affected by the February 6th earthquake.

UK-Med in Ukraine

The most demanding mission, in terms of personnel deployment and number of patients assisted, is the one opened in 2022 in Ukraine. The response to the invasion was swift. As early as March 1st, at the request of the Ukrainian authorities, UK-Med sent an assessment team to the country in order to understand where its intervention was most needed.

The organisation’s Director of Fundraising and Communications Jackie Snell describes the role of the assessment mission as follows: “We don’t decide what has to be done. We speak with the local health authorities to understand what their needs are. This is what we did in March and our following activities were based on the initial assessment.”

Over the months, UK-Med has sent around one hundred British and international doctors to Ukraine. These are senior healthcare staff who are willing to travel to carry out the organisation’s activities around the world.

UK-Med work in Ukraine is varied and can be divided into four areas.

Firstly, primary health care is provided. Primary health care can be associated with the work of general practitioners. This type of activity is made necessary by the destruction of infrastructure and the mass displacement of the population fleeing the war.

We are familiar with the images of millions of Ukrainians forced to find refuge abroad. The figures are dramatic indeed. According to data from the United Nations High Commissioner for Refugees (UNHCR), by February 15th 2023, over eight million Ukrainians have obtained refugee status or other types of temporary protection in countries across the European continent. At the same time, the internal movement of people in Ukraine involves equally troubling numbers. The International Organisation for Migration (IOM) reports that there are approximately 5,352,000 internally displaced people in the country as of January 2023. Within a few months of the beginning of the war, some regions of Ukraine were literally emptied, while others doubled in their pre-war population. “No healthcare system can handle these numbers,” Snell explains.

In order to provide primary health care, UK-Med uses mobile clinics. G describes them as “completely self-sustainable clinics with a doctor and a nurse. The mobile clinics allow us to perform weekly consultations, dispensing medicines and prescribing secondary care if necessary.” The areas in which the clinics operate are decided on a weekly basis according to the needs of the local authorities. “They tell us where they are working to avoid overlapping,” explains the field manager.

UK-Med also delivers secondary healthcare (i.e. surgical operations) in Ukraine. The organisation performs surgical operations in the cities of Dnipro and Lviv. The care of patients who require expensive titanium and stainless steel surgical aids, as well as long courses of physiotherapy and rehabilitation, is particularly important.

Moreover, UK-Med provides training to Ukrainian medical staff alongside the country’s population. Paramedics learn techniques concerning the medicalisation of wounds in the proximity of battlefields. As hospitals are far from the front, infections during transportation are very common. The police, the fire service, volunteers and the civilian population all get medical training as well. Ukrainian doctors benefit from the experience of their UK-Med colleagues in conflict areas. Within a few weeks, local doctors have got used to working in hospitals facing war conditions.

Finally, the organisation promotes access to mental health services. This is a long-term activity as it will take years to overcome the traumas of war.

Photo: UK-Med

UK-Med’s activities are flexible and require continuous coordination with the Ukrainian authorities and other humanitarian organisations active in the country. The necessities change constantly at the local level.

It is useful to analyse some local cases in this regard, such as the Sumy, Poltava and Kharkiv Oblasts.

UK-Med in Sumy and Poltava

Sumy used to host a population of around 260,000 inhabitants before February 24th 2022. The border with Russia lies only about forty kilometres from the city centre. The Russian army occupied part of Sumy Oblast in the first weeks of the invasion. The region was completely liberated by early April, but the occupation left severe damage to the region’s medical infrastructure.

In particular, the hospital in Trostianets, an important regional centre, was destroyed. For this reason, the local authorities have requested the support of UK-Med. “They were no longer able to perform any surgical activity, in spite of the high number of requests. Furthermore, the risk of transporting patients to other cities was too great,” explains the regional field manager. “Sumy Oblast gets hit time and time again by Russian artillery strikes and missile attacks, especially in the border area. Nevertheless, life goes on more or less normally, but only half of the pre-war population remained,” he adds.

The situation is reversed in Poltava Oblast. Poltava is further away from the border with Russia and it has double the 300,000 residents it used to have before the war. “Accommodation capacity is limited, with some very precarious situations. Former schools and the Poltava psychiatric hospital are used for this purpose.” In addition to the primary care activities carried out by its mobile clinics, UK-Med is also an external partner in projects which aim to provide stable accommodation for internally displaced people. For example, the Foreign, Commonwealth and Development Office, a department of the British government, is building a village for more than five hundred people using modular containers. UK-Med’s contacts in the area are crucial for the realisation of the project.

The main concern is to ensure that what is donated to the organisation reaches those in need.

UK-Med in Kharkiv

The activities of the organisation change according to the dynamics of the conflict. The liberation of Sumy and Poltava Oblasts allowed work to begin in these areas in April. The same process occurred in the Kharkiv region in October after the breakthrough offensive of the Ukrainian army in early September.

The field manager of the area is Mathieu Radoubé, who knows Ukraine well thanks to his long-term experience in Donbas both as a journalist and as an employee of the French foreign ministry.

UK-Med works in eight locations in Kharkiv Oblast. These include two shelters for displaced people in Kharkiv itself and six villages that were under Russian occupation until September. Some of these villages are in proximity to the Russian border. With the arrival of a new mobile clinic, the organisation will soon be able to operate in twenty locations across the oblast.

The main task of the organisation is to provide primary health care in areas that the Ukrainian healthcare system cannot cover. “The idea is to return to the same places every two weeks and treat the same patients,” explains Radoubé. “We make sure they get the right medical support until local authorities can resume their work.” This is what happened in two locations in the Balakliia district; after three months, UK-Med transferred responsibility for the area to the local doctor, who returned after he fled at the beginning of the war.

Source: Twitter

So far, UK-Med has treated 521 patients in the area, despite the frequent bombings that hit the region (the patient figure refers to February 8th, when we spoke to Mathieu and is understandably constantly evolving). The most common pathologies are those typical of an elderly population: cardiovascular hypertension, diabetes, respiratory diseases and winter viruses.

Kharkiv Oblast has emptied out, even more dramatically than Sumy. The people who remained are usually over sixty and could not leave due to economic and social conditions.

Photo: UK-Med

Future plans

During our conversations with UK-Med staff, it emerged that most of the work still needs to be done. This will not end with the end of the war or with the further advances of the Ukrainian army, quite the opposite.

“Even where territories appear to be accessible again, the inhabitants cannot really return. There is no electricity and gas, and it is extremely cold. Moreover, clinics have been destroyed or have been emptied, schools are unusable and many houses no longer have roofs. When the conflict ends, it will be necessary to provide humanitarian aid for years in order to return to normality,” explains Radoubé.

This is true in all the areas affected by the war. For instance, in Kherson city, which was liberated by the Ukrainian army on November 11th, a UK-Med team found “infrastructure and a community devastated by the occupation”.

His previous experience in Donbas allows Radoubé to make some predictions for the future. “People forget crises after some time. This is exactly what happened with the conflict in Donbas. It must be understood that most of the work will have to be done after the war ends.”

To contribute to UK-Med’s important work in Ukraine and other parts of the world, you can donate on this page on the organisation’s website. To find out more about UK-Med’s activities in the rest of the world, read here.

This article was originally published in Italian on the Meridiano 13 website and social media channels.

Aleksej Tilman is an Italian Communications Specialist with a strong interest in the Caucasus. He covers the region for Meridiano 13 and other outlets, including Q Code Magazine and Valigia Blu.

aid, Health care, UK foreign policy, Ukraine at war