More than half of the families living near the “contact line” cannot access healthcare
The conflict in eastern Ukraine, now in its sixth year, has hindered access to healthcare for millions of people. According to the Protection and Health/Nutrition clusters, some 40 per cent of families living within 20-km of the “contact line” face significant challenges accessing healthcare services. The closer one gets to the “contact line,” the more difficult it is to access healthcare. A staggering 57 per cent of families do not have safe and adequate access to hospitals and medical services within five kilometers of the “contact line.”
Multifaceted impact on healthcare systems
There are about 600 primary health care facilities throughout Luhanska and Donetska oblasts in Government controlled areas (GCA) and along the “contact line” in non-Government controlled areas (NGCA). Over 35 per cent of them have sustained damage and an unknown number is in disrepair due to lack of maintenance. Lack of healthcare workers, who long left eastern Ukraine in search of safety and/or better opportunities elsewhere, hinders access to healthcare even more. Shortage of critical medical supplies, equipment and basic commodities continue to be reported across all conflict-affected areas, while costs for medical care continues to rise. Humanitarian agencies operating in NGCA also report shortage of medication for diabetes, cardiovascular conditions, cancer, and other non-communicable diseases.
In Luhanska and Donetska oblasts, in areas under government control, some 40 per cent of the population experience trauma resulting in stress, depression, anxiety, and post-traumatic stress disorder. However, there is a general lack experience in treating issues of mental health.
Isolated communities suffer the most. In the communities close to the “contact line”, availability of public transport, damage to roads and restricted movement through military checkpoints further challenge people’s access to healthcare. Restrictions of movements, often due to the presence of landmines or constant shelling, also mean that ambulances cannot reach patients, putting people with disabilities, the elderly, and families with young children, at most risk of being unattended.
According to Protection and Nutrition/Health Clusters, 8 in 10 families living within the 20-kilometers of the “contact line” also find the cost of medicine as one of the main challenges, especially as it is associated with transportation costs. For this reason, mobile clinic services and humanitarian efforts that aim to reach these isolated settlements are deeply critical. An allocation of some US$3.2 million by the Ukraine Humanitarian Fund, which is expected to be disbursed by September 2019, will address some of these challenges.
Humanitarian action to date is making a significant difference – over 200,000 people benefited from healthcare support programmes between January and June 2019. However, in a situation where 1.3 million people need access to healthcare in the East, much more needs to be done. First, practical measures to address challenges in terms of distance, cost of travel and accessibility for disabled people must be urgently undertaken by the Government and prioritized by humanitarian actors; and second, with the healthcare projects under 2019 Humanitarian Response Plan funded less than 25 per cent, international donor support must urgently be strengthened.