Unlike some other humanitarian emergencies where local healthcare systems collapse or struggle to meet people’s needs
hospitals and civil society organisations in Ukraine continue to function in the ongoing war in the country
Since hands-on medical care is largely taken care of
Médecins Sans Frontières (MSF) teams are currently focusing on building a network of support to hospitals and first responders
Here we share a window into an MSF team’s two-day visit in late May offering support to people in a rural town in central Ukraine
At 7.30 am there is a rush at the entrance of a hotel in Kropyvnytskyi
a city in central Ukraine 150 kilometres from the nearest frontline
People load some medical and logistics materials into three cars
and the project coordinator does the last briefings on the situation and planned activities with the mobile team members as they get ready to leave
The convoy crosses vast and mostly empty fields for soya
The cloudy blue sky and the yellow soya flowers recreate the bi-coloured Ukrainian flag
Over 1,000 people displaced by the war are registered in the town
go to the local hospital and ambulance centre
they will carry out training sessions about mass casualty response and decontamination; in other words
on how to triage during a situation of a high influx of wounded patients and on how to proceed in case of an attack with non-conventional weapons
go to assess the condition of people in the displaced communities
They would like to offer individual mental health consultations and try to arrange a psychotherapy group
The war is having a huge psychological impact and many people suffer from symptoms like intense fear
head to a school to launch a two-day workshop on sexual and gender-based violence (SGBV)
the Brazilian logistician Tanain and other staff visit the humanitarian centre to donate relief items
Addressing needs of people who are displaced
Olena is currently the village council secretary
“Many were transiting to other places.”
“It was awful… nobody was prepared
so we organised ourselves to do different tasks: to cook
clean… Everyone brought things,” continues Olena
“As women with small babies couldn’t stay in the social centres
There was a lot of solidarity; I have never seen anything like this.”
Olena’s own son and partner used to live in Kyiv
but they moved here also shortly after the war started
“It is now very important to get humanitarian assistance,” says Olena
“We can temporarily ask farmers to provide food
but other things like hygienic items are helpful… people are running out of money
An MSF team was in Holovanivsk two weeks earlier
so before this visit the local authorities had identified the needs: blankets
Victimisation and barriers for survivors of sexual violence
The facilitators talk about the feeling of victimisation some women can have after giving birth to a child as a result of a rape
or about the barriers male survivors experience
“It doesn’t matter what you wear
you don’t have a sign to be raped,” midwife Florencia says in the session to the group
“It is always the guilt of the perpetrator.”
“The training is very useful and informative,” says Olga
“It’s extremely important in these times because we often encounter cases of violence
We want as many people as possible to be aware of such cases.”
Understanding survivors’ bureaucratic challenges
Each participant takes a different role: a police officer
The woman portraying a survivor holds a string and moves from one person to the other seeking assistance
she creates a complex spider web out of string
The web represents the bureaucratic hurdles survivors find in real life
To create a single pathway with all the services
including medical treatment and psychological assistance
something MSF is trying to support health authorities with in parts of Ukraine
"Our aim is to sensitize these first line responders in order to increase the number of people reaching the services,” says Florencia
Violence has put people in vulnerable situations
the MSF psychologists carry out psychological support sessions with adults and their children displaced by the conflict
Maryna and Olena come from the Donetsk region and arrived here one and two months ago
They live in an empty house in a village near Holovanivsk with another woman; all of them have children between six and 12 years of age
“A relative living here [in Holovanivsk] was told by administration officials about the place where we are now,” says Olena
we were afraid about how people would react
We didn’t want them to feel sorry for us
Maryna had a beauty parlour and Olena ran a small store
Now they are helping in a local kitchen to prepare food and grow some vegetables
Sandra also shares her experience on the effects of the war
She is in the last year of her bachelor studies on international management and comes from Kharkiv
and my parents and husband are with me,” says Sandra
It takes me just one minute to get frustrated
to start crying… I still can’t believe this is possible.”
She tries her best to occupy her mind with tasks
She says some of her friends chose to stay in Kharkiv
despite the extremely hard situation – one girlfriend who has a small daughter is living in a partially destroyed home
“I don’t miss any material belongings,” says Sandra
I would like to just get back home.”
I felt nauseous just by looking at food,” continues Sandra
“During the first days we always moved to the bunker
we went to the bathroom and covered our heads with pillows and blankets
“Jet fighters flew over the building,” she says
every time it seemed they were hitting us.”
the MSF medical team concludes the training; Yanina and Oleksii sit again in their paediatric department office dressed in white coats
She is from Zaporizhzhia and he is from Melitopol
but both moved to Holovanivsk two years ago
“We have had fewer patients since 24 February [start of the war] but they come with more severe conditions,” says Yanina
“A lot of people from the region have left Ukraine and many people who are displaced within the region don’t know exactly what we do.”
done by children who have received medical support
The patients draw about their experiences with health issues
“In the first month of the war we worked at night and the surgical team was 24 hours on standby,” says Yanina
These days we stay in the safe area of the corridor.”
“We have received humanitarian assistance over the last months
The training is important in rural areas for the staff to develop knowledge
not to panic and to know how to act step by step,” she continues
“We have had children from occupied territories
He developed allergic rhinitis [inflammation of the lining of the nose] from spending one month in the bunker and was in a bad psychological condition.”
Things are not easy for the doctors themselves either
They check every day on their own families
the easiest is to just come to work,” says Oleksii
“I still have so many relatives in Melitopol
My parents live near the military airport and keep hearing military planes
People trying to leave Melitopol to other parts of Ukraine spend days in each checkpoint.”
the siren alert sounds on everyone’s mobile phones
The previous two were in the middle of the night
the different members of the MSF team regroup
wrap up their work and get into the three cars to travel back to Kropyvnytskyi
The two-day visit to support people in Holovanisk has come to an end