This repository of 167 articles provides a comprehensive insight into the health care challenges caused by the Ukraine crisis. These articles were collated between February 2022 – June 2022.
This health science resource page is provided by the Geneva Centre of Humanitarian Studies and aims to inform governments, humanitarian organisations, our students and media representatives of the latest research papers on the health situation of those fleeing Ukraine or trapped in the country. This page includes systematic reviews and primary and secondary analysis and it also refers to online resources from reputable organisations where updated information is published.
The Centre is also hosting regular webinars on the Ukraine crisis and the health implications of those affected, in collaboration the Lancet Migration European Regional Hub. The most recent webinar on March 30, 2022, can be viewed here.
Refugees and Mental health crisis in Ukraine
Asian Journal of Psychiatry
Authors: Shoib, S. et al.
War Psychiatry: Identifying and Managing the Neuropsychiatric Consequences of Armed Conflicts
20.6.2022 – Journal of Primary Care & Community Health
Authors: – Jain, N. et al.
War refugees and veterans have been known to frequently develop neuropsychiatric conditions including depression, post-traumatic stress disorder (PTSD), and anxiety disorders that tend to leave a long-lasting scar and impact their emotional response system. The shear stress, trauma, and mental breakdown from overnight displacement, family separation, and killing of friends and families cannot be described enough. Victims often require years of mental health support as they struggle with sleep difficulties, recurring memories, anxiety, grief, and anger. Everyone develops their coping mechanism which can involve dependence and long-term addiction to alcohol, drugs, violence, or gambling. The high prevalence of mental health disorders during and after the war indicates an undeniable necessity for screening those in need of treatment. For medical health professionals, it is crucial to identify such vulnerable groups who are prone to developing neuropsychiatric morbidities and associated risk factors. It is pivotal to develop and deploy effective and affordable multi-sectoral collaborative care models and therapy, which primarily depends upon family and primary care physicians in the conflict zones. Herein, we provide a brief overview regarding the identification and management of vulnerable populations, alongside discussing the challenges and possible solutions to the same.
War against Ukraine: Humanitarian aid and how much morality can science bear
17.6.2022 – 4 open sciences
Author: Brucher, B.
Evaluation of change in emergency care knowledge and skills among front-line healthcare providers in Ukraine with the Basic Emergency Care course: a pretest/post-test study
14.6.2022 – BMJ
Authors: Sean M Kivlehan, Amy Allen, Olha Viun, Dmitry A Makarov, Daniel Schnorr, Sonny Patel, Sergii A Ryzhenko, Phuong Pham, Timothy B Erickson
Objective: Evaluate the change in participant emergency care knowledge and skill confidence after implementation of the WHO-International Committee of the Red Cross (ICRC) Basic Emergency Care (BEC) course.
Design: Pretest/post-test quasi-experimental study.
Setting: Mechnikov Hospital in Dnipro, Ukraine.
Participants: Seventy-nine participants engaged in the course, of whom 50 (63.3%) completed all assessment tools. The course was open to healthcare providers of any level who assess and treat emergency conditions as part of their practice. The most common participant profession was resident physician (24%), followed by health educator (18%) and prehospital provider (14%).
Interventions: The 5-day WHO-ICRC BEC course.
Primary and secondary outcome measures: Change in pre-course and post-course knowledge and skill confidence assessments. Open-ended written feedback was collected upon course completion and analysed for common themes.
Results: Participant knowledge assessment scores improved from 19 (IQR 15-20) to 22 (IQR 19-23) on a 25-point scale (p<0.001). Participant skill confidence self-assessment scores improved from 2.5 (IQR 2.1-2.8) to 2.9 (IQR 2.5-3.3) on a 4-point scale (p<0.001). The most common positive feedback themes were high-quality teaching and useful skill sessions. The most common constructive feedback themes were translation challenges and request for additional skill session time.
Conclusions: This first implementation of the WHO-ICRC BEC course for front-line healthcare providers in Ukraine was successful and well received by participants. This is also the first report of a BEC implementation outside of Africa and suggests that the course is also effective in the European context, particularly in humanitarian crisis and conflict settings. Future research should evaluate long-term knowledge retention and the impact on patient outcomes. Further iterations should emphasise local language translation and consider expanding clinical skills sessions.
Providing care for those fleeing war: challenges and solutions for Polish doctors looking after refugees from Ukraine
10.6.2022 – BMJ
Authors: Mateusz Babicki, Agnieszka Mastalerz-Migas
War in Ukraine: the opportunities for oncogynecologic patients in Poland –
6.6.2022 – BMJ
Authors: Marcin Bobiński, Olha Hoptyana, Karolina Rasoul-Pelińska, Margaryta Lyzogub, Agnieszka Rychlik, Andrei Pletnev
Ukraine crisis highlights inequities in refugee care
6.6.2022 – Canadian Medical Association Journal
Author: Abigail Cukier
Infectious diseases amidst a humanitarian crisis in Ukraine: A rising concern
3.6.2022 – Annals of Medicine & Surgery
Authors: Mohammad Yasir Essar, Lolita Matiashova, Christos Tsagkaris, Valeriia Vladychuk, Michael Head
As of the 24th of February 2022, the war in Ukraine has increased the risk for infectious diseases outbreaks in the country and beyond. The disruption of healthcare services, the destruction of critical infrastructure, the displacement of millions of civilians and the crowded living conditions in bunkers pose a formiddable threat to public health. Infections are emphasized due to the low rates of vaccination against COVID-19 and the high prevalence of chronic infections such as Tuberculosis and HIV/AIDS in Ukraine compared to the WHO Europe region. Collaboration between authorities and humanitatian organizations is necessary, in order to strengthen epidemiological surveillance and deploy vital resources that are required for the prevention and the management of infections.
Public health surveillance in countries hosting displaced people from Ukraine
2.6.2022 – Europe’s Journal on Infectious disease surveillance, epidemiology, prevention and control
Authors: Julien Beauté, Piotr Kramarz
Russia-Ukraine conflict and COVID-19: a double burden for Ukraine’s healthcare system and a concern for global citizens
2.6.2022 – Postgraduate Medical Journal
Authors: Olivier Uwishema, Bhavana Sujanamulk, Mortada Abbass, Rabih Fawaz, Amaan Javed, Khaled Aboudib, Ashraf Mahmoud, Adekunbi Oluyemisi, Helen Onyeaka
Editorial – The conflict between Ukraine and Russia significantly influences the healthcare sector. The ongoing COVID-19 pandemic and the armed conflict have badly devastated the established healthcare system. Only 36.08% of the Ukrainian population has received the COVID-19 vaccination, with the majority receiving two doses, and currently, Ukraine records the highest mortality rate in the world. In addition to the conflict injuries, increased susceptible deaths to COVID-19 can be found due to inadequate vaccination rates for the disease. To save their lives and for their well-being, many individuals have been relocating to the underground metro stations, other cities, nearby towns and countries. In these settings, social distancing, hand sanitation and wearing masks are not prioritised. In the current circumstances, the broken healthcare system needs to be rebuilt, and the Non-Governmental Organizations (NGOs), doctors and all the front-line workers should extend their humanitarian support to the Ukrainian population. Conclusion: It is an arduous task for healthcare organisations to supply vaccines and medicines in this ‘armed conflict’ between Russia and Ukraine. This can only happen when both parties extend their support to rebuild the shattered healthcare infrastructure.
Oncology specialists’ perspective on caring for patients with cancer during the early days of war in Kyiv, Ukraine
1.6.2022 – the Lancet Oncology
Authors: Philipp Barakat, Oleksandr Stakhovskyi, Viacheslav Kopetskyi, Mary Caitlin King, Carol Nieroda, Vadim Gushchin
Many Ukrainian oncologists woke up to a new wartime reality on Feb 24, 2022. In this Reportage, we describe the unique challenges in Ukraine and ways oncologists coped with them in the early days of the humanitarian disaster. Two authors are Ukrainian oncologists from the National Cancer Institute in Kyiv, Ukraine. Through a messaging service, they provided first-hand accounts from the war zone to a second group of researchers in Baltimore, MD, USA. The US team documented the narrative and organised it into several themes. This Reportage aims to provide insight into the thought processes and decision making of highly trained oncologists who found themselves providing care for their patients in the early days of a war.
Letter: Capacity Building for Surgical Epilepsy Care in Ukraine
1.6.2022 – Neurosurgery
Authors: Markosian, Christopher BA; Soroka, Mariya BA, Forbes, Jonathan A. MD; Tomycz, Luke D. MD
War in Ukraine ups demand for iodine pills
1.6.2022 – the Lancet Diabetes & Endocrinology
Author: Talha Burki
An unexpected consequence of the Russian invasion of Ukraine, which began on Feb 24, 2022, has been the surge in demand for iodine pills in many European countries and others further afield. Online vendors have been selling tablets of potassium iodide, the salt of stable iodine, for twice their pre-war price. Shortages have been reported in pharmacies across several European nations. The run on iodine has been prompted by fears that the war in Ukraine could involve a nuclear incident. Exposure to radioactive iodine is associated with a heightened risk of developing thyroid cancer. Ingesting potassium iodide before and after the exposure cuts the risk by saturating the thyroid with stable iodine.
The Russian invasion of Ukraine: Implications for haematologists
6.2022 – British Journal of Haematology
Author: Robert Peter Gale
War in Ukraine: Challenges for women’s and perinatal health
6.2022 – Sexual and Reproductive Healthcare
Authors: Iryna Mogilevkina, Nataliia Khadzhynova
Inside the Ukraine war: health and humanity
6.2022 – BMJ
Authors: Wireko Andrew Awuah, Aashna Mehta, Jacob Kalmanovich, Rohan Yarlagadda, Matthew Nasato, Mrinmoy Kundu, Toufik Abdul-Rahman, Anastasia Deborah Fosuah, Vladyslav Sikora
Ukraine: A Humanitarian Disaster With Long-Term Consequences
6.2022 – Health Affairs
Author: Rabih Torbay
Paediatric refugees from Ukraine: guidance for health care providers
31.5.2022 – Swiss Medical Weekly
Authors: Jaeger, F. N., et al.
Background: With the invasion of Ukraine by the Russian Army in February 2022, refugees, the majority of whom are women and children, started fleeing the war to neighbouring countries. Even before the current escalation, the conflict in the eastern part of Ukraine has led to the internal displacement of more than 200,000 children, and many others have experienced attacks, e.g. on schools. This inevitably leads to limitations in health care delivery. During transit, overcrowding, poor shelter and vulnerability may further put refugees at increased risk for infectious diseases. This consensus document aims to provide information and guidance regarding health issues that paediatricians and general practitioners may face when caring for Ukrainian children.
Methods: Members of the Migrant Health Reference Group of Paediatrics Switzerland and the Paediatric Infectious Disease Group in Switzerland developed this recommendation between March and April 2022 in a modified Delphi process.
Results: A total of 50 recommendations were agreed on with a ≥80% consensus. These include the following topics: i) general aspects, including interpreter services, urgent health needs, personal history and general check-ups; ii) mental health, including how to search for signs of psychological distress without going into traumatic details; iii) vaccinations, including recommendations for evaluation and catch-up; iv) screening for tuberculosis, human immunodeficiency virus, and hepatitis B and C; and v) providing age-appropriate preventive and health service information.
Conclusion: This document provides current evidence and guidance when caring for paediatric refugees from Ukraine. The recommendations focus on Switzerland but may well be used in other countries. These are based on current evidence and may need to be adapted to individual situations and once further evidence becomes available.
Not all refugees are equal at the Ukrainian border
30.05.2022 – Nature Human Behavior
Authors: Sky, K.
War in the Time of COVID-19 Crisis: A Public Health Emergency in Ukraine
27.05.2022 – Prehospital and Disaster Medicine
Authors: Muhammad Mainuddin Patwary, Matthew H.E.M. Browning, Alfonso J. Rodriguez-Morales
Strengthening Diabetes Care In Humanitarian Crises In Low- And Middle-Income Settings
27.05.2022 – The Journal of Clinical Endocrinology & Metabolism
Authors: Sylvia Kehlenbrink, Éimhín Ansbro, Stéphane Besançon, Saria Hassan, Bayard Roberts, Kiran Jobanputra
(A case study on the 2022 Ukraine crisis is included in this paper) Amidst the growing global diabetes epidemic, the scale of forced displacement due to armed conflict and humanitarian crises is at record-high levels. Over 80% of the displaced population lives in lower- and middle-income countries (LMICs) which also host 81% of the global population living with diabetes. Most crises are protracted, often lasting decades, and humanitarian aid organizations are providing long-term primary care to both the local and displaced populations. Humanitarian crises are extremely varied in nature and occur in contexts that are diverse and dynamic. The scope of providing diabetes care varies depending on the phase of the crisis. This paper describes key challenges and possible solutions to improving diabetes care in crisis settings. It focuses on: (1) ensuring a reliable supply of life preserving medications and diagnostics, (2) restoring and maintaining access to healthcare, and (3) adapting service design to the context. These challenges are illustrated through case studies in Ukraine, Mali, the Central African Republic, and Jordan.
The War in Ukraine and Migration to Poland: Outlook and Challenges
27.5.2022 – Intereconomics
Authors: Maciej Duszczyk, Paweł Kaczmarczyk
The outbreak of war in Ukraine has impacted many spheres of political, economic and social life. In particular, the fl ight from war zones drastically changed the migratory situation in Ukraine itself as well as in many countries of the EU, including Poland. Poland is playing the most important role among the countries receiving war refugees from Ukraine, with around 3.5 million persons who arrived in Poland between 24 February and mid-May 2022. As we show in this article, this phenomenon is due not only to geographic factors (common border) but also due to the long-lasting tradition of (labour) migration between Ukraine in Poland. This notwithstanding, the unprecedented in-flow of war refugees clearly raises questions about future developments and challenges related to the presence of Ukrainian citizens in Poland. This contribution presents an attempt at estimating the possible future stocks of immigrants from Ukraine in the country and points out related challenges. For obvious reasons, this attempt is subject to great uncertainty. However, the presented scenarios indicate that regardless of developments on the front line, we have to reckon with the fact that the number of immigrants from Ukraine in Poland will be
significantly higher in the coming months (or maybe years) than at the beginning of 2022, and this poses certain challenges for public services and public institutions in Poland. We show that labour immigration to Poland, the crisis on the Polish-Belarusian border, and an influx of war refugees from Ukraine changed the status of Poland from a typical emigration country to an immigration one, without going through the intermediate phase, i.e. the immigration status. On top of that, in the second half of 2021 and the first half of 2022, Poland and refugees were a focus not only in the media but also in political discussions at the highest levels. This will have, both in the medium and long term, a huge impact on the perception of Poland in the world and could be (and possibly will be) a subject of internal political debate.
Psychotraumatology of the war in Ukraine: The question of the psychological care of victims who are refugees or who remain in Ukraine
27.5.2022 – Annales Médico-psychologiques, revue psychiatrique
Authors: Jean-Pierre Bouchard, Nancy Stiegler, Anita Padmanabhanunni, Tyrone B.Pretorius
The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a good number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of the number of available and dedicated psychologists, including remotely, from the countries hosting the most refugees, are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained on the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organising and coordinating these actions must be carefully considered and implemented in an evolving way to optimise their effectiveness.
Violation of the right to abortion at the time of the war in Ukraine
27.5.2022 – Sexual & Reproductive Healthcare
Authors: Andrea Cioffi, Camilla Cecannecchia, Fernanda Cioffi
Abortion is still a controversial medical practice. One country where it is not possible to have an abortion freely is Poland. During the war between Russia and Ukraine, many Ukrainian women became pregnant due to rape. These women, refugees in Poland, have asked for an abortion; however, under Polish law, it is not possible to have an abortion if the rape has not yet been legally recognized. This situation is causing a very serious violation of the fundamental rights to the health and self-determination of Ukrainian women. It will be necessary to implement all possible international measures to allow these women to abort freely.
Providing responsive primary care for Ukrainian refugees
26.05.2022 – British Journal of General Practice
Authors: Aaron Poppleton, Dennis Ougrin, Yana Maksymets
The conflict in Ukraine has displaced millions of people, creating a new refugee crisis. A formal route exists for Ukrainians to reside and access health care in the UK, including primary care. In this article we explore the health of refugees from Ukraine before, during, and after their migration to the UK, with a particular lens focusing on how UK primary care can seek to meet these needs.
Ukraine conflict: Prioritizing lives and health
25.5.2022 – PLOS Medicine
War in Ukraine-Possible endangerment of refugees through poliomyelitis : Information of the National Committee for Polio Eradication in Germany (NCC)
24.05.2022 – Nervenarzt
Authors: Uta Meyding-Lamadé, Kathrin Keeren
This paper is in German.
As a result of the war in Ukraine, more than 3 million people, mostly women and children, have already left the country. According to estimates by the UN refugee agency, millions more people will flee Ukraine or relocate within the country. On March 4th, 2022, the EU decided that war refugees from Ukraine can apply for temporary protection at the responsible foreigners authority. An application for asylum to secure a right of residence or to claim social and medical services (including vaccinations) is not necessary, but can still be made at a later date.
In addition to all the humanitarian suffering caused by war and flight, infectious diseases also pose an additional risk for the refugees. The refugees should be protected from them as well as possible. The ECDC has compiled preventive measures (e.g. disease surveillance, vaccination, communication) and recommends that European countries strengthen these in the current very challenging situation.
Protecting the Thyroid in Times of Conflict (Ukraine 2022)
23.05.2022 – Thyroid
Author: Daniel J. Toft, Schneider
With the onset of the war in Ukraine, radiation anxiety, evidenced by sales of potassium iodide (KI), began to surface widely, particularly after February 24th when the Reuters news organization reported “Chernobyl power plant captured by Russian forces” and subsequently on March 3rd with news of a fire in the Zaporizhzhia Nuclear Power Station, the largest in Europe. Authoritative guidelines and reviews about using KI to protect the thyroid have been published and should be consulted for comprehensive coverage of the topic. For the most part, these foresee a release of radioactive iodine from a power plant accident during peacetime. In this commentary, we summarize some basic facts about protecting the thyroid using KI, but we focus on the considerations arising in times of conflict.
Policy responses to the Ukraine crisis threaten European biodiversity
23.5.2022 – Nat Ecol. Evol.
Authors: Strange, N. et al.
“Doctors ask me to feed my kids-but how?” The Russia-Ukraine war hits Syrian refugees in Lebanon
20.5.2022 – BMJ
Author: Chen, A.
War in Ukraine: the impacts on child health
20.05.2022 – British Journal of General Practice
Author: Richard Armitag
The Russian invasion of Ukraine has triggered an enormous humanitarian crisis that has inflicted, and continues to inflict, deep and enduring harms on human health. One of the groups most heavily affected, including the greatest impacts on health and wellbeing, is children. Prior to the outbreak of war, child health in Ukraine was heavily burdened by concerning rates of infant mortality, low provision of routine vaccinations, and high prevalence of infectious diseases including multidrug-resistant tuberculosis. As such, the country’s over-stretched and under reform health system, which is officially state funded yet considerably supplemented by out-of-pocket payments, was poorly positioned to respond to the additional burdens of child health created by the war.
The Ukrainian children emergency: How the Pediatric Oncology Unit of Turin supports cancer patients and their families who have escaped war
20.5.2022 – Pediatric Blood Cancer
Authors: Zucchetti, C. et al
Due to the war in Ukraine, many children have been killed and those who suffer from severe diseases, such as oncological pathologies, are facing serious challenges as their treatment is interrupted. The objective of this report is to describe one of the first Italian humanitarian expeditions launched to rescue children and their families to provide them with the best possible cancer care. The Pediatric Oncology Unit of Turin has welcomed 60 Ukrainians who are patients, caregivers and siblings. This report underlines the activities that have been implemented to offer this new type of patient the best possible care.
Nursing associations and war in Ukraine
Authors: Federica Riva Rovedda, Paola Di Giulio
(article in Italian) Nurses’ associations and war in Ukraine. The tragic irruption of war with all its scenarios of horror and destruction in the heart of Europe has documented the depth of the absence of a culture of peace in the international community of States, which have not be willing nor capable to propose a credible platform leading to a diplomatic solution of a conflict where all big powers are complice. While the strictly health related impacts represent a direct and specific interest and challenge for the nursing profession, it is clear that we are facing a future where a new awareness of being citizen of a world which requires a different culture and commitment must become part of our training and strategies of
presence in the society. A survey of the positions assumed by the nursing organisation at international level, together with few model reflections on the broader implications of what we are living, is proposed as a first expression of a long term commitment and interest.
Ukraine War Could Push an Additional 47 Million Into Acute Hunger
17.5.2022 – Jama network
Authors: Howard D. Larkin
Food and fuel supply disruptions due to the war in Ukraine could put as many as 47 million more people worldwide at risk of malnutrition and starvation, according to an analysis by the United Nations’ World Food Programme (WFP). This translates into 323 million acutely food insecure people in 81 countries this year.
Sustainable Development Goals in the Time of Crisis
16.5.2022 – J Korean Med Sci.
Authors: Zimba, O., Gasparyan, A., Ahmed, S.
Russo-Ukrainian war amid the COVID-19 pandemic: Global impact and containment strategy
13.5.2022 – International Journal of Surgery
Authors: Manish Dhawan, Om Prakash Choudhary, Priyanka, AbdulRahman A Saied
A joint international collaboration to address the inevitable mental health crisis in Ukraine
13.5.2022 – Nat Med.
Authors; Bai, W. et al
The Ukrainian refugee crisis and the COVID-19 pandemic in Europe
13.5.2022 – Int J. Surg.
Authors: Rahimi, F., Abadi, A.,
A joint international collaboration to address the inevitable mental health crisis in Ukraine
13.05.2022 – Nature Medicine
Authors: Wei Bai, Hong Cai, Sha Sha, Chee H. Ng, Afzal Javed, Jair Mari, Zhaohui Su, Naotaka Shinfuku, Yu-Tao Xiang
On 24 February 2022, Russia launched a full-scale invasion of Ukraine, marking a major escalation in hostilities. More than 4 million people have fled Ukraine into neighboring countries, causing Europe’s largest refugee crisis since the Second World War. The mental health problems and challenges among refugees and other populations affected by the war have received little attention, compared to political boycotts and economic sanctions. The rapid escalation of a mental health crisis warrants urgent attention.
Unified European support framework to sustain the HIV cascade of care for people living with HIV including in displaced populations of war-struck Ukraine
13.05.2022 – The Lancet HIV
Authors: Marta Vasylyev MD, Agata Skrzat-Klapaczyńska, Jose I Bernardino et al
Ukraine is one of the countries in Europe most affected by HIV. The escalation of open war on the European continent has affected HIV care in Ukraine in an unprecedented way. Treating physicians in Europe have little experience on how to handle HIV-specific care under these circumstances. A framework is urgently needed that both defines and sets out strategies to handle the specific challenges for emergency support for people living with HIV, both those staying in Ukraine and those becoming displaced. The optimal allocation of the few available medical resources, primarily antiretroviral therapy, is necessary to best prevent individual morbidity and achieve population transmission control. Professional HIV networks play a central role to create, optimise, and execute support strategies. Through a rapid literature review we identified the key strategies needed to create a support framework, adapted to Ukraine’s HIV epidemiology. We produce a unified support framework aiming to reduce the inevitable impact on Ukraine’s HIV care cascade now, and when rebuilding it after the war.
Russian-Ukrainian war impacts the total environment
12.5.2022 – Sci Total Environ.
Authors: Pereira, P. et al.
The Russian-Ukrainian war triggered a tsunami that dramatically impacted the world economy, geopolitics, and food security. Due to the extreme humanitarian situation, the effects on the environment have been overlooked. However, due to the intense fighting, the impacts will be dramatic and produce an environmental disaster. The war is already affecting areas beyond Ukraine (explosions in Russia and Moldova territory). This discussion paper aims to shed light on the potential effect of this vast conflict on the ecosystems and their services. Although the war is still ongoing, there is evidence of severe air pollution and greenhouse gas emissions resulting from the intense fights. Also, warfare activities were conducted in the vicinity of the Zaporizhzhia nuclear power plant (the biggest in Europe) and Chernobyl, increasing the fear of radiation leaks. The biodiversity is being drastically affected due to intense deforestation and habitat destruction with potential implications for wildlife. Bombing, trench and tunnel excavations will likely negatively impact soil degradation and landscape morphology. This assumes particular importance since Ukraine has some of the most fertile soils globally (Chernozem), affecting food production. Water availability and quality are likely to be affected due to infrastructure destruction and the transport of pollutants to water reserves. The ecosystem services supplied will likely be strongly damaged since deforestation will decrease the capacity of the ecosystems to regulate air pollution or climate. Soil degradation will hamper food production, and landscape aesthetics, cultural heritage and social cohesion destruction drastically affects cultural services. Finally, the impacts on human health are already tremendous. However, it can be even higher due to exposure to high levels of contamination and sanitary conditions degradation. The war is still ongoing, and there is considerable uncertainty regarding the impacts. However, we may expect a dramatic effect on the total environment.
Sexual and reproductive health rights of Ukraine’s young sanctuary seekers: Can we pre-empt risks and uncertainty?
10.5.2022 – Journal of Child Health Care
Authors: Pat Cox, Sarah Neal, Jane March-McDonald, Aisha Hutchinson
Life-Saving Care for Patients with End-Stage Kidney Disease during the War in Ukraine 2022
10.5.2022 – Clinical Journal of the American Society of Nephrology
Authors: Natalia Stepanova, Mykola Kolesnyk, Zain Mithani, Baneen Alkofair, Rebecca Shakour, Anna Petrova, Volodymyr Novakivskyy, Jeffrey Hymes, Szymon Brzosko, Jeff Giullian, Zelde Espinel, James Shultz
Ukraine’s medically vulnerable patients, persons living with disabling medical conditions that require specialized care and customized approaches to safeguarding them from harm, have been incommensurately affected by the war. Among these are more than 11,000 patients who receive kidney replacement therapy (KRT). More than 1,500 have received kidney transplants, 6,000 depend upon hemodialysis, 2,700 receive hemodiafiltration, and almost 1,000 receive peritoneal dialysis (PD).
Public health crises and Ukrainian refugees
10.5.2022 – Brain, Behavior and Immunity
Authors: Zhaohui Su, Dean McDonnell, Ali Cheshmehzangi, Junaid Ahmad, Sabina Šegalo, Claudimar Pereira da Veiga, Yu-Tao Xiang
Conflicts are inevitable, and so are refugees. Due to conflicts in Ukraine, the global refugee population has reached new highs. As people continue to flee Ukraine amid the ongoing pandemic in droves, their exposure to COVID-19 and infectious diseases that are common among the refugee population, such as tuberculosis, is on the rise as well. Also factoring in the fact that Ukraine has a large population living with communicable diseases like HIV and hepatitis C, along with other non-communicable conditions like diabetes and cancer, there is a pronounced need to protect these refugees and local residents from potential public health crises. In this paper, we investigate the challenges that health and government officials face in addressing refugees’ health needs and preferences. Furthermore, we discuss the imperative to provide timely and effective health services to refugees, such as psychoneuroimmunology-based interventions that could help address refugees’ multifactorial and multifaceted health needs and requirements. While conflicts are inevitable, public health crises are not. In light of the renewed imperative to safeguard shared humanity and solidify global solidarity, collaborative actions are needed to ensure fair, kind, and true public health environments are available to refugees of the current conflict and beyond.
Prevention of conflict-related sexual violence in Ukraine and globally
10.05.2022 – The Lancet
Authors: Lindsay Stark, Kim Thuy Seelinger, Reine-Marcella Ibala, Yana Tovpeko, Denis Mukwege
Russia’s invasion of Ukraine on Feb 24, 2022 has already resulted in the forced displacement of over 5·8 million people outside of Ukrainian borders and an additional 7·1 million internally. Women and children, who account for more than 90% of the displaced, are at risk of sexual violence, rape, and trafficking during displacement.1 Local and international organisations have documented reports of sexual violence perpetrated by Russian military forces. This mounting crisis suggests, not for the first time, that conflict-related sexual violence requires urgent action.
Sexual violence as a weapon of war in Ukraine
10.05.2022 – BMJ
Author: Jelke Boesten
Responding to the Ukraine refugee health crisis in the EU
9.5.2022 – The Lancet
Author: Spiegel, P.
Meeting the health needs of displaced people fleeing Ukraine: Drawing on existing technical guidance and evidence
8.5.2022 – The Lancet Regional Health: Europe
Authors: Bernadette N.Kumar, Rosemary James, Sally Hargreaves, Kayvan Bozorgmehr, Davide Mosca, Seyed-Moeen Hosseinalipour, Khawla Nasser AlDeen, Chrysanthi Tatsi, Reem Mussa, Apostolos Veizis, Daniela Kállayová, Karl Blanchet, Rita Sá Machado, Miriam Orcutt, Santino Severoni
The invasion of Ukraine has unleashed a humanitarian crisis and the impact is devastating for millions displaced in Ukraine and for those fleeing the country. Receiving countries in Europe are reeling with shock and disbelief and trying at the same time to grapple with the reality of providing for a large, unplanned, unprecedented number of refugees mainly women and children on the move. Several calls for actions, comments and statements express outrage, the risks, and the impending consequences to life and health. There is a need to constantly assess the situation on the ground, identify priorities for health and provide guidance regarding how these needs could be addressed. Therefore, the Lancet Migration European Regional Hub conducted rapid interviews with key informants to identify these needs, and in collaboration with the World Health Organization Health and Migration Programme, summarized how these could be addressed. This viewpoint provides a summary of the situation in receiving countries and the technical guidance required that could be useful for providing assistance in the current refugee crisis.
Correspondence on international collaboration for addressing mental health problem during the Ukraine war crisis
6.5.2022 – Asian J Psychiatr
Authors: Keebayoon, A., Mungmunpuntipantip, R., Wiwanitkit V.
Digital psychological first aid for Ukraine
5.5.2022 – The Lancet Psychiatry
Authors: Iryna Frankova, Eric Vermetten, Arieh Y Shalev, Marit Sijbrandij, Emily A Holmes, Robert Ursano, Ulrike Schmidt, Joseph Zohar
The ongoing war in Ukraine has already taken an enormous toll on the lives of many. Ukrainians and others affected by the war need to sustain their mental health in this context. Hobfoll and colleagues identified five essential elements of immediate and midterm psychosocial support following trauma exposure: ensuring safety; fostering calming; maintaining a sense of self and community efficacy; sustaining connectedness; and fostering hope. These elements are widely accepted as general guidelines for the development of primary and secondary prevention strategies and are core in recommendations during the “golden hours” of the early care needed.
Hepatitis: Ukrainian refugees should be offered vaccines and free treatment, says WHO
5.5.2022 – BMJ
Author: Elisabeth Mahase
The Russian invasion of Ukraine: a humanitarian tragedy and a tragedy for science
4.5.2022 – Embo Reports
Author: Shcherbata, H.
The Invasion of Ukraine prompts us to support our Ukranian colleagues but also to keep open communication with the Russian scientists who oppose the war.
Joint statement: Ensuring high-quality viral hepatitis care for refugees from Ukraine
3.5.2022 – ECDC
This joint statement from ECDC, the WHO and the European Association for the Study of the Liver (EASL) provides an overview of public health guidance aimed to ensure that the needs of refugees in relation to viral hepatitis are appropriately met, for all stages along the continuum of care from prevention through to treatment.
Fate and future of the medical students in Ukraine: A silently bubbling educational crisis
2.5.2022 – Med Educ.
Authors: Jain, N. et al.
Addressing Public Health Challenges during Humanitarian Crisis
1.5.2022 – SBV Journal of Basic, Clinical and Applied Health Science
Authors: Subhash C Parija, Prateek S Bobhate
A humanitarian crisis is defined as an event or a series of events that threaten the health, safety, or well-being of a community. These crises may be man-made or natural disasters or complex emergencies viz. conflicts, wars, epidemics, pandemics, and other natural disasters like earthquake and famines, requiring unique targeted interventions toward the affected sectors. Worldwide, about 80 million people’s lives are put at risk due to humanitarian crisis arising from human conflicts, viz. Sudan and Syria, or natural disasters. In the current ongoing conflict in Ukraine, thousands of lives have been lost including that of children and many more have been severely injured. It has been estimated that around 4 million people would flee away from Ukraine in order to find refuge and support from across the region. The most vulnerable population groups in such times are women and children, elderly persons, persons with disability, and ethnic minorities. The humanitarian crisis poses an immediate public health risk to the refugee population with regard to not only infectious diseases but also noncommunicable diseases (NCDs), maternal and child health issues, vaccinepreventable diseases, and also mental health disorders.
Ongoing humanitarian crisis in Ukraine
1.5.2022 – The Lancet Haematology
WHO information note on ensuring continuity of essential tuberculosis services for people with or at risk of the disease within ukraine and in refugee-hosting countries
4.2022 – WHO
War in Ukraine and the inverse care law
30.4.2022 – The Lancet Regionl Health: Europe
Author: Richard Armitage
Much attention has been focused on the nearly 5 million refugees that have left Ukraine since the beginning of the Russian invasion of the country on 24 February 2022, and calls have been made to secure essential resources – including finances, facilities and healthcare – to safeguard the physical and mental health of this vulnerable population in its receiving countries. However, while these calls for compassionate humanitarianism are entirely appropriate and immediately required, the provision of crucial assistance to the vulnerable populations that still remain in Ukraine – groups that are likely to harbour health needs that are generally greater than those that have fled the country – must be urgently delivered.
War and politics. The 2022 Russian invasion of Ukraine and refugee crisis on the eastern EU border from the perspective of border studies
29.4.2022 – Border and Regional Studies
Authors: Opiola W. et al
Since February 24, 2022, we have been witnessing the next stage of what began in the 2014 Russo-Ukrainian War: a full-scale military invasion of Ukraine. For the first time in the history of the European Union, the intensive armed conflict is now approaching the border of the EU and Schengen Zone. The consequences of war: the refugee crisis, humanitarian aid, and economic problems have affected EU countries both immediately and directly. While keeping in mind the human tragedy and the tragedy of Ukraine, we would like to address a few important questions from the perspective of regional and border scholars. From this perspective, the 2022 Russian invasion of Ukraine is another stage of the new political order in Europe, preceded by the war in Ukraine that started in 2014, the 2015 migration crisis, 2021 Belarus-EU border crisis, which altogether – from the perspective of the border studies – could be described as re-bordering and securitization of borderlands.In this joint editorial, we address four main questions. Firstly, how we can interpret the Russian invasion in the wider, historical context, taking the frontier thesis as an explanatory category developed by Turner (1994). Secondly, the Ukrainian refugee crisis, in the context of the previous Belarusian-EU border crisis, is a multi-layered issue, where religion, gender, geopolitics, and rationales meet. Thirdly, apart from the military and political actions, war and refugee flux could be seen from the perspective of a grassroots movement of aid. Fourthly, the war in Ukraine brings uncertainty and questions about democracy and peace in Western Europe.
Ukraine’s private clinics step into the breach of a targeted health system
29.4.2022 – BMJ
Author: Nataliia Bushkovska
Responding to the humanitarian crisis of the war in Ukraine with lessons from COVID-19
29.4.2022 – The Lancet
Authors: David Archard, Alena Buyx, Jean-François Delfraissy
The COVID-19 pandemic has highlighted the extent to which human, political, and economic interconnections shape the contemporary world. Despite Europe-wide efforts to coordinate the provision of vaccines, the ideal of a unified response to the pandemic by an international community has been hampered by the deployment of unilateral strategies by individual states, each seeking an acceptable balance of political stakes and available resources. The crisis of multilateralism that became apparent with the COVID-19 health crisis is a concern that takes on particular resonance after 4 weeks of war in Ukraine, which is only one of many conflicts in the world today.
Disaster Management During War and COVID-19: Humanitarian and Prehospital Interventions
28.4.2022 – Prehosp Disaster Med
Author: Corpuz, J.
The war in Ukraine: A voice from Poland
28.4.2022 – Anaesthesia Critical Care and Pain Medicine
Authors: Zielinska, M., Tkachenko, Y., Ducki, M
Emergency in Ukraine: external situation report number 9
28.4.2022 – WHO
Situation overview: movement of Ukranians back in Ukraine
28.4.2022 – UNHCR
War in Ukraine and Racism: The Physical and Mental Health of Refugees of Color Matters
27.4.2022 – International Journal of Public Health
Authors: Cénat, J. M., et al.
Ukraine: Humanitarian Impact Situation report
27.4.2022 – OCHA
Update on the Coordinated Efforts of Looking After the Health Care Needs of Children and Young People Fleeing the Conflict Zone of Ukraine Presenting to European Emergency Departments—A Joint Statement of the European Society for Emergency Paediatrics and the European Academy of Paediatrics
26.4.2022 – Frontiers in Pediatrics
Authors: Nijman, R. G., et al
This joint statement by the European Society for Emergency Paediatrics and European Academy of Paediatrics aims to highlight recommendations for dealing with refugee children and young people fleeing the Ukrainian war when presenting to emergency departments (EDs) across Europe. Children and young people might present, sometimes unaccompanied, with either ongoing complex health needs or illnesses, mental health issues, and injuries related to the war itself and the flight from it. Obstacles to providing urgent and emergency care include lack of clinical guidelines, language barriers, and lack of insight in previous medical history. Children with complex health needs are at high risk for complications and their continued access to specialist healthcare should be prioritized in resettlements programs. Ukraine has one of the lowest vaccination coverages in the Europe, and outbreaks of cholera, measles, diphtheria, poliomyelitis, and COVID-19 should be anticipated. In Ukraine, rates of multidrug resistant tuberculosis are high, making screening for this important. Urgent and emergency care facilities should also prepare for dealing with children with war-related injuries and mental health issues. Ukrainian refugee children and young people should be included in local educational systems and social activities at the earliest opportunity.
26.4.2022 – OCHA
Ukraine: a cardiac surgical perspective
25.4.2022 – Cardiol Young
Authors: Novick, W. et al
Responding to the humanitarian crisis of the war in Ukraine with lessons from COVID-19
25.4.2022 – The Lancet
Authors: David Archard, Alena Buyx and Jean-Francois Delfraissy
Effects of posttraumatic stress and combat losses on the combatants’ resilience –
25.4.2022 – Československá psychologie
Authors: Ihor Prykhodko, Oleksandr Kolesnichenko, Yanina Matsehora, Viktor Aleshchenko, Oleksander Kovalchuk, Taras Matsevko, Vasyl Krotiuk, Viktoria Kuzina
Women, children, and adolescents face extreme vulnerability in conflict—and so do the health workers striving to protect them
25.4.2022 – BMJ
Authors: Helen Clark, Kersti Kaljulaid
Public health issues and health rendezvous for migrants from conflict zones in Ukraine: A French practice guideline
25.4.2022 – Infectious Diseases Now
Authors: N Vignier, V Halley des Fontaines, A Billette de Villemeur, F Cazenave-Roblot, B Hoen, F Chauvin, D Lepelletier, C Chidiac, E Billaud
Given the number of people leaving the war zone in Ukraine and arriving in France, the French high council for public health (HCSP) has drawn up a number of recommendations. The experts have taken into account the vulnerability of migrant populations, which is exacerbated by (a) promiscuity that increases the risk of exposure to infectious agents; (b) the psychological consequences of conflict, family separation and exile; (c) prevalence in Ukraine of communicable diseases such as (possibly) multi-resistant) tuberculosis, HIV and HCV; (d) low vaccination coverage (risk of circulation of poliovirus) and (e) the risk of spreading infectious diseases (Covid-19, measles…).Consequently, experts recommend that priority be given to: i) Initial (immediate) reception, which will help to provide emergency care and to assess immediate needs (psychological disorders, risk of medication breakdown and risk of infection); (ii) Other priority measures (vaccination catch-up, including vaccination against SARS-CoV-2 and mandatory vaccination for children’s entry into school, screening for post-traumatic stress disorder and tuberculosis) must be implemented as soon as feasible. At this stage, it is imperative: To ensure coordination and access to information throughout the country, by providing medico-social support (opening of social rights and access to care); To digitize medical data for the purposes of traceability; To use professional interpreting and/or health facilitators, or else, if necessary, digital translation tools. (iii) Finally, experts stress the need for vigilance in terms of management, conservation of social rights and continuity of care after the initial period, and organization of a “health rendezvous” within four months of a migrant’s entering the country.
Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees
24.4.2022 – Acta Paediatrica
Authors: Jonas F. Ludvigsson, Andrii Loboda
Transgender Ukrainians facing “exacerbated” challenges
23.4.2022 – The Lancet
Author: Ed Holt
Activists report that LGBT+ Ukrainians fleeing the war are forced to leave the country illegally and fear for their ability to access health care.
European Countries Step-up Humanitarian and Medical Assistance to Ukraine as the Conflict Continues
23.4.2022 – Journal of Primary Care & Community Health
Authors: N Jain, S Prasad, A Bordeniuc
On the 24th of February 2022, the Russian Federation began an unprovoked invasion of Ukraine, marking the biggest military attack in Europe since the second world war. Over 4 million people have fled their homeland within the first month of the war and have triggered a large refugee crisis with impacts far beyond the Ukrainian border. People in the neighboring countries have shown tremendous support by stepping forward to donate food, clothes, medications, money, and other essential supplies. The governments and other regional stakeholders have also been supportive in accommodating and easing regulations for the incoming refugees. Herein, we summarize the humanitarian measures and medical donations that have been made by European countries as they stepped up their efforts to provide refugees with all necessary basic services. We further highlight potential oncoming challenges in Ukraine and the host countries along with relevant solutions to these challenges. The current scenario highlights the need for multi-party and multi-level collaborations (both public and private) to tackle the emerging situation.
War amid a Pandemic: The Public Health Consequences of Russia’s Invasion of Ukraine
22.4.2022 – CSIS
Authors; Michaela Simoneau, Humzah Khan
Ukraine: one in three people with chronic conditions have problems accessing healthcare
22.4.2022 – BMJ
Author: Melina Zachariou
22.4.2022 – BMJ
Author: On 24 February 2022, Russia launched a military invasion of Ukraine. Reports of sexual violence against women and girls began to emerge less than two months later. Multiple perpetrator rape, sexual assault at gunpoint, and rape in front of children have been reported to non-governmental and human rights organisations in Russian controlled areas. Research on the use of rape as a weapon of war in other armed conflicts around the world tells us that we should not be surprised.
On 24 February 2022, Russia launched a military invasion of Ukraine. Reports of sexual violence against women and girls began to emerge less than two months later. Multiple perpetrator rape, sexual assault at gunpoint, and rape in front of children have been reported to non-governmental and human rights organisations in Russian controlled areas. Research on the use of rape as a weapon of war in other armed conflicts around the world tells us that we should not be surprised.
Obtaining proof of vaccination status and assessing vaccination records of refugees from Ukraine. Supplement to: Guidance on vaccination and prevention of vaccine-preventable disease outbreaks for countries hosting refugees from Ukraine, April 2022 update
21.4.2022 – WHO
Guidance on vaccination and prevention of vaccine-preventable disease outbreaks for countries hosting refugees from Ukraine, April 2022 update
21.4.2022 – WHO
This document provides guidance on interventions to prevent vaccine-preventable disease outbreaks in the context of mass population movement resulting from the ongoing crisis in Ukraine. The priority actions include: 1. planning and provision of resources to fully vaccinate refugee children with routine vaccinations in the national immunization schedule of the host country; 2. prioritizing vaccination against poliomyelitis, measles, rubella and COVID-19; a. inactivated poliovirus vaccine (IPV) for children under 6 years; b. measles- and rubella-containing vaccine (MRCV) to children up to 15 years who do not have at least two documented doses of these antigens; c. COVID-19 vaccine for priority groups in line with WHO recommendations and national guidelines; 3. identifying and closing any immunity gaps in the host population and proactively addressing any identified weaknesses in national immunization service delivery and programme performance; 4. ensuring effective disease surveillance and reporting systems are in place; and 5. identifying, investigating and rapidly responding to signals of vaccine-preventable disease outbreaks.
War in Ukraine: an immense threat to the fight against tuberculosis
21.4.2022 – European Respiratory Journal
Authors: Victor Dahl, Giovanni Battista Migliori, Christoph Lange, Christian Wejse
As reported by the Global Tuberculosis Network in the European Respiratory Journal, coronavirus disease 2019 (COVID-19) has distressingly resulted in a plateauing of the global decrease in tuberculosis (TB) incidence as well as entailed a surge in mortality for the first time in a decade. As the COVID-19 pandemic response is gradually being integrated into healthcare systems worldwide, the war in Ukraine poses a new threat to TB control in Europe. Over the years, an admirable progress in combating TB has been achieved globally and regionally, although optimal control of TB was not yet fully in sight in Ukraine or Russia. Incidence and mortality rates have been falling steadily in both Ukraine and the Russian Federation, and between 2010 and 2020, the number of TB deaths in Russia has fallen by as much as 10% per year. Nevertheless, the eastern areas of the World Health Organization European region, including Ukraine and Russia (and also bordering countries such as Belarus and Moldova), account for the largest burden of multidrug-resistant (MDR)-TB in the world and also have a relatively high burden of drug-susceptible TB. Russia and Ukraine have the second and fifth highest rates of confirmed individuals with extensively drug-resistant (XDR)-TB, respectively, along with high prevalences of latent TB infection. Even before the military conflict, the diagnosis and treatment of patients with M/XDR-TB in Ukraine was limited by availability of diagnostic tools and medicines. Together with HIV, social determinants, and other risk factors for TB, drug-resistant TB is among the major challenges in controlling TB in the European region, and there is a dire need to ramp up case-finding. The reported proportion of HIV/TB co-infection is 22% and 24% among patients with a known HIV status for Ukraine and Russia, respectively, which is also highly unsettling.
Ukraine War Refugees – Threats and New Challenges for Healthcare in Poland
20.4.2022 – The journal of hospital infection
Authors: Katarzyna Lewtak,Krzysztof Kanecki, Piotr Tyszko, Paweł Goryński, Magdalena Bogdan, Aneta Nitsch-Osuch
Between February 2022, when the war in Ukraine began, and April 1, 2022, the number of refugees to neighboring countries reached 4,137,842 people. The majority have fled to Poland. The main challenge for the health system in Poland in this situation is how to develop effective adaptation measures.
UKRAINE: HUMANITARIAN SITUATION IN KHARKIV, LUHANSK, AND DONETSK
19.4.2022 – ACAPS
Applying the national mental health policy in conflict-affected regions: towards better social inclusion (Ukrainian case)
19.4.2022 – Mental Health and Social Inclusion
Authors: Eleanor Quirke, Vitalii Klymchuk, Nataliia Gusak, Viktoriia Gorbunova, Oleksii Sukhovii
The ongoing armed conflict in Ukraine has had wide-ranging health, social and economic consequences for the civilian population. It has emphasised the need for comprehensive and sustainable reform of the Ukrainian mental health system. The Ukrainian Government has approved a vision for national mental health reform. This study aims to draw on the lessons of mental health reform in other conflict-affected settings to identify areas of priority for applying the national mental health policy in conflict-affected regions in the direction of better social inclusion of people with mental health conditions (Donetsk and Luhansk regions, directly affected by the conflict).
Neuroscience of trauma and the Russian invasion of Ukraine
18.4.2022 – Nature Human Behaviour
Authors: Ali Jawaid, Magdalena Gomolka, Anastasiia Timmer
Since 24 February 2022, Ukrainian residents have been facing ‘complex trauma’, which combines multiple exposures to trauma, often in a sequential fashion. These individuals are constantly exposed to several forms of trauma: fear of losing life and/or freedom, grief, separation from families, social isolation, social disruption and forced migration, to name a few. Even when these exposures occur in an isolated form, they have long-term sequelae for human psychological and physical health. These sequelae include an increased risk of post-traumatic stress disorder, depression, and anxiety disorders, as well as physical ailments. However, when these traumas occur in combination, the effect is amplified and the signatures of trauma may even appear in the germline. Stark evidence comes from studies of survivors of the Holocaust and their descendants that suggest intergenerational transmission of traumas that resulted from war and genocide, implicating both psychosocial and biological routes of transmission. Despite fundamental differences between the war in Ukraine and the Holocaust, some principles of the intergenerational transmission of war trauma may still be pertinent.
Immunization in state of siege: the importance of thermostable vaccines for Ukraine and other war-torn countries and territories
18.4.2022 – Expert Review of Vaccines
Authors: Christos Tsagkaris, Lily Laubscher, Marios Papadakis, Valeriia Vladychuk, Lolita Matiashova
The value of alleviating suffering and dignifying death in war and humanitarian crises
16.4.2022 – The Lancet
Authors: William E Rosa, Liz Grant, Felicia Marie Knaul, Joan Marston, Hector Arreola-Ornelas, Olena Riga Roman Marabyan, Andriy Penkov, Libby Sallnow, M R Rajagopal
Despite a vast literature on humanitarian crisis response, palliative care, pain relief, and care for the dying and bereaved need increased and urgent attention, particularly in the context of armed conflict. The Lancet Commission on the Value of Death challenged the medicalisation of dying and death and reaffirmed the moral injustice of the global palliative care and pain relief divide. The devastating humanitarian crisis in Ukraine raises the vital importance of these issues.
War in Europe: health implications of environmental nuclear disaster amidst war
15.4.2022 – European Journal of Epidemiology
Author: Jessica E Laine
Recent incidents at nuclear facilities in Ukraine related to the attacks from Russian forces highlight the fragility of nuclear power plants and other nuclear facilities in war and the very real potential for another environmental nuclear disaster and associated health risks in Europe. Nuclear catastrophes from war can occur from radioactive materials released from war threatened nuclear power plants and other nuclear facilities in war zones, in addition to the direct threat from the deployment of nuclear weaponry and can result in immediate and long-term health impacts. Despite historical nuclear catastrophic events, including the Chernobyl nuclear power plant accident and atomic bombings of Hiroshima and Nagasaki, and that for more than a century epidemiologists have studied the consequences of radiation exposures, there are still major unanswered questions regarding radiation risks and human health. Epidemiologists will need to continue to quantify the health effects from exposure to environmental radiation, including background radiation, and are able to contribute to conversations about reliance on nuclear energy and alternative energy futures. As a society we are compelled to rethink our ties to nuclear energy, especially with the potential of increasing reliance on nuclear power amid oil and gas crisis and considering climate change, nuclear warfare, including nuclear weapon testing, and the fragility of humanity and health to even low doses of radiation from these and other natural and unnatural sources.
Caring for children with cancer evacuated from Ukraine
14.4.2022 – the Lancet Child & Adolescent Health
Authors: Maura Massimino et al.
Since the war in Ukraine started on Feb 24, 2022, thousands of children and civilians have been killed, and the resulting humanitarian crisis is one of the worst that Europe has experienced in recent times. Among the 2 million child refugees who fled Ukraine, children and adolescents with cancer are facing particular challenges as their treatment is interrupted by the war. The international paediatric oncology community has been trying to find ways and resources to deal with a new emergency—to continue care provision for these patients. St Jude Global has set up SAFER Ukraine, a humanitarian effort to offer safe passage out of Ukraine for patients with childhood cancer and their families. Many paediatric oncology centres in Europe have made preparations to receive patients from Ukraine and found themselves having to deal with unusual critical issues on the spot
The voices of Ukrainian and Russian scientists
14.4.2022 – Cell
Authors: Stoika R. et al
The brutal attack on Ukraine by the Russian Federation has shocked the world. While the world works to end the violence and help refugees, as a scientific journal, our thoughts are also with those in the scientific community who are directly or indirectly impacted by the war. We have been inspired by and applaud the labs around the world that have opened their doors to displaced scientists and remain committed to supporting scientists, whoever and wherever they are. Because science requires collaboration and trust, we urge the scientific community to continue efforts like this and to remain united, especially in times as difficult as these. In this Voices piece, we feature short comments from scientists from Ukraine and scientists from Russia. This small sampling is far from exhaustive, but our sincere thanks go to those scientists who were willing to share their thoughts on this volatile and emotionally charged situation; the views expressed are those of the contributors alone. We join the world in hoping for a swift resolution to the conflict, for the good of humanity.
The Conflict in Ukraine: What Does It Mean for HIV and TB?
13.4.2022 – Journal of the Association of Nurses in AIDS Care
Author: Michael V Relf
Invasion of Ukraine — support mental health of children and adolescents
13.4.2022 – Nature
Author: Ali Jawaid
Russia’s brutal invasion of Ukraine is likely to affect the mental health of children and adolescents, who currently comprise almost half of those fleeing the country. They are facing trauma that compounds fear and grief from forced migration and parental separation — and more — on an appalling scale.
Humanitarian access disintegrating in Ukraine: MSF
11.4.2022 – CMAJ
Authors: Duong, D., Vogel, L
Caring for Ukrainian refugee children with acute and chronic diseases
11.4.2022 – The Lancet
Authors: Maria Giżewska, Annemiek M J van Wegberg, François Maillot, Friedrich Trefz, Francjan J van Spronsen
Care for the increasing number of refugees from Ukraine is both a priority and a challenge for state authorities, social workers, and private initiatives. By March 29, 2022, more than 2·34 million refugees from Ukraine had crossed into Poland, most of them women and children. European countries must help prevent additional human catastrophes.
Preparing for the Mental Health Consequences of a Nuclear Event in Ukraine: The Time is Now
11.4.2022 – Psychiatry and Clinical Neuroscience
Authors: Joshua C Morganstein, Robert J Ursano, David M Benedek, Mie Kurosawa, Jun Shigemura
The February 2022 invasion of Ukraine created the greatest humanitarian disaster in decades. The Ukrainians are already exposed to the traumas of war, and many have also experienced separation from family, becoming a refugee and losing their homes, cherished possessions, communities, and social support. The risks posed by ongoing armed conflict and concerns about use of chemical weapons are exacerbated by escalating fears of devastation from intentional or accidental nuclear and radiological events. These fears have been stoked by the Russian President putting nuclear arms on high alert with elevated radiation levels already detected when the Russian military occupied Chornobyl (Chernobyl) nuclear power plant (NPP) and stirred up the radioactive ground cover. Though a nuclear war remains possible , more imminent and probable threats include a NPP failure from interrupted electricity or damage from munitions fire, or the loss of ability to safely manage a plant by NPP workers being killed or forced to work as prisoners under extreme stress with inadequate sleep and nutrition. Regardless of the extent to which radiological exposure ultimately occurs in the conflict in Ukraine, the potential for such events creates significant risk to global health security. Healthcare systems play a critical role in responding to radiological events and must be prepared to address the direct radiological exposure health needs and the mental health concerns, which are significant and complex (World Health Organization, 2020). While damage to the Ukrainian healthcare system may prevent implementation of optimal practices to address the mental health aspects of radiological events, the impact of such an event would be felt by myriad neighboring countries that would experience fallout from radiological material and receive refugees with potential exposure.
Vaccination of Ukrainian Refugees: Need for Urgent Action
11.4.2022 – Clinical Infectious Diseases
Authors: Piotr Rzymski, Halina Falfushynska, Andrzej Fal
The unprovoked aggression of Russian military forces on Ukraine in February 2022 has caused a high influx of refugees, including children, to neighboring countries, particularly Poland. This caused additional pressures on the healthcare system and the need to meet challenges for public health, such as those related to infectious diseases. Here, we discuss the potential epidemiological risks associated with the war-induced influx of refugees (COVID-19, measles, pertussis, tetanus, and poliomyelitis) and highlight the need for their swift management through educational campaigns, counteracting anti-science misinformation and pursuing vaccinations of refugees but also improving or maintaining good levels of immunization in populations of countries welcoming them. These are necessary actions to avoid overlapping of war and infectious diseases and associated public health challenges.
International collaboration for addressing mental health crisis among child and adolescent refugees during the Russia-Ukraine war
8.4.2022 – Asian Journal of Psychiatry
Author: Cai H et al.
Health-care provision for displaced populations arriving from Ukraine
8.4.2022 – The Lancet Infectious Diseases
Authors: Alena Kamenshchikova et al.
More than 4·2 million people, including 208 000 non-Ukrainians, have fled Ukraine to other European countries in recent weeks, with the majority being women, children, and older people. The current crucial objectives are to ensure that people can safely leave the conflict zone and access basic facilities such as housing, food, water, sanitation, and emergency care. However, going forward, it is important for the governments of receiving countries and transit countries to develop clear short-term and long-term strategies for the provision of health services. These strategies must include access to vaccination, maternal and child care services, screening programmes, and care for chronic conditions and mental health.
Sexual and reproductive health, rights and justice in the war against Ukraine 2022
8.4.2022 – Sexual and Reproductive Health Matters
Authors: Eszter Kismödi, Emma Pitchforth
While campaigning for sexual and reproductive health and rights remains a day-to-day concern, wars, such as the war started on February 24 against Ukraine, bring an immediate threat to people’s lives, safety, and human rights. Sexual and Reproductive Health Matters has covered the impacts of conflict and forced migration on sexual and reproductive health and rights in enough countries to know that attention must be drawn to these issues now in the context of the war against Ukraine and that international and national obligations need to be invoked to protect the most vulnerable.
5 health crises that endanger Ukrainian lives as the war continue
7.4.2022 – International Rescue Committee
Children growing up in conflict zones in Ukraine and beyond need urgent mental health support
6.4.2022 – The Lancet
It is with great sorrow that we write to express our solidarity with the people of Ukraine, particularly the children. In violation of international law and human rights, the ongoing military operations are threatening both the physical health and mental wellbeing of Ukrainian children. The exposure of children to crude military violence can have lifelong ramifications. Similar to the children growing up amid a humanitarian crisis in Aghanistan,the consequences of the conflict in Ukraine could be detrimental to the future wellbeing of Ukrainian children within family, professional, and social settings. If the conflict is prolonged and engulfs all of the country, a whole generation of Ukrainians could face mental health trauma, anxiety, and depression, with long-term implications for physical health and social wellbeing.
Older people: forgotten victims amid the Ukrainian humanitarian disaster
6.4.2022 – The Lancet Public Health
Authros: Benedetta Armocida, Silvia Ussai, Maksym Pavlovych, Martina Valente, Eduardo Missoni, Marco Pistis, Baldassare Lauria, Flavia Bustreo, Graziano Onder
With improvement in life expectancy and the rapid population ageing in recent decades, when a humanitarian crisis occurs, a larger group of older people than in previous decades might be disproportionately affected. Although older people have been recognised as a vulnerable group in humanitarian crises, they have not traditionally been considered a priority for humanitarian assistance. International guidelines take older people into account and specific recommendations exist on the inclusion of this population amid humanitarian crises; however, their concrete extent of real-world applicability remains limited.
Impact of war on the dynamics of COVID-19 in Ukraine
5.4.2022 – BMJ Global Health
Authors: Dmytro Chumachenko, Tetyana Chumachenko
On 24 February 2022, Russia unreasonably attacked Ukraine. The current estimated number of victims in Ukraine is 18 million. In addition to the destruction and humanitarian crisis caused by the war, Russia’s military intervention in Ukraine came at the peak of the wave of COVID-19 caused by the Omicron strain. The calculated predictive incidence of COVID-19 in Ukraine at the beginning of March, modelled by our group as part of the National Research Foundation of Ukraine project 2020.02/0404, was about 30 000 new cases daily. War significantly exacerbates the situation with COVID-19 in Ukraine, which is confirmed by our analysis of six key factors in the spread of infection.
Trauma and displacement in Ukraine: the challenge to medicine and politics
5.4.2022 – QJM: An International Journal of Medicine
Author: B D Kelly
The health needs of refugees from Ukraine
5.4.2022 – British Medical Journal (BMJ)
Authors: Adrianna Murphy, Daniela Fuhr, Bayard Roberts, Christopher I Jarvis, Anna Tarasenko, Martin McKee
Since Russia’s reinvasion of Ukraine on 24 February 2022, more than 4 million people have fled the country. Seeking safety from escalating violence, most refugees have gone to the neighbouring countries of Poland, Slovakia, Hungary, Romania, and Moldova. By far the largest number are in Poland, which as of 29 March 2022 had welcomed over 2 million refugees.This vulnerable population will have both immediate and long term healthcare needs.
Prioritising mental health and psychosocial services in relief and recovery efforts in Ukraine
4.4.2022 – The Lancet psychiatry
Authors: Wei Shi, Peter Navario, Brian J Hall
Russia’s invasion of Ukraine has created a humanitarian crisis with more than 6·5 million internally displaced people and more than 3 million refugees in neighbouring countries. Mental disorders are prevalent in conflict settings. A 2019 survey of 2203 internally displaced people fleeing Russian occupied territories from a previous invasion documented high levels of depression (22%), anxiety (17%), and PTSD (32%). However, mental health and psychosocial support are inadequately prioritised within complex humanitarian relief efforts, or in subsequent efforts to rebuild following conflict. We must ensure that mental health and psychosocial support are central to relief and recovery efforts in Ukraine.
The UN must provide secure medical and humanitarian assistance in Ukraine –
2.4.2022 – The Lancet
Author: Southall, P.
The Ukraine crisis: Mental health resources for clinicians and researchers
2.4.2022 – Journal of Traumatic Stress
Authors: Mark Shevlin, Philip Hyland, Thanos Karatzias, Nino Makhashvili, Jana Javakhishvili, Bayard Roberts
The mental health consequences of the war in Ukraine will be enormous. Mental health professionals who are providing care for people in Ukraine, or those resettled elsewhere, may require access to standardized and validated assessment tools.
Catastrophic Health Consequences of the War in Ukraine
1.4.2022 – JAMA Network
Phil B. Fontanarosa, MD, MBA; Annette Flanagin, RN, MA; Robert M. Golub, MD
Poland’s buckling healthcare system nevertheless welcomes Ukraine refugees with open arms
1.4.2022 – British Medical Journal (BMJ)
Author: Sally Howard
Since Russian troops invaded Ukraine, an estimated two million refugees have crossed the border to Poland, a country with one of the lowest per capita healthcare spends in the EU.
Mental health responses in countries hosting refugees from Ukraine
1.4.2022 – BJPsych Open
Authors: Kenneth R Kaufman, Kamaldeep Bhui, Cornelius Katona
Wartime toxicology: the spectre of chemical and radiological warfare in Ukraine
1.4.2022 – Taylor & Francis Online
Authors: P. R. Chai, Y. Berlyand, E. Goralnick, C.E. Goldfine, M. J. VanRooyen, D. Hryhorczuk, T. B. Erickson
The unprovoked invasion of Ukraine by the Russian Federation has resulted in the largest humanitarian crisis in Europe since World War II. As fighting intensifies throughout Ukraine, there is an increasing concern that the Russian Federation may consider the direct use of chemical or radiological weapons against military personnel and civilians in Ukraine. Despite prohibition of chemical weapons from the Chemical Weapons Convention of 1997, recent evidence has demonstrated that state actors will continue to use these agents as weapons of war and terror, despite publicly denying their use. We review chemical weapons produced and used by the Russian Federation (or its allies) to identify plausible risks in the Russian war in Ukraine. We also provide rapid assessment and treatment guidelines to recognize and manage these acute exposures.
Editorial: The Public Health Implications for the Refugee Population, Particularly in Poland, Due to the War in Ukraine
1.4.2022 – Med Sci Monit
Authors: Kowski , Mariusz Gujski.
On February 24, 2022, the Russian Federation initiated a military invasion of Ukraine, resulting in a significant armed conflict in Europe. Large numbers of refugees and asylum-seekers have left Ukraine. As of March 29, more than 4 million refugees, including over 1.5 million children, have left Ukraine, while about 7 million individuals have become displaced within Ukraine. Most refugees have gone to bordering countries, with 76% coming to Poland. This large number of refugees in such a short time requires urgent public health measures to ensure their health and safety. Refugees to Poland must receive access to healthcare, social care, and education. Those who have chronic disease and malignancy must continue to receive treatment. Medical students’ continued education and training in their host countries should be prioritized to provide needed healthcare resources. Epidemiological disease surveillance and disease prevention are required at this time. The continuation of the current conflict in Ukraine also poses a potentially severe risk to the global environment and long-term food security. This editorial aims to highlight the public health implications for the refugee population, particularly in Poland, due to the current war in Ukraine.
Attacks on Health Care in the War in Ukraine: International Law and the Need for Accountability
1.4.2022 – JAMA Network
Authors: Lawrence O. Gostin, JD; Leonard S. Rubenstein, JD
As of March 31, 2022, the World Health Organization’s Surveillance System for Attacks on Health Care (SSA) reported at least 82 attacks on health care in Ukraine, resulting in 72 deaths and 43 injuries. Most attacks involved the use of heavy weapons against health care facilities, personnel, patients, and medical supplies.In Mariupol, a direct Russian airstrike on a hospital complex reportedly injured at least 17 health workers and patients; an expectant mother later died.Russian forces reportedly took 100 patients and health workers and 400 civilians as hostages inside an intensive care hospital. These are part of a larger global pattern of attacks on health care in conflict zones.In the period 2016-2020, more than 4000 incidents of violence against health care in conflict areas were reported.
Health impacts of the Russian invasion in Ukraine: need for global health action
31.3.2022 – The Lancet
Authors: Olha Zaliska, Oleksandra Oleshchuk, Rebecca Forman, Elias Mossialos
More than 1 month since Russia began its illegal invasion of Ukraine the tragic human suffering and loss of life are clear. Each day brings more death, injuries, and stories of people fighting for their lives. The implications of the war extend beyond the military and civilian casualties. There are geopolitical, financial, infrastructural, and health impacts. And the effects of this war, particularly on health and health care within and outside Ukraine, will continue long after violent conflict ends.
An open letter on the war in Ukraine from UK paediatric emergency doctors
30.3.2022 – The Lancet Child and Adolescent Health
Authors: Magnus, D., Reavley, P., Denselow, J.
Cyber risks to Ukrainian and other health systems
30.3.2022 – The Lancet Digital Health
Author: Udani SamarasekeraAs of March 14, 2022, WHO estimates that 18 million people in Ukraine have been affected by Russia’s military invasion. 6·7 million people are internally displaced and 3 million have fled the country. Alongside this devastating armed conflict is a less visible Russian cyberwar against Ukraine’s digital infrastructure, including the health sector. Other countries could also be affected, with warnings issued for the UK and US health-care systems to strengthen their defences against cyber threats from Russia and its allies.
Ukraine: War, bullets, and bombs – millions of children and adolescents are in danger
30.3.2022 – Child Abuse & Neglect Volume 128, June 2022
Authors: João Antonio Ravache de Alencar Rodrigues, Nádia Nara Rolim Lima, Modesto Leite Rolim Neto, Ricardo Riyoiti Uchidad
As the Russia-Ukraine conflict continues to unfold, the ever-evolving situation can be particularly difficult for children and teenagers. Children living in these areas face serious threats from bombing, landmines and unexploded ordnance. Their lives are also threatened by the destruction of vital infrastructure – health centers, schools and water supplies – because of the fighting. War can have a devastating effect on children’s mental and physical health, with potentially lifelong consequences. Fears can generate fantasies of the end of the world, as well as the fear of losing a loved one or life itself, nightmares and regressions to previous evolutionary stages. This situation is creating dramatic scenes at train stations, where families are forced to say goodbye.
Children: innocent victims of war in Ukraine
30.3.2022 – The Lancet Children and Adolescent Health
Rapid Gender Analysis of Ukraine: Secondary Data Review
29.3.2022 – UN WOMEN, Care International
Since 24 February 2022, and the invasion of the sovereign territory of Ukraine, there have been devastating effects in the country, including massive civilian displacement and casualties. The Rapid Gender Analysis (RGA) seeks to draw attention to the gender dynamics in the war in Ukraine—both preexisting and emerging—and draws out recommendations for humanitarian leadership, actors and donors to ensure consideration of the gendered dimensions of risk, vulnerability and capabilities in response and preparedness to this crisis. This RGA is based on secondary data resources—both pre-crisis information as well as information that has been released after 24 February. Resources comprise English, Ukrainian and Russian language sources across humanitarian information resources and media as well as information obtained through anecdotal discussions with UN Women partners. The secondary data review was conducted between 14 and 22 March 2022. This RGA builds upon the RGA Ukraine Brief developed by CARE International during the first week of the crisis and will be followed by another publication that will include an analysis of both primary and secondary data.
Armed conflict and human displacement may lead to an increase in the burden of tuberculosis in Europe
29.3.2022 – International Journal of Infectious Diseases
Authors: Victor Naestholt Dahl, Simon Tiberi, Delia Goletti, Christian Wejse
Wars are associated with an increase in TB burden. With the ongoing war inUkraine, the risk of a massive deterioration of TB management is huge. Europe must find the resources to take care of the health needs of refugees. Scaling up screening of TB infection and disease and treatment is essential
The impact of “the war that drags on” in Ukraine for the health of children and adolescents: Old problems in a new conflict?
29.3.2022 – Child Abuse & Neglect
Authors: Jucier Gonçalves Júnior, Liromaria Maria de Amorim, Modesto Leite Rolim Neto, Ricardo Riyoiti Uchida, Anna Tereza Miranda Soares de Moura, Nadia Nara Rolim Limaf
The early months of 2022 have already included several distressing world events. From the ongoing COVID-19 pandemic, to protests against vaccine mandates and COVID-19 restrictions, to the Russian invasion of Ukraine. Escalating conflict in Ukraine poses an immediate and growing threat to the lives and well-being of the country’s 7.5 million children. Humanitarian needs are multiplying – and spreading by the hour. Children have been killed. Children have been wounded. They are being profoundly traumatized by the violence all around them. Hundreds of thousands of people are on the move, and family members are becoming separated from their loved ones.
Protecting life in a time of war
28.3.2022 – PubMed
Authors: Carol Lynn Curchoe, T Arthur Chang, Mark P Trolice, Evelyn E Telfer, Alexander M Quaas, William G Kearns, Judy E Stern, David F Albertini
Despite centuries of lessons from history, war endures. Across Earth, during nearly every year from the beginning of the twentieth century to present day, over 30 wars have been fought resulting in 187 million casualties, excluding the most recent conflict, which is the impetus for this essay (Timeline of 20th and 21st century wars). We are, sadly, a war-mongering people. The word “war” word infiltrates our vernacular, e.g., the war on poverty, on drugs, on cancer, on COVID, and, apropos, on terror. How did rational approaches to disagreement and conflict evade the world’s progress? Reproductive physicians and scientists are dedicated to safeguard lives and build families. Violence is antithetical to our mission as professionals, and moral integrity as humans. We are deeply concerned for, and stand in unity with, our Ukrainian colleagues—the embryologists, scientists, OBGYN and REI physicians, infertility patients, and all people under siege. Reproductive health services for Ukrainians (as with many other war-torn regions) have collapsed. Deeply disturbing reports have emerged that cite civilian hospitals (including maternity centers) being targeted. Liquid nitrogen supplies are scarce. Pregnant mothers and gestational carriers are at emergent risk of delivering in extremely harsh conditions, cold underground bunkers and refugee queues.
Extending a lifeline to people with HIV and opioid use disorder during the war in Ukraine
28.3.2022 – The Lancet Public Health
Authors: Frederick L Altice, Daniel J Bromberg, Sergii Dvoriak, Anna Meteliuk, Iryna Pykalo, Zahedul Islam, Lyu Azbel, Lynn M Madden
Meeting the health challenges of displaced populations from Ukraine
26.3.2022 – Lancet
Authors: Ioffe, Y. et al
Growing concern over Ukrainian refugee health
26.3.2022 – The Lancet
Author: Ed Holt
Increasingly traumatised refugees are fleeing to nearby countries raising concerns over health-care capacity. Ed Holt reports from Vyšné Nemecké, Slovakia.
Meeting the health challenges of displaced populations from Ukraine
26.3.2022 – The Lancet
Authors: Yulia Ioffe, Ibrahim Abubakar, Rita Issa, Paul Spiegel, Bernadette N Kumare
Resilience and perseverance under siege: providing cancer care during the invasion of Ukraine
25.3.2022 – The Lancet Oncology
Authors: Darya Kizub, Nelya Melnitchouk, Andriy Beznosenko, Galyna Shabat, Solomiia Semeniv, Leticia Nogueira, Patricia J Watson, Kim Berg, Edward J Trapido, Zelde Espinel, James M Shultz
Mental health and welfare of prisoners of war and people living in detention in the Ukrainian conflict
25.3.2022 – The Lancet Psychiatry
Authors: Michael Liebrenz, Dinesh Bhugra, Anna Buadze, Roman Schleifer, Alexander Smith, Robert van Voren
The Russian invasion of Ukraine has engendered profound suffering, with early reports of millions of refugees and thousands of casualties. Extensive literature has highlighted the psychological pathologies in the aftermath of warfare, and, as in all emergencies where human rights are often the first victim, proactively safeguarding vulnerable groups is critical. In the present crisis, civil authorities have understandably focused on protecting the general populace. However, we must not neglect the mental health care and welfare of prisoners of war (POWs), people living in detention, and psychiatric patients.
Caring for people with diabetes and non-communicable diseases in Ukraine: a humanitarian emergency
25.3.2022 – The Lancet Diabetes & Endocrinology
Authors: Galyna Maystruk, Sigiriya Aebischer Perone, Valentyna Anufriyeva, Philippa Boulle, François Chappuis, Bruno Lab, David Beran
As war in Europe becomes a reality with the armed conflict in Ukraine, the global community has responded politically and economically, and is in the midst of preparing an large-scale humanitarian response. The first response needs to reach individuals who are directly affected by the conflict and those who are fleeing to neighbouring countries, and address health, food, water, and shelter needs. Nevertheless, with 90·5% of mortality and 81·7% of disability-adjusted life-years in Ukraine due to non-communicable diseases (NCDs), the response for the Ukrainian population must also include NCD care as a priority.
Ukraine war: The humanitarian crisis in Kharkiv
25.3.2022 – British Medical Journal (BMJ)
Authors: Dmytro Chumachenko, Tetyana Chumachenko
For more than a month now, Russian troops have been destroying the Russian-speaking city of Kharkiv in Ukraine, where we live, along with 1.5 million other inhabitants. In Kharkiv, the war has resulted in the deaths of hundreds of civilians, large-scale destruction of infrastructure, and also a humanitarian crisis, which is getting worse every day.
Ukraine’s children: use evidence to support child protection in emergencies
23.3.2022 – BMJ
Authors: Lucie Cluver, Ben Perks, Sabine Rakotomalala, Wadih Maalouf
The new humanitarian crisis in Ukraine: Coping with the public health impact of hybrid warfare, mass migration, and mental health trauma
23.3.2022 – Disaster Medicine and Public Health Preparedness
Authors: Sonny S Patel, Timothy B Erickson
One of the largest mass movements of displaced people from their homelands in recent history must be recognized and assisted by the Free World. The unprovoked Russian attacks on Ukraine during February-March 2022 will leave long-lasting devastating effects on millions of innocent victims. Nations worldwide, especially NATO member countries, will need to intervene to ameliorate the situation. This letter describes major public health issues apart from the COVID-19 pandemic that are emerging concerns, such as shortages of healthcare professionals, chronic care treatments and health prevention services, disinformation communication campaigns affecting the healthcare infrastructure, and the generational impact of the conflict on people’s mental health. A global response and public health support need immediate action including humanitarian assistance, food security, clean water supplies, adequate shelter, and safe transportation out of the active military zones.
Tuberculosis services disrupted by war in Ukraine
22.3.2022 – The Lancet Infectious Diseases
Author: Ed Holt
The war in Ukraine is threatening continuity of care for patients with tuberculosis in the country. Ed Holt reports.
War in Ukraine and barriers to diabetes care
21.3.2022 – The Lancet
Authors: Alessi, J., Yankiv, M.
Brain health: The hidden casualty of a humanitarian crisis
21.3.2022 – The Lancet Regional Health Europe
Authors: Charles R. Marshall, Alastair J. Noyce, Aidan Neligan, Ruth Dobson
The Russian invasion of Ukraine in February 2022 presents substantial threats to the health of the Ukrainian population. Neighbouring countries also face challenges due to an influx of refugees from Ukraine and escalating geopolitical isolation. The collapse of healthcare infrastructure and medicine supply chains, along with mass migration pose immediate risks both in terms of the ability to care for the casualties of war and the capacity to provide appropriate ongoing care of those with other medical problems. The war has sparked Europe’s fastest mass migration for a generation, which is likely to have profound downstream consequences for public health. In such a humanitarian crisis, the increased burden of disease due to traumatic injury, infection and mental illness is typically well recognised but the potential impact on both short and long term neurological health may be neglected.
War in Ukraine and barriers to diabetes care
21.3.22 – The Lancet
Authors: Janine Alessi, Marina Yankiv
The conflict and violence that followed the military invasion of Ukraine in late February, 2022, has already left substantial scars on the population. The human cost of the combat becomes more evident each passing day. On March 15, 2022, the ongoing hostilities affected hundreds of thousands of inhabitants and substantially damaged crucial civilian infrastructure in eastern Ukraine, including homes, schools, hospitals, and water and gas pipelines. In some southeastern cities, such as Mariupol, people have been facing critical shortages of food, water, and life-saving medicines, which were aggravated by the blockade of humanitarian convoys trying to reach the region with supplies. According to the UN High Commissioner for Human Rights, a total of 691 civilian deaths were confirmed by March 14, 2022—a number that is probably underestimated. In the middle of this social and humanitarian crisis, patients who have chronic diseases perceive health resources deteriorating at an unprecedented rate, raising concerns about their sustainability. For people living with a disease as prevalent as diabetes, the scarce access to essential health resources is even more worrisome. According to the International Diabetes Federation Atlas, there were about 2 325 000 inhabitants with type 2 diabetes in Ukraine in 2021, representing a prevalence of 7·1%. For type 1 diabetes, around 6700 children and adolescents had the diagnosis in the past year.
Examining the pre-war health burden of Ukraine for prioritisation by European countries receiving Ukrainian refugees
18.3.2022 – Lancet Regional Health: Europe
Authors: Marchese, V. et al
Ukrainian researchers flee war trauma and terror
18.3.2022 – Science
Author: Richard Stone
Refugees find aid and jobs, but many remain to fight Russian invaders.
From Ukraine: displaced twice and on the road again
18.3.2022 – British Medical Journal (BMJ)
Author: Anonymous MSF staff worker
As dawn broke on 24 February 2022 in Kyiv, I woke to the sound of explosions and the wails of air raid sirens. Huddled in my little apartment in the city, I felt sick with anxiety. I knew instantly that, from then on, my life and the lives of so many others would never be the same. Something irreversible had just happened: the glimmer of hope which many of us had kept alive despite the rising fear of an imminent war had been violently smothered.
Ukraine crisis Public Health Situation Analysis – Refugee-hosting countries
17.3.2022 – WHO
The UN must provide secure medical and humanitarian assistance in Ukraine
17.3.2022 – The Lancet
Authors: David P Southall, Rhona MacDonald, Olena Kostiuk, Volodymyr Shcherbakov, Aniko Deierl
We are calling for more involvement by the UN in the current conflict in Ukraine. Continuation of the health and humanitarian crisis will result in many deaths and much suffering unless there is safe delivery and implementation of humanitarian and medical aid, including secure humanitarian corridors and safe medical evacuation. Substantial international protection forces, able to ensure safe humanitarian work in Ukraine, are essential and urgently needed.
Examining the pre-war health burden of Ukraine for prioritisation by European countries receiving Ukrainian refugees
17.3.2022 – The Lancet
The recent escalation of conflict after the Russian invasion of Ukraine on February 24, 2022, has already displaced 2,800,000 Ukrainian refugees, and the number is expected to rise in days ahead. Ukrainians can move freely between European Union Member States (EU MS) for up to 90 days, while the Council of the European Union has approved for the first time the adoption of the Temporary Protection Directive, which will allow a one-year, renewable permit to reside and to access essential services (including health assistance) in all EU MS. This will possibly facilitate a fair distribution of refugees beyond Western Balkans, already struggling with migration flows in recent years. Once entitlement to health assistance is formalized in all EU MS, there are some major aspects of the Ukraine health profile that should be considered to forecast refugees’ health needs.
Protection of perinatal mental health during the war in Ukraine
17.3.2022 – The Lancet Regional Health Europe
Authors: Chiara Sacchi
The dreadful days of war in Ukraine are producing what has already been described as the fastest mass migration to Europe in at least three decades. According to UNHCR, during the first week of Russia’s invasion, 1 million people fled Ukraine for neighboring countries, and most of the migrants crossing Poland’s borders are women with children. Refugee women giving birth in desperate conditions are unbearable documented images, and UNFPA estimates that 80,000 women will give birth in the next three months in Ukraine with severely compromised maternal health conditions.
Predicting refugee flows from Ukraine with an approach to Big (Crisis) Data: a new opportunity for refugee and humanitarian studies
16.3.2022 – Econstor
Author: Juric Tado
Fate of people with HIV in jeopardy in Ukraine
16.3.2022 – The Lancet
Addressing the mental health needs of civilian combatants in Ukraine
16.3.2022 – The Lancet Psychiatry
Authors: Richard A Bryant, Paula P Schnurr, David Pedlar
War-affected civilians are at heightened risk of mental health problems, including post-traumatic stress disorder (PTSD), anxiety, and depression. Data from the WHO World Mental Health Surveys have highlighted that recovery from PTSD is particularly slow in the context of war, indicating that the mental health impacts of the current crisis could be long lasting. Additionally, although recent events represent a very stark escalation in fighting, Ukraine has been defending itself against Russia since 2014, and this ongoing conflict has already led to a range of mental health problems. The cumulative effects of war and displacement since 2014 are likely to predispose many Ukrainian people to adverse mental health outcomes from the current fighting.
Surge of HIV, tuberculosis and COVID feared amid war in Ukraine
15.3.2022 – Nature
Authors: Leslie Roberts
Ukraine war: GPs get updated guidance on treating refugees and returning citizens
14.3.2022 – BMJ
Author: Gareth Iacobucci
Impact of war and forced displacement on children’s mental health-multilevel, needs-oriented, and trauma-informed approaches
14.3.2022 – European Child & Adolescent Psychiatry
Authors: David Burgin, Dimitris Anagnostopoulos, Board of Policy Division of ESCAP, Benedetto Vitiello, Thorsten Sukale, Marc Schmid, Jorg M Fegert
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war.
Ukraine’s humanitarian disaster: priorities for health
12.3.2022 – The Lancet
As the Russian invasion of Ukraine enters its third week, the results of President Vladimir Putin’s cruel and destructive onslaught are becoming clearer. At least 352 civilians have been killed and 1684 wounded so far, although Ukraine’s State Emergency Service puts the number of civilian deaths at more than 2000. Official sources report that 17 children have been killed and 30 injured. Roughly 2 million people have fled to neighbouring countries. Russian officials have reported that nearly 500 of their troops have been killed; Ukrainian armed forces puts the number at more than 11 000. The global community has spoken of solidarity with Ukraine, but the humanitarian emergency and widespread harms to health and wellbeing demand a concerted international plan.
Meeting the health challenges of displaced populations from Ukraine
11.3.2022 – The Lancet
Authors: Ioffe Y., Abubakar I., Issa R., Spiegel P., Kumar B. N
Conflict in Ukraine undermines an already challenged health system
11.3.2022 – The Lancet
Authors: Sophie Roborgh, Adam P Coutts, Patrick Chellew, Valerii Novykov, Richard Sullivan
The Ukrainian refugee crisis and the pathology of racism
11.3.2022 – British Medical Journal (BMJ)
Authors: Simar S Bajaj, Fatima Cody Stanford
War has catastrophic impacts on human health, but the risks facing those fleeing violence are made all the more dangerous when compounded by racism.
Russia’s invasion of Ukraine threatens HIV response
11.3.2022 – The Lancet HIV
Author: Ed Holt
Ukraine has an estimated 260 000 people living with HIV and, until the conflict broke out, a wide range of treatment, support, and prevention services had been provided across the country through state bodies and non-governmental organisations (NGOs). But since fighting began, access to treatment has become increasingly limited in some areas. Antiretroviral therapy (ART) supplies are dwindling, and other support services have been massively scaled back or abandoned completely in some places.
Conflict in Ukraine and its impact on cancer care
11.3.2022 – The Lancet Oncology
More than 2 million refugees have fled Ukraine since the Russian invasion began on Feb 24, 2022, and over 4 million people, 10% of the population, are expected to be forcibly displaced as they seek safety, creating a wide-ranging humanitarian crisis. Ukraine has a high cancer burden with more than 160 000 new diagnoses in 2020 alone. The country also has one of the highest childhood cancer mortality rates globally. Thus, disparities in cancer care in Ukraine were already high before Russia’s unprovoked aggression and will now undoubtedly worsen as a result of the conflict.
Ukraine: diabetes on the front line
9.3.2022 – The Lancet Diabetes & Endocrinology
The crisis in Ukraine is evolving rapidly, with 2 million people estimated to have fled the country as of March 8 and many more facing unimaginable danger and uncertainty. Despite some advances made in Ukraine’s attempts to transform and modernise its health system, Ukrainian citizens still face large inequalities in health-care services, inadequate access to medical supplies and equipment, and have the lowest life expectancy compared to all other European countries. In a country still struggling with the burden of the COVID-19 pandemic, the Russian invasion of Ukraine has further disrupted medical services, including diabetes care.
The disasters of war. On kidney patients in the Ukrainian-Russian war
7.3.2022 – Journal of Nephrology
Authors: Barbara P.G., Gaetano L.M.
Humanitarian crisis in Ukraine
5.3.2022 – New Scientist
Author: Clare Wilson
People in Ukraine face a loss of healthcare and clean water that could cause a rise in infectious disease, reports Clare Wilson, with some hospitals already out of oxygen
Ukraine and the lessons of Alexander Herzen
5.3.2022 – The Lancet
Author: Richard Horton
A pandemic. And now war. A war, the UK’s Ukraine Ambassador wrote last week “on the whole of the civilised world”. The burden of war falls mostly on women and children. 10 million children younger than 5 years died in conflicts between 1995 and 2015. Women and children will now be dying from preventable causes in Ukraine. The health and humanitarian crisis afflicting Ukraine has received far too little attention. Consider those forcibly displaced. Although hard to predict, as many as 5 million people, up to three-quarters of whom will be women and children, are likely to become refugees. European nations must allow visa-free entry for these displaced families. Delay will be lethal. But one does not have to be displaced to be at risk. Deaths and physical injuries from direct violence are high in close combat urban settings. Protracted conflicts also bring food insecurity. Outbreaks of infectious disease are common. Surveillance systems and vaccination programmes will be disrupted. In the midst of a continuing pandemic, with a population poorly vaccinated against SARS-CoV-2 (34% of Ukrainians have received two doses of vaccine and only 1·7% a third dose), the risk of local spikes of COVID-19 is likely. Destruction of safe water and sanitation facilities only adds to the danger. Continuity of care—maternity services, dialysis, chemotherapy and immunotherapy for cancers, insulin supplies, mental health care—will be derailed. The history of war teaches that sexual violence will be pervasive. Amid the talk of punitive sanctions against Russia, the basic needs of the Ukrainian people are being overlooked.
Humanitarian work in Ukraine disrupted
Author: Sharmila Devi
The UN and other aid agencies have begun planning for a severe human-itarian and health crisis following Russia’s invasion of Ukraine on Feb 24, amid fears the conflict could spark an exodus of up to 5 million refugees. WHO Europe warned of “humanitarian catastrophe in Europe”, including significant casualties as well as further damage to already fragile health systems.
Scientists in the line of fire
4.3.2022 – Science
Authors: Marcia McNutt, John Hildebrand
The devastation and despair gripping Ukraine following the unprovoked invasion by neighboring Russia is heartbreaking and unthinkable. Such a loss of life and homeland has stirred wide concern around the world. This war sets back progress to establish a peaceful and sustainable world and to address important problems faced by all humanity, including climate change, environmental degradation, public health, and inequality. The international community of scientists cooperates extensively to address the challenges of our time, and a war that is destroying a stable and healthy nation and provoking a refugee crisis is no exception. What can the scientific community do most immediately to provide support and aid to its Ukrainian colleagues in their time of need? The community should focus on strengthening regional partnerships in Eastern Europe, networking to find refugees safe havens, speaking out forcefully against this invasion, and preparing to help rebuild Ukrainian science when the time is right.
Relationship between Socio-Demographic Factors and Posttraumatic Stress Disorder: A Cross Sectional Study among Civilian Participants’ Hostilities in Ukraine
26.2.2022 – International Journal of Environmental Research and Public Health
Authors: Stanisław FelORCID, Krzysztof Jurek, Katarzyna Lenart-Kłoś
Health and health care in Ukraine: in transition and at risk.
2.2022 – The Lancet
Ukraine invasion: Agencies warn of humanitarian catastrophe in Europe
25.2.2022 – BMJ
Author: Wise, J.
Centre Media Coverage
- Ukraine: what can stop the war? – Dr Erica Moret, SwissInfo, 19 April 2022
- Les images de Boutcha révèlent un incroyable mépris pour la vie – Dr Valérie Gorin, Le Temps, 4 April 2022
- La guerre en Ukraine jour après jour – Article with commentary by Dr Erica Moret, 24 Heures, 22 March 2022.
- L’invitée de La Matinale – Valérie Gorin, spécialiste de l’humanitaire, de la guerre et des images – Radio interview on the war in Ukraine with Dr Valérie Gorin, RTS, 18 March 2022.
- Les sanctions fonctionnent moins bien contre un Etat autoritaire – Interview with Dr Erica Moret, Le Temps, 10 March 2022.
- Dans le labyrinthe infernal des corridors humanitaires – Article with commentary by Prof Karl Blanchet. Le Temps, 7 March 2022.
- “Les sanctions contre la Russie sont sans précédent” – Interview with Dr Erica Moret, Alternative Economique, 5 March 2022
- Comment aider au mieux la population ukrainienne? – Article with commentary by Prof Karl Blanchet. Tribune de Geneve, 2 March 2022