Ukraine: The impact of four years of full-scale war

In four years of full-scale war, MSF has been forced to leave seven hospitals and more than 40 other mobile clinic locations due to insecurity. According to the WHO, more than 2,800 health facilities across Ukraine have been damaged or destroyed since 2022. For many communities, life as it once existed is gone. MSF teams are supporting those who now live in shelters.

For many people living near the front line, the decision to leave home takes a long time, and is extremely difficult – despite the extreme danger posed by the encroaching front line. With limited financial means and few alternatives, elderly people and those with chronic illnesses often remain in their homes until sustained bombardment and the collapse of infrastructure and essential services, including medical services, leave them no choice but to flee.

The scale of destruction in Ukraine is enormous and has only grown since Russian forces invaded in 2022. The nature of frontline warfare encompassing artillery, drones and missiles, means that nothing and no one is spared as it shifts. MSF teams have also been forced to adapt – leaving seven hospitals and over 40 locations where they were running mobile clinics – when the situation becomes too dangerous.

Fleeing the invasion

Lyman, in Donetsk region, is one district where MSF was running mobile medical clinics before insecurity made operations impossible. In June 2024, activities were suspended entirely. Today, approximately 2,000 residents remain in the frontline town, which faces daily shelling.

Lyman was also 67-year-old Zinaida’s home, who now lives in the Dnipro displacement shelter. She recalls life before the full-scale invasion. She remembers pulling tables into the street on public holidays to eat with neighbours. She remembers her garden.

“We had apples, plums, cherries, pears, peaches. So many roses and lilies,” she says. “Now my daughter grows flowers, but I no longer feel like doing anything.”

Liubov, 65, from Siverskodonetsk also lives in the shelter with Zinaida, Kateryna and Damir. She says her apartment was looted after Russian forces took control. But what weighs most heavily on her is separation from her family.

“My parents stayed under occupation. My father died in 2024, and I couldn’t return to bury him. I send my mother video messages — it hurts that I cannot be there.”

The work continues as needs increase

As the war grinds on, hospitals, pharmacies, schools and shops have been destroyed or closed. Entire towns have become uninhabitable. As fighting continues, displacement has risen — and the humanitarian needs grow more complex and prolonged.

MSF continues to provide medical and psychological care across Ukraine: supporting hospitals near the frontline, running ambulances for war-wounded patients, and operating mobile clinics in shelters and communities hosting displaced people and in locations where people are trying to remain despite collapsing services and encroaching frontlines.