Ukraine war and refugee crisis
Fighting in Ukraine has killed or injured thousands of people, while more than 5.6 million refugees are currently scattered across Europe.
Médecins Sans Frontières / Doctors Without Borders (MSF) teams are working to deliver emergency medical aid to people still in Ukraine, as well as those now seeking safety in neighbouring countries.
The situation is extremely volatile and we have witnessed the devastating impact of the conflict on civilians – cities have faced being surrounded by military forces, heavy bombardment and limited access to food and water.
With periods of brutal and intense conflict in the east and south of the country, it’s estimated that almost six million people remain displaced within Ukraine itself.
Many hospitals have struggled with dramatic shortages of medical supplies – from surgical tools to drugs for chronic diseases – while the mental health consequences of the conflict have been enormous.
And, since October 2022, places previously thought to be safe have suffered deadly and devastating missile strikes. These have often damaged critical energy infrastructure and have affected the ability of healthcare facilities to operate.
Throughout everything, people have faced a terrible choice: stay in an unsafe place or flee home into uncertainty.
The information about our response, below, is correct as of 17 February 2023.
Our emergency response in Ukraine
MSF medical teams are experts at working in conflict zones and complex humanitarian crises, while our experienced logistics staff and robust supply chains ensure that critical supplies reach where they are needed.
We are providing:
- Primary healthcare, including treatment for chronic illnesses, for vulnerable people who've fled their homes and stayed behind in areas with heavy fighting
- Support to Ukrainian medics with supplies and training
- Medical evacuations for patients from overwhelmed hospitals to safer areas
- Support to Ukrainian psychologists and first responders to provide mental healthcare for people who’ve faced intensely traumatic experiences
We have worked to rapidly scale up our medical and humanitarian response where the needs are greatest and where we can have a life-saving impact.
Help us prepare for the next emergency
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Thanks to the generosity of people like you donating to our general funds, we haven't needed to launch an appeal for our work in Ukraine and surrounding countries.
Please consider giving an unrestricted donation, which will give our medical teams across the world the valuable flexibility to respond as needs arise.
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Our response in Ukraine: In-depth
Our priority in Ukraine is getting Ukrainian medics and organisations the supplies they need.
We're providing technical support and training on how to manage large numbers of wounded people, and relieving pressure by medically evacuating patients to hospitals in safer parts of the country.
While the initial focus was on surgery, trauma and intensive care needs, there is now a worrying situation for patients with chronic diseases such as hypertension, diabetes and asthma who urgently require drugs and support.
However, with full-scale warfare in some areas, movements are difficult, dangerous or simply impossible. Communication networks are not always available and there is a significant amount of misinformation.
Many people who stayed behind in conflict-hit areas – now retaken by Ukraine – were elderly or vulnerable people with chronic conditions. MSF teams are continuing to provide care and medications to help manage their health and prevent things from getting worse.
At the same time, we’re also seeing that people are emotionally shattered by what they’ve been through. Anxiety, panic attacks and trouble sleeping are common symptoms amid an acute and widespread mental health crisis.
In response, we have increased our focus on mental health activities, including supporting Ukrainian psychologists and training first responders to administer psychological first aid.
Ukraine war: Our work in numbers
MSF STAFF WORKING IN UKRAINE IN 2022
UKRAINIAN CITIES WHERE MSF HAS MEDICAL ACTIVITIES
PATIENTS EVACUATED BY MSF'S MEDICAL TRAIN IN 2022
Updated 17 February 2022
Medical evacuation trains
On 1 April 2022, MSF began running a two-carriage ‘medical train’ to evacuate patients in serious-but-stable conditions to safety. Shortly after, we built a second and more highly-medicalised train, capable of providing intensive care for critical patients.
The train takes patients from overburdened Ukrainian hospitals close to active frontlines to hospitals with more capacity that are further away from the fighting.
In 2022, more than 2,500 patients were evacuated along with family members. This includes 78 babies and toddlers evacuated from an orphanage in Zaporizhzhia, some of whom had been injured by the widely-reported missile strike on Kramatorsk train station.
In the first six weeks of 2023, a further 216 patients and their families have been transported.
Supporting hospitals: After months of disruption, the healthcare system in Donetsk is slowly recovering. We donate supplies to under-pressure hospitals and train staff in specialised emergency response – including mass casualty plans.
Ambulance referrals: MSF ambulances have so far transferred 1,180 patients between 16 different healthcare facilities in the region, often moving patients to care further away from the frontline. Many of these people have severe trauma injuries.
Emergency care: MSF supports an emergency department in Kostiantynivka, as well as surgical and intensive care units. In 2022, MSF treated 752 patients in the emergency room and performed 168 surgical interventions.
Mobile clinics: In Lyman, an area that was retaken by Ukrainian forces in late 2022, MSF runs a mobile clinic service. Our teams held 3,152 healthcare consultations before the end of the year.
Dnipro and Zaporizhzhia oblasts
Displaced people: In and around Dnipro, MSF teams are providing healthcare at around 40 shelters for people who have fled parts of Donetsk and Luhansk. In Zaporizhzhia, we are supporting thousands who were displaced by the intense fighting in Mariupol.
Mobile clinics: We provide consultations and medication for people with chronic illnesses such as hypertension, asthma, diabetes, heart disease and epilepsy. Teams also deliver psychological first aid and distribute basic relief items.
Boarding houses: MSF teams have started working with boarding houses which provide care for the most vulnerable – such as the elderly, people with disabilities and abandoned children. This includes nurse training and support to prevent and control infections.
Emergency team: In coordination with the authorities, we have developed an agile emergency response team that can reach communities with urgent medical care when the frontline is moving fast.
Supporting hospitals: In Zaporizhzhia, we continue to support frontline hospitals with medical supplies. We are also improving mental health programmes to support workers dealing with the daily trauma of the conflict.
Sexual and reproductive health: MSF runs a clinic providing crucial services that include contraception, healthcare information, and care for people who have experienced sexual violence.
Emergency and surgical care: In Apostolove, our teams run a triage and emergency department and provide direct surgical support. The teams held 972 consultations in 2022 and admitted 403 patients for violent trauma injuries.
Kherson and Mykolaiv oblasts
Mobile clinics: In Mykolaiv and areas recently retaken by the Ukrainian forces in Kherson, MSF mobile clinics provide essential healthcare services, psychological counselling and work to rehabilitate healthcare facilities damaged in the fighting. We are seeing urgent needs around chronic diseases and mental health after months of occupation and limited access to care.
From a base in Kryvyi Rih, other mobile clinics have been reaching people in parts of Kherson heavily affected by the conflict. In 2022, these teams carried out 8,307 medical consultations across 144 towns and villages.
Ambulance referrals: In areas around Kryvyi Rih and Kherson, an MSF ambulance referral service – including an intensive care ambulance – transports patients to more advanced treatment. In 2022, 973 patients were transported.
Chronic disease and psychiatric care: In Kherson city – where MSF is one of the only NGOs working – our teams provide consultations for patients living with long-term conditions. When Kherson’s psychiatric hospital lost power due to airstrikes, we also worked to evacuate 400 patients to other medical facilities further from the frontlines.
Stabilisation points: In Kochubeivka and Svobodny, we run critical stabilisation points where trauma patients are treated before travelling on to hospitals.
Mobile clinics and mental health: MSF teams run mobile clinics in rural towns and villages across the Kharkiv region. Services include essential healthcare, sexual and reproductive care and mental health support. Most of our patients in this region are women over the age of 60, often with chronic illnesses, while many patients are unable to otherwise reach healthcare. This is due to both a lack of transport and many medical centres being damaged or destroyed. We also distribute non-food relief items and hygiene kits.
Psychiatric support: We provide medical and psychiatric support at two care homes for mental health patients with severe conditions – many of whom didn’t receive proper care for almost seven months since the start of the conflict.
Care for careers: MSF runs a mental health programme for local healthcare professionals facing burnout and extreme stress. This includes group support and training that focuses on coping mechanisms.
Tuberculosis (TB): As before the escalation in fighting in February 2022, MSF teams continue to support a programme for TB patients in the Zhytomyr region. This includes medication, mental health care, social support and packages of food and hygiene items.
Survivors of torture: In Hostomel, on the outskirts of Kyiv, MSF runs a project treating survivors of torture. The programme focuses on mental health as well as physiotherapy support. We also provide wider mental health care at 10 locations outside of Kyiv. In 2022, our teams held almost 1,000 individual consultations and 184 group therapy sessions.
Physiotherapy: In Kyiv, we provide physiotherapy and psychological counselling for war-wounded people, and work to train local healthcare staff. This is in response to a major gap in Ukraine’s healthcare system and an overwhelming need for rehabilitation services.
Supplies and training: MSF supports 23 healthcare facilities in the area with donations of medical supplies. Between April and December 2022, we also ran 146 training sessions for healthcare professionals, focusing on mass casualty response, decontamination, trauma and mental health. A total of 2,301 people took part. At the same time, our mental health team has seen more than 9,463 patients in group therapy sessions since April 2022.
Rehabilitation: Following the project in Kyiv, we run another rehabilitation project in Vinnytsia that provides physiotherapy and mental health support. As well as hands-on treatment, our teams work to train local staff.
Mobile clinics and mental health: We run mobile clinics in the southern part of the region where displaced people have been sheltering but haven’t been able to access essential healthcare. We are seeing a strong need for increased mental health services, particularly for war-wounded people, veterans and people with post-traumatic stress disorder.
Uzhhorod and Ivano-Frankivsk
Outpatient support: In Ivano-Frankivsk, our teams are supporting an outpatient department and a mobile clinic focusing on displaced people. This service is run by doctors who were themselves displaced by the fighting. In 2022, we held 3,017 medical consultations, mainly for chronic diseases, heart conditions and respiratory tract infections. Further mobile clinics carried out 3,925 consultations in Uzhhorod, Mukachevo and Perechyn.
Training: Expert MSF staff carried out training sessions on decontamination, mass casualty events, mental health and sexual and gender-based violence. In 2022, 1,892 healthcare professionals took part.
Supplies: MSF supports 20 healthcare facilities on a regular basis with donations of medical supplies. We also distribute relief items to nearby displaced people, particularly in rural areas where we are working to rehabilitee shelters.
Our emergency response in neighbouring countries
MSF is committed to providing medical aid to people affected by the conflict no matter where or who they are.
As of 24 January 2023, the UN has recorded 19,673 refugees from Ukraine in Belarus.
MSF teams are responding to the medical needs of people now stranded at the country’s border with the EU. Our staff here are seeing people with frostbite, chronic diseases and injuries related to violence. Since November 2021, we have assisted more than 1,200 people from various countries of origin.
Elsewhere, MSF continues to support patients with drug-resistant TB in partnership with the National Tuberculosis Programme.
More than 9.4 million people have crossed from Ukraine into Poland since 24 February 2022.
MSF teams are working with the Ministry of Health to ensure patients who were previously part of our TB programme in Ukraine are now able to access treatment in Poland.
According to the UN, more than 2.8 million people have crossed into Russia from Ukraine.
We are currently working in the Arkhangelsk and Vladimir regions to provide life-saving care for patients with drug-resistant TB, while we have recently scaled up work to treat patients with HIV in St Petersburg and Moscow.
This is crucial to ensuring the continuity of care for patients arriving from Ukraine.
Our teams are also working with partner organisations to support newly-arrived displaced people from Ukraine who are now sheltering in the Voronezh, Belgorod and Rostov-on-Don regions.
So far, we have supported more than 20,952 people with relief items including food, hygiene kits and essentials.
MSF teams have been present in Russia for more than 30 years.
Before the conflict
Before the escalation in fighting, MSF teams were already working in Ukraine’s eastern Donbas region, where conflict broke out in 2014.
Despite a ceasefire in 2015, regular violence and access to healthcare became a daily challenge for people living along the ‘contact line’. Our teams ran projects providing treatment for chronic illnesses including HIV/AIDS, TB and diabetes, as well as mental health support.