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Ukraine war and refugee crisis

Ukraine war and refugee crisis

An MSF doctor monitors the condition of a patient on board a medical evacuation train travelling from Pokrovsk to Livi Caption
An MSF doctor monitors the condition of a patient on board a medical evacuation train travelling from Pokrovsk to Livi

Fighting in Ukraine has killed or injured thousands of people, while more than 5.9 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 encirclement 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 four 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 22 February 2024

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.

At MSF's out-patient department in Batil refugee camp Gandhi Pant, a nurse, escorts a patient with a possible appendicitis to a waiting ambulance. 

Batil is one of three camps in South Sudan’s Upper Nile State sheltering at least 113,000 refugees who have crossed the border from Blue Nile state to escape fighting between the Sudanese Armed Forces and the SPLM-North armed group. Refugees arrive at the camp with harrowing stories of being bombed out of their homes, or having their villages burned. The camps into which they have poured are on a vast floodplain, leaving many tents flooded and refugees vulnerable to disease. Mortality rates in Batil camp are at emergency levels, malnutrition rates are more than five times above emergency thresholds, and diarrhea and malarial cases are rising.

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.

Map of MSF activities in Ukraine, February 2024 Caption
A map of MSF activities in Ukraine - November 2022

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

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353

MSF STAFF WORKING IN UKRAINE IN 2023

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12,724

MENTAL HEALTH CONSULTATIONS IN UKRAINE IN 2023

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479

SURGERIES PERFORMED BY MSF IN UKRAINE IN 2023

Updated 22 February 2024

Evacuations and referrals

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.

We also currently have 15 ambulances  capable of transporting those in critical condition. Due to a shift in the war's dynamic, where patients stay in eastern Ukraine, rather than being referred to the west, our activities using the train have wound down.

In 2023, we transported 3,808 patients by train over 137 trips and carried out 10,542 ambulance referrals

Mobile clinics

Donetsk, Kherson, Zaporizhzhia and Kharkiv

The war has had a devastating impact on the continuity of care for those with pre-existing conditions, such as diabetes and hypertension, and the mental health of people after experiencing fear, isolation and fighting – both for internally displaced people and those still living near the frontlines.

To ensure continuity of care and respond to the emerging mental health needs, MSF mobile clinic teams of psychologists, doctors and health promoters are supporting patients and communities with medical consultations, psychological consultations, medical and non-medical donations, and supporting the capacity of the healthcare system by reconstruction of health facilities and training healthcare staff.

In 2023, MSF conducted 59,567 primary health consultations

Emergency and surgical care

Kherson city and Kostiantynivka and Selydove hospitals in Donetsk region

Near the eastern and southern frontline areas, people are experiencing incredible hardship as daily shelling and fighting continue.

MSF is seeing patients with traumatic injuries from shelling, bomb, and shrapnel blasts. Atnd, as health facilities are coping with emerging and increased needs, patients injured in car accidents or those with non-communicable diseases (for example, cardiovascular emergencies) are still prevalent.

In 2023, MSF carried out 1,991 emergency room consultations and performed 479 surgical interventions

MSF mass casualty training taking place at a hospital in Lviv Caption
MSF mass casualty training taking place at a hospital in Lviv

Rehabilitation

Kyiv city, Vinnytsia city, Cherkasy, Kharkiv, Mykolaiv and Sumy

MSF teams are supporting the Ukrainian healthcare system with specialisation and training in physiotherapy and post-operative care, as well as psychological consultations for people who have suffered severe injuries caused by the war. 

Without adequate, early post-surgical treatment, their recovery may remain incomplete or take much longer than necessary, affecting their lives and weighing on an overwhelmed healthcare system.

In 2023, MSF carried out 4,393 physiotherapy sessions for 292 patients

Post-traumatic stress disorder

Vinnytsia

In 2023, MSF started providing specialised psychotherapeutic services for people experiencing war-related post-traumatic stress disorder (PTSD) symptoms in Vinnytsia.

A newly custom-designed mental health centre was opened in September 2023. MSF offers psychological sessions for both individuals and members of the patient’s support network. Our specialists provide them with techniques to help reduce and prevent the worsening of symptoms, increase coping skills, improve interpersonal functionality, and decrease the consequences of traumatic stress.

In 2023, MSF conducted 778 counselling sessions for 237 patients in Vinnytsia

Other MSF activities across Ukraine

Tuberculosis: in Kherson and Mykolaiv regions, MSF is providing screening of suspected TB cases through mobile clinics.

Donations: In 2023, MSF donated more than £10 million worth of medical donations and construction costs to damaged healthcare facilities in Poltava, Sumy, Kharkiv, Ivano-Frankivsk, Zakarpattia, Kirovohrad, Zhytomyr, Kyiv, Mykolaiv and Kherson.

Training: Between the start of 2023 and January 2024, MSF carried out mental health training with 189 groups and a total of 2,785 people; as well as training on physiotherapy with 82 groups and a total of 192 people in Poltava, Kharkiv, Kirovohrad and Mykolaiv oblasts.

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.

More than 11.7 million people have crossed from Ukraine into Poland since 24 February 2022. More than 1.6 million people have registered for temporary protection.  

MSF is actively working to support the Ministry of Health to ensure that patients can access treatment for drug-resistant tuberculosis, including patients previously supported by MSF in Ukraine.

According to the UN, more than 2.8 million people have crossed into Russia from Ukraine as of 30 July 2023.

Since the start of the conflict, MSF has been supporting people displaced to the southern regions of Russia in Voronezh, Belgorod and Rostov regions.

In close collaboration and partnership with local NGOs, we organised teams of local social workers, medical consultants and psychologists, to ensure that people displaced from their homes, mostly newly arrived ones, receive all the necessary qualified medical services in licensed medical clinics and have access to other state healthcare and social services. 

MSF has provided support to more than 23,600 displaced people, including more than 3,200 people who received mental health support.

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.

Ukraine crisis: latest news and stories