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19 November 2024
Today marks 1,000 days since the Russian Federation’s full-scale invasion of Ukraine began, plunging the country into an enduring humanitarian crisis. The toll on Ukraine’s population and its health-care system has been devastating, as the war continues to escalate health needs across the nation. Despite these challenges, the resilience of Ukraine’s health system, supported by international agencies like the World Health Organization (WHO), stands as a testament to human determination in the face of adversity.
The Cost of War on Health
The war has drastically increased the burden on Ukraine’s health-care infrastructure, with rising cases of trauma, mental health issues, and noncommunicable diseases (NCDs). Millions face ongoing attacks, displacement, and financial barriers to care. Over 6 million Ukrainians are now refugees, with another 3.5 million displaced internally. These populations face heightened risks of physical and psychological harm.
The challenges are exacerbated by health worker shortages, especially near conflict zones. Critical gaps in personnel, including doctors, nurses, and midwives, jeopardize the delivery of care in regions under siege. Despite these obstacles, Ukrainian health-care workers have demonstrated extraordinary commitment, continuing to serve their communities under dangerous and often life-threatening conditions.
Attacks on Health Care: A Grim Reality
Ukraine remains the site of the largest health emergency in the WHO European Region, with 2,134 confirmed attacks on health-care facilities as of 18 November 2024. These attacks have resulted in significant casualties, with health worker fatalities nearly tripling this year compared to 2023.
In 2024 alone, 27% of these attacks caused injuries, and 8% led to fatalities. Tragically, 65 deaths and 377 injuries were reported among health workers and patients—figures that highlight the increasing intensity of the violence.
The destruction of critical infrastructure, coupled with the advent of another harsh winter, threatens to further destabilize health services. Essential utilities like heating, electricity, and water are at risk of disruption, complicating health-care delivery in affected areas.
Strengthening Health Workforce Resilience
To address the severe shortage of health workers, WHO has intensified efforts to strengthen Ukraine’s health workforce. The focus includes improving data collection, workforce planning, and professional development, particularly for nurses, whose contributions are vital to the health-care system.
These initiatives aim to counteract worrying trends of health worker migration and declining enrollment in medical professions, which threaten the sustainability of Ukraine’s health-care system.
Primary Care and Recovery Efforts
WHO’s role in Ukraine has evolved from emergency relief to capacity-building, emphasizing primary health care as a cornerstone of the recovery process. The organization collaborates with Ukrainian authorities to address critical issues such as NCD management, mental health care, and infection control.
To support stability in conflict-affected areas, WHO has established 24 modular primary health-care clinics, providing both immediate relief and long-term solutions. The organization also continues to train health workers in trauma care and mass casualty response, ensuring preparedness for ongoing and future crises.
Health Reforms and Long-Term Recovery
Despite the ongoing war, Ukraine has made significant strides in health reform, supported by WHO. These efforts include improving health financing, enhancing primary care services, and promoting transparency in procurement processes.
Digital health solutions and emergency response tools are also being implemented to modernize the system and ensure efficient service delivery. Additionally, WHO is collaborating with the European Union to enhance Ukraine’s health security through improved disease surveillance and response systems.
A Vision for the Future
Ukraine’s journey through 1,000 days of war reveals the incredible resilience of its people and its health system. With continued support from WHO and global partners, the country is building a more robust health-care system capable of enduring present and future challenges.
This commitment aligns with the Sustainable Development Goals, prioritizing the creation of a health system that can support the recovery, stability, and long-term well-being of the Ukrainian people. As the war continues, the resilience and determination of Ukraine’s health-care workers and international allies offer hope for a brighter, healthier future.
