More than 1.5 million refugees have now fled the fighting in Ukraine, according to data from the U.N. High Commissioner for Refugees (UNHCR). The Commissioner of UNHCR, Filippo Grandi, called it the “fastest moving refugee crisis we have seen in Europe since the end of World War II.”

In addition, 1,123 casualties have been reported, including 364 deaths. These figures are likely to be significantly lower than the actual number, as the casualties are hard to verify.

Temporary humanitarian corridors have been agreed upon so that civilians can flee certain cities in Ukraine. However, these corridors have not come to fruition so far, as shelling has continued unabated.

“No one expected that we’d have a war crisis, a humanitarian crisis,” a Ministry of Health contact told a Direct Relief staffer. “We need wartime supplies.”

In addition, the contact reported, “we are seeing huge numbers of [internally displaced persons] from Kharkiv moving to the west. They have nowhere to live and no food. We are trying to arrange shelter, food, and first aid. Kharkiv has been badly bombed; it is a disaster.”

Direct Relief’s Response

Material Aid and Funding

• Approximately 65 pallets of medical aid, including sutures, insulin syringes and other chronic disease medicines, pain relievers, prenatal vitamins and much more, are currently being built in Direct Relief’s warehouse for transport to Ukraine’s Ministry of Health.
• A 20-pallet shipment of 360 field medic backpacks, used by first responders tending to injuries and other medical problems in the field, has crossed the Ukrainian border and been received by Ukraine’s Ministry of Health.
• Another 13 pallets of medical aid from Direct Relief are in transit to a major Ukrainian NGO. The shipment included 108 field medic backpacks, personal care items for displaced people, 50 oxygen concentrators, a large-scale emergency health kit containing chronic disease medications and supplies often requested after emergencies,. The supplies will be transported to the Ukrainian border, with an estimated arrival time of Tuesday or Wednesday.
• As insulin has been identified as a critical medical need, Direct Relief is dispatching nine pallets of the cold-chain medicine, also for the Ukrainian Ministry of Health.
• Two hundred 10-liter oxygen concentrators are also scheduled to be sent to the Ministry of Health this week.
• A Ukrainian NGO and long-term Direct Relief partner that distributes medical aid to hospitals and other health facilities has been granted $100,000 in emergency funding.

Information & Analysis

• Direct Relief is employing crowd-sourced information from Premise that can be used to gather tailored health or infrastructure data related to health systems and refugee communities.
• Using data from Meta, the organization is working to address different dimensions of the crisis. CrisisReady, a collaboration between Harvard scientists and Direct Relief, is producing updates to current information and expanding an analysis of displacement to include the entire region.
• Direct Relief has established arrangements to share information with the UN, the Health Cluster, the European Commission, and the World Bank.

Operations and Administration

• A Direct Relief staff member is currently in Warsaw to meet with pivotal figures and NGOs working to respond. The staffer will also travel to Romania to meet with entities providing refugee support.
• Direct Relief is in contact with Ministries of Health throughout the region to assess needs. The organization is also coordinating support through the U.N. Health and Logistics cluster system.
• FedEx has offered to arrange a humanitarian charter to Warsaw.
• Direct Relief is exploring the possibility of establishing a regional warehouse, from which medical aid might be readily dispatched to Ukraine. The organization’s closest warehouse is currently in the Netherlands.

Issues of Concern

Over the coming weeks, Direct Relief will monitor and respond to several issues related to the Ukrainian conflict.

• Insulin and other cold-chain medications will be in critically short supply. More than 1.5 million people with diabetes have registered in Ukraine, including more than 12,000 children. Access to insulin for children and adults will quickly become a critical issue. Direct Relief is coordinating with the Ukrainian Diabetes Federation, the International Diabetes Federation, and Life for a Child to address insulin and supply needs.
• Even before the conflict, Ukraine was experiencing a chronic shortage of medical-grade oxygen. Now, the production and delivery of oxygen to hospitals is being significantly disrupted, affecting hospital care around the country. The WHO estimates that demand for oxygen will increase by 20 to 25% due to the conflict.
• Covid-19 was already spiking at the time of the invasion. Now, with displaced communities living in close proximity, a lack of testing, and a full vaccination rate of only approximately 36% among Ukrainians, Covid-19 is likely to spread rapidly and go undetected. In the face of more urgent threats, the disease is unlikely to be a high priority. A lack of medical-grade oxygen will only compound the problem.
• Infectious diseases are likely to become an urgent issue. Ukraine has the second-highest rates of HIV/AIDS in the region, and drug-resistant tuberculosis is a significant problem. In addition, Ukraine has been fighting a polio outbreak since late 2021. The disruption in access to medications and health services, combined with the displacement of communities, will exacerbate these and other public health issues.
• Pregnant and new mothers, and their children, will be exceedingly vulnerable as the fighting continues. Access to maternal and child health care is disrupted, and there will be shortages of food and other essential supplies. Damage to gas and power infrastructure, with external temperatures hovering around zero, are also particularly concerning for these populations.

Dan Hovey and Andrew Schroeder contributed reporting to this update.