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UKRAINE — As the war in Ukraine goes on, so does daily life. A recent delivery of food kits to villages in the eastern Kharkiv region is a happy occasion – but everyone keeps an eye or ear out towards the volatile Russian border just 2.5 miles away, behind the nearest hill.
“If the Russians detect a large concentration of people, they can target it, no matter who they are,” says a volunteer of the NGO distributing bags to a waiting crowd of mainly senior citizens.
Russia’s Orlan drones often buzz over the area looking for opportunities, explains the head of the Kharkiv district military administration, Volodymyr Usov, adding that the villages and nearby military positions get shelled every week or two. Fearful of Western-supplied missiles, Russian jets bank as close to the border as possible before releasing laser-guided bombs, he says.
Volunteers distribute food aid to villagers in Liptsi, Kharkiv region. (Photo: Nick Allen, Direct Relief)
The bright spring day thankfully passes without incident as the food drop is repeated in three villages. Stories abound here of hardship, theft, abductions and outrages at the hands of the forces that took control on the first day of Moscow’s full-scale invasion on February 24, 2022. In the ruined school in Liptsi, Usov says the boiler room was used to torture detainees and that Ukrainian intelligence operatives recovered electrocution devices after the Russians left.
A stocky local fireman who says he was held here for six months and, according to his colleagues, weighed 100lbs (45kg) when released, confirmed to visitors that he was “treated badly” by his captors. “But I can’t complain,” he says with a good-natured but forced grin.
“That is a typical reaction of people,” says Pavlo, a 23-year-old volunteer with the Kharkiv-based Yevgen Pyvovarov’s Charity Fund (YPCF), one of Direct Relief’s medicine supply partners in the east. “No matter what awful things happened to them, they know someone else who had it worse.”
Vladimir and Oksana had just completed their house when the war left it in ruins (Photo: Nick Allen, Direct Relief)
According to the locals, when the Russians were driven from the area in the Ukrainian counter-offensive last September, they promptly shelled positions they formerly occupied – schools, administration buildings, and medical facilities. The brand new hospital in Liptsi was hit and gutted by fire, and villagers now travel 20 miles to Kharkiv, Ukraine’s second-largest city, for medical care.
The whack-a-mole of medicine supply
Now that the immediate threat to the city has receded, municipal and regional authorities are working feverishly to rebuild housing, infrastructure and care systems, including the health service. Shipments of medicines are now reaching Kharkiv and other cities from US organizations like Direct Relief and Americares, the Canada-Ukraine Foundation, UN agencies and the International Committee of the Red Cross (ICRC).
“If we have another winter like the last, things are going to get very tough.”
But after months of neglect of peoples’ existing health issues and a surge of fresh ones caused or exacerbated by the war – strokes, malnutrition and PTSD, to name a few – it is like a constant game of whack-a-mole: Gaps in the supply chain get closed and new gaps open up as needs change.
A day after the food delivery to the villages, the Kharkiv Regional Clinical Hospital director, Kostyantyn Loboiko, peruses boxes of medications that YPCF delivered on behalf of Direct Relief.
“This is used for a very wide range of illness, from respiratory infections to sicknesses of the nervous system,” Loboiko says about the consignment of Prednol-L, a corticosteroid with an anti-inflammatory effect several times greater than hydrocortisone. It’s something they are not even free to buy locally due to regulations, he says, but these supplies should last the hospital a few months.
Kharkiv Hospital director Kostyantyn Loboiko examines a new shipment of medicine (Photo: Nick Allen, Direct Relief)
He also welcomed the large boxes of Norepinephrine Bitrate, used to treat life-threatening low blood pressure (hypotension): “This works against any kind of shock, be it traumatic or anaphylactic – practically every type of shock reaction can be treated with this, it’s really useful.”
However, the need persists in Ukraine’s towns and cities for hundreds of medicines, as well as basics like catheters, drips, syringes, masks, crutches, and orthopedic braces – the list is seemingly endless.
“We sent a special request for children’s vitamins,” said Dr. Christian Carrer, regional director of France’s Association Internationale de Coopération Médicale (AICM), Direct Relief’s core partner in the eastern Poltava region. “There are many children who spent many months in shelters and when they come out they need a lot of vitamins.”
Shouldering the weight together
In April, medical products from Direct Relief were supplied to hospitals and clinics across Ukraine, including a major delivery to replenish the near-empty shelves at the children’s hospital in the River Dnieper city of Kremenchuk. It currently treats some 250 children, many suffering from war injuries, but it has received no assistance, including from the state, since early February.
“We try to purchase medicines every month, but not all volumes, so the responsibility falls on the parents to buy them when their children are with us,” says deputy director Iryna Roman. “This assistance [received today] is multi-faceted and provided care items, consumables, and medical instruments, so it should sustain us for the next six months.”
Approximately a ton of medical products were brought to the vast regional psychiatric hospital outside Poltava city, which has around 800 patients, many of them transferred from hospitals in front-line areas. Again, the support eases the pressure on the hospital, says head doctor Viktor Voloshyn, who, in addition to medical care, must ensure other essentials are in place. The hospital’s bakery, for example, uses ten tons of flour a month, so AICM added two tons of flour to its delivery, along with hundreds of cans of food.
AICM staff deliver Direct Relief-donated emergency medical packs at the Kremenchuk Children’s Hospital (Photo: Bogdan Morozovski, AICM)
In all locations visited in April, directors faced the same challenge of insufficient funding and supply by the state as the country battles for its survival. Six months into his new job as head of Kharkiv’s Regional Clinical Psychiatric Hospital No. 3, Dr. Gennady Bondarchuk was still clutching for solutions. Even now, when the hospital has only 25 of the 80 doctors it should have, its budget barely covers staff wages.
When the hospital asks the authorities how it is supposed to keep going, the answer is blunt: “Go and raise funds!” That effort is hampered by negative perceptions of psychiatric care that still exist here and in many other countries. “Multi-profile hospitals are more successful at fundraising. Donors don’t much like hospitals like ours,” Bondarchuk says matter-of-factly. So donated medical products are a huge help as they continuously battle to fund food supplies and other essentials.
“If you experience something extreme, you either break because of it or you adapt and grow stronger, learn and make good use of it.”
Other hospitals visited, like Kharkiv’s Municipal Polyclinic No. 11, have the additional task of repairing war damage. Located in the city’s heavily affected northern Saltovka region, 80% of its windows were blown out by Russian shelling. According to the Kharkiv city council, 77 hospitals and clinics in the region have been damaged so far in the conflict.
The priority during the summer months is to optimize energy, water and other systems so that healthcare institutions are autonomous if the situation takes a turn for the worse, says Olga Demianenko, head of the city’s department for cooperation with international organizations: “If we have another winter like the last, things are going to get very tough.”
Healing for the long term
At the same time, there is a new understanding in today’s extreme conditions that health care must be broader and better geared to the future. Supplies of medicine and equipment are indispensable, but they are two pieces of the puzzle. Compared with the priority of fighting and surviving in the early war months, there is a clear sense now of the long-term need for physical and psychological recovery.
Local authorities and Ukrainian NGOs are developing their own rehabilitation programs. The Kharkiv Renovation Fund, an organization with 15 staff members set up by a local businessman at the start of the war, is creating a small rehabilitation clinic in the city center. This will be made as bright, welcoming and functional as possible for military personnel and civilians alike: “Every soldier who comes back is a citizen, not just a soldier,” says founder and director Oleksandr Bondar.
Other Ukrainian NGOs are following suit on different scales and with different concepts. Direct Relief’s partner in the city of Dnipro, TAPS (Tragedy Assistance Program For Survivors), is going all out with three distinct programs: The creation of a $1.3mn integrated rehabilitation department for soldiers and civilians at the city’s Hospital No. 16; the construction of a large recreational and rehabilitation center for military personnel and their families in the countryside outside Dnipro; and week-long ‘camps’ in the Carpathian Mountains for war-widows and bereaved children in rest facilities staffed with psycho-social care experts.
A destroyed Russian T-72 tank rusts in a field near Vesele north of Kharkiv (Photo: Nick Allen, Direct Relief)
Despite the ordeals of recent months, it all makes for a stronger, more unified society as Ukrainians learn to pull in the same direction, says the volunteer Pavlo: “If you experience something extreme, you either break because of it or you adapt and grow stronger, learn and make good use of it.”
Editor’s note: Since the war began in 2022, Direct Relief has deployed more than 1,350 tons of medical aid, 254.1 million defined daily doses, $32.2 million in financial assistance, and $899 million in material aid assistance to Ukraine.
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